Persistent neuropathic pain symptoms after FPV drone-related thoracic blast injury without rib fractures: a pilot observational study from the Ukraine War.

Authors

Ceri Battle, Edward Baker, Jacopo Davide Giamello, Remo Melchio, Dmytro Dmytriiev

Published in

European journal of trauma and emergency surgery : official publication of the European Trauma Society. Volume 52. Issue 1. Jul 21, 2026. Epub Jul 21, 2026.

Abstract

The aim of this exploratory pilot study was to describe First Person View drone (FPV) related, blast-mechanism thoracic trauma with no rib fractures in Ukrainian military patients sustained during the Russia-Ukraine Conflict, and report the prevalence of persistent neuropathic pain symptoms at three months among patients admitted to a rehabilitation and pain medicine service.
A retrospective, single-centre observational, exploratory study design was used. Military patients (≥ 16 years old) with blast-mechanism thoracic injuries with no rib fractures, admitted to a hospital's rehabilitation and pain medicine service in Ukraine for ≥ 24 h were included. The PainDETECT survey was completed at three months post-injury. Participant characteristics were summarised using descriptive statistics. Exploratory univariate and multivariate analyses were performed to explore possible associations between variables and the development of persistent neuropathic pain symptoms.
217 patients were included in the final analysis. Median age was 39 years (IQR: 32-47.5). 131 (60.4%) patients were admitted to critical care with 91 (41.9%) patients requiring mechanical ventilation. The median hospital length of stay was 22 days (IQR: 16-25) and critical care length of stay was 4 days (IQR: 2-5). Persistent neuropathic pain symptoms were reported in 173 out of 217 patients (79.7% absolute event rate). Univariate analysis revealed a stark contrast in absolute rates based on the mechanism: 99.4% (172/173) of patients exposed to blasts developed persistent symptoms compared to just 0.6% (1/45) in the low-energy and bullet-like injury group, representing an absolute risk difference of 0.97 (95% CI: 0.93-0.99, p < 0.001).
The results of this pilot study demonstrate a very high rate of persistent neuropathic pain symptoms at three months in this cohort of military patients admitted to a rehabilitation and pain medicine service, highlighting significant implications for rehabilitation of long-term complications. We highlight that FPV-drone blasts can lead to significant soft tissue injuries to the thorax, in the absence of rib fractures.

PMID:
42479227
Bibliographic data and abstract were imported from PubMed on 21 Jul 2026.

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