Comparative retrospective study of injuries during military parachuting training and airborne operations from 2013 to 2020

Introduction French paratroopers have been deployed during airborne operations for nearly a century. Parachute operations have increased since the start of Operations Serval and Barkhane in the Sahelo-Saharan strip. These military operations allow paratroopers to be dropped behind enemy lines. Our primary objective was to compare injuries sustained during airborne operations and training. Our secondary objective was to compare serious injuries sustained during airborne operations and training. Methods We conducted a multicentric comparative retrospective study of military parachuting injuries sustained during training and airborne operations from 1 January 2013 to 31 December 2020. Parachuting injuries included in our study came from the French Army Injury Register. Results During the study period, 91 injuries (among 90 wounded), including one death, were recorded during airborne operations and 2744 injuries (among 2516 wounded), including one death, were recorded during training. Proportionally, injuries were more common during airborne operations (3.3%) than training (0.3%), especially during military freefall operations. Operational static-line jumps are more associated with serious injuries than training ones (OR 3.17, 95% CI 1.79 to 5.62). Compared with training, operational jumps caused proportionally more knee injuries (OR 2.73, 95% CI 1.65 to 4.51, p=0.008) but fewer upper limb injuries (OR 0.36, 95% CI 0.17 to 0.74). A physician and/or nurse medically supported 83.3% of airborne operations. Data collection initially differed between paratrooper units until the French Army introduced a harmonised collection tool (Register of Parachuting Incidents ( Fiche de Recueil Accident en Parachute )). Conclusion Our study highlights a significantly increased injury rate during airborne operations, especially serious ones, likely due to the cumulative effect of well-known parachuting risk factors (eg, unknown or high wind speed, unknown landing ground type, combat load and night drop), justifying surveillance by qualified parachuting health staff.