Injured British troops faced with awful dilemma after roadside blasts

Many are choosing amputation because of ongoing difficulties of recovery from attacks in Afghanistan
Headley Court Military Hospital

British troops badly injured in Afghanistan are choosing to have amputations even when their limbs can be saved because the recovery is often much quicker and less painful.

Some soldiers who have lost their legs can be running within six weeks, while those with supposedly less severe wounds can need multiple operations over months before they see any kind of improvement.

Experts explained the difficulties facing doctors and patients as they launched a new £8m centre to research the devastating effects roadside bombs have had on the armed forces during the conflicts in Iraq and Afghanistan.

The aim of the unit based at Imperial College in London is to find ways of giving better protection to soldiers, and also to look at the long term effects blast trauma can have on the body.

One of the things mystifying scientists is why cells that are supposed to regenerate muscle, begin to generate bone instead. This can cause excruciating pain for victims of so-called IEDs - improvised explosive devices.

An estimated 300 troops have had amputations in the last decade, and 3,000 more are needing help to recover from serious long-term injuries.

Colonel John Clasper said medical advances meant troops were surviving "with far worse injuries than we ever saw before" but he felt more could be done to provide soldiers with better protection.

"(Some) patients consider themselves worse than amputees because they have horrific injuries to their ankles and heels and they don't recover as quickly as the amputees.

"There are quite a number of soldiers who request amputations. They see their colleagues who have had amputees are doing far better and getting back to work quicker and are not in the same amount of pain.

"If you lose your leg in Afghanistan, you can recover very very quickly. You can be running within six weeks, you can reach a very high activity level and be redeployed out to Afghanistan.

"The people that suffer severe lower limb trauma are potentially looking at two to three months recovering, repeated operations, sometimes a painful leg, sometimes a numb leg, sometimes repeated infections."

He said soldiers suffering from such wounds often decided to amputate rather than go through such a difficult recovery.

"If two people are injured in the same incident, one loses his leg and one keeps his leg, the perception is that the one that keeps his leg is going to do better, but the boys don't think that. They will see the one that his lost his leg getting on far quicker."

The unit at Imperial has been researching blast injuries for two years, sometimes using limbs left to medical science.

It will now work with military doctors to look at the way IED explosions injure troops; the team has spent £100,000 on a device which mimics an IED blast in the laboratory.

Called ANUBIS - the anti-vehicle underbelly blast injuries simulator - scientists can see exactly how the force of an upward blast ruptures the floor of an armoured vehicle and damages the feet and legs.

They have also been testing different military boots to see which ones offer the best protection. Their findings will be fed back to the military, and to the Department of Health. They will also share information with counterparts in the US.

The Royal British Legion has donated £5m for the research. Its director general, Chris Simpkins, said that even for personnel who had suffered "single, double and sometimes triple amputations", the loss of limbs was "very often just the tip of the iceberg."

"The research is designed to identify what the immediate, medium and long term affect of blast injuries are on the human body. Those people are going to be surviving for the next 50, 60 70 year and even 80 years.

"Long after we have withdrawn from Afghanistan there will be a legacy because of the injuries they have received. In the past we have not had the same number of people surviving for that length of time.

"We don't yet understand what the long term impacts are going to be. While we see reports of those people who have paid the ultimate sacrifice, we don't see reported very often the number of people suffering these life changing injuries."

The Ministry of Defence is not funding the project directly, but said it is providing staff and access to military data.