Upgradation of aircrew with minor musculoskeletal injuries in the operational bases: Need for a relook

Abstract

Objectives: Musculoskeletal injuries (MSKI) have been one of the most common contributors to disabilities among aircrew. The existing policy mandates all cases of MSKI in aircrew of the Indian Air Force, including minor injuries such as a sprain of small joints and phalangeal fractures to be evaluated at the Institute of Aerospace Medicine (IAM), majority of which do not warrant a complete Human Engineering (HE) assessment. Hence, a need was felt to decentralize evaluation and empower other boarding centers/operational bases with local aerospace medicine specialists to carry out the evaluation. Material and Method: A retrospective analysis was carried out of a total of 930 cases of MSKI among serving aircrew who reported to IAM between Jan 2016 and Oct 2020. Results: About 27.68% of cases were of lower limb injuries and 16.52% of cases were of upper limb injuries. About 36.77% of cases of upper limb and 52.71% of cases of lower limb injuries were treated surgically while 63.23% upper limb and 47.29% lower limb injuries were managed conservatively. Full functional recovery within 12 weeks was seen in a significant number of conservatively treated distal upper and lower limb injuries not involving joints. Conclusion: HE assessment of MSKI at IAM is comprehensive including exposure to simulated aeromedical stressors. However, certain minor musculoskeletal disabilities did not require full HE evaluation and simulator facilities of IAM. Sending aircrew with such minor disabilities from field units to IAM amounts to an administrative obligation that can be avoided by empowering other medical boarding centers and local operational bases which have aerospace medicine specialists. This paper discusses the procedure of conduct and facilitation of aeromedical evaluation of aircrew in the non-flying medical category with certain minor MSKI in the field.