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The Role of Local Steroid Injections in an Operational Field Hospital Setting
  1. Maj A Ramasamy, MA MRCS(Glas), Surgical SHO.2,
  2. Surg Cdr RR Shah, FRCS (Trand Orth), Consultant Orthopaedic Surgeon.1,
  3. Wg Cdr TPS Bhullar, FRCS FRCS (Ed Orth), Consultant Orthopaedic Surgeon.1,
  4. Capt F Warnock, BSc (Hons), MCSP, Physiotherapist1 and
  5. Capt T Pitman, BSc (Hons), MCSP, Physiotherapist1
  1. 1BMH Shaibah, Op TELIC 8, Iraq, BFPO 645.
  2. 2RAMC 3 Broad Garth, Quayside, Newcastle Upon Tyne NE1 3HE 0191 2611511/07968 147007 arul49{at}


Objectives To assess the safety and effectiveness of administering local steroid injections in an operational field hospital environment.

Method A prospective study of patients presenting to the physiotherapy department at the British Military Hospital (BMH) Shaibah, Iraq was undertaken from July 2006 – September 2006. Patients with a condition amenable to local steroid injection and who had not improved with conservative therapy were considered for the study. They then underwent local injection with steroid and local anaesthetic.

Results During this period 12 patients were identified that fitted the criteria for local steroid injection. This represented 7% (12/179) of patients who were seen by the physiotherapy department in either an in or out-patient setting. All patients were injected with local anaesthetic and steroid injection with a single dose of intravenous antibiotic as antimicrobial cover. 10/12 (83.3%) were able to return to their unitwithin this theatre of operation. The only complication was one case of post injection flare of pain, which settled after 48 hours.

Conclusion The use of local steroid injection, as an adjunct to physical therapy, can enable service personnel to remain in the theatre of operations. These patientsmay have otherwise required aero medical evacuation. We consider the use of a local steroid injection to be a safe and effective intervention in certain patients where conservative measures alone do not work. This study highlights the safety of using steroid injections in an operational field hospital setting. Further large scale studies may help corroborate this conclusion.

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