Extremity War Injuries and Disaster Preparedness

Together, Civilian and Military Surgeons Advance the Care of Wounded Warriors

The majority of trauma that occurs in Operation Iraqi Freedom and Operation Enduring Freedom is orthopaedic-related, particularly involving the upper and lower extremities. The AAOS supports several research events and programs partnering military orthopaedic surgeons to advance the care of the wounded warrior. Its annual symposia series, “Extremity War Injuries,” has served to define current knowledge regarding management of extremity war injuries for NIH, Congress, the Department of Defense, orthopaedic surgeons, researchers, industry, and other relevant governmental agencies. Beginning in 2006, the AAOS, along with the Orthopaedic Trauma Association (OTA) and the Society of Military Orthopaedic Surgeons (SOMOS) has sponsored three symposia and subsequent publications:

• 2006 AAOS/OTA Extremity War Injuries: State of the Art and Future Directions
• JAAOS Special Issue: Extremity War Injuries: State of the Art and Future Directions (September 2006)
• 2007 AAOS/OTA Extremity War Injuries II: Development of Clinical Treatment Principles
• JAAOS Summary Article: Extremity War Injuries: Development of Clinical Treatment Principles (October 2007)
• 2008 AAOS/OTA/SOMOS Extremity War Injuries III: Challenges in Definitive Reconstruction
• AAOS Now (March 2008): EWI III Continues a Tradition
• 2009 AAOS/OTA/SOMOS Extremity War Injuries IV Research Symposium
• 2010 AAOS/OTA/SOMOS/ORS Extremity War Injuries V: Barriers to Return to Function

In 2006, the AAOS formed the Extremity War Injuries and Disaster Preparedness Project Team (EWIDP) to formalize relationships between civilian and military surgeons for collaboration on research and treatment of extremity war and disaster injuries.

• EWIDP Project Team Members
• EWIDP Project Team Charges

Opportunities for Involvement:

The AAOS/OTA Landstuhl Distinguished Visiting Scholars Program provides opportunities for experienced civilian traumatologists to assist the military surgeons at the Landstuhl Regional Medical Center (LRMC). The visiting scholars have the unique opportunity to see the processes by which the military is currently achieving an unprecedented reduction in combat mortality. Visiting scholars are surgeons with at least 10 years experience,who have demonstrated excellence in teaching, and have substantial experience in civilian orthopaedic trauma clinical care,. The selection committee (consisting of a tri-service panel of military orthopaedic trauma surgeons, distinguished members of the OTA and AAOS leadership, and a representative from the Orthopaedic service at LRMC) has considered the applicants very carefully to assist in the ongoing process to provide the best possible care to our wounded.

• Visiting Scholar Proposal, Expectations, and Selection Process
• For more information about this program, please contact the Orthopaedic Trauma Association

The Orthopaedic Extremity Trauma Research Program (OETRP), part of the United States Army Institute of Surgical Research Medical Research and Materiel Command’s medical research program, funds both peer-reviewed intramural and extramural orthopaedic trauma research. The OETRP is an independent function of the AAOS. In an effort to provide better treatment and improve clinical outcomes from combat casualties, the OETRP is to complement, expand, and broaden the research in orthopaedic trauma that is currently funded by the Department of Defense, National Institutes of Health, and industry. 

• Learn how to submit your research proposal or view previously funded proposals.
• OERTP-Funded Research: Correlation of Procalcitonin and Cytokine Expression with Dehiscence of Wartime Extremity Wounds (Forsberg, et al. J. Bone Joint Surg. Am., Mar 2008; 90: 580 - 588).

In the News:

• AAOS Now (January/February 2007): What shall we do with the wounded
• AAOS Now (March/April 2007): A brief background of combat injuries
• AAOS Now (March/April 2007): Orthopaedic surgeons wage war against extremity injuries
• AAOS Now (June 2007): AAOS fellow testifies on war injuries
• AAOS Now (July 2007): Wound management, evacuation key in treating battlefield injuries
• AAOS Now (October 2007): Serving wounded warriors
• AAOS Now (October 2007): Iraq: A week in theater - Living in a bunker, treating civilians
• AAOS Now (February 2008): Harkin: Increase funding for trauma research
• AAOS Now (March 2008): EWI III continues a tradition
• Grand Rapids Press (March 2008): Grand Rapids surgeon learns medical advances can be products of war
• AAOS Now (March 2008): Symposium fuels support for research
• AAOS Now (June 2008): AAOS, OTA voice support for funding AFIRM
• Washington Post (July 2008): Books: 'Fighting to Report - and Survive - the War in Iraq'
• AAOS Now (November 2008): Orthopaedic trauma research receives $66 million
• AAOS Now (December 2008): The ultimate volunteer experience: Serving at LRMC
• AAOS Now (December 2008): What will you do when disaster strikes? Disaster preparedness: What every surgeon needs to know
• AAOS Now (December 2008): EWI-IV continues tradition of advancing orthopaedic care
• AAOS Now (February 2009): A salute to orthopaedics and the military
• AAOS Now (February 2009 – Annual Meeting Edition): War injuries drive orthopaedic advances
• AAOS Now (February 2009 – Annual Meeting Edition): AAOS honors Distinguished Visiting Scholars
• AAOS Now (March 2009): EWI-IV highlights advances in combat care
• AAOS Now (March 2009): Developing a predictive model for wound healing
• AAOS Now (April 2009): Trauma care links military, civilian surgeons

Federal Advocacy Efforts (All in PDF format):

• Testimony (All in PDF format):
• Testimony to the Senate Appropriations Committee Subcommittee on Defense (June 2008)
• Congressional “Dear Colleague” Letters (All in PDF format):
• View the Extremity War Injuries “Dear Colleague” Letter (House), signed by Rep. Tom Latham and Rep. C.A. Dutch Ruppersberger supporting the OETRP.
• View the Extremity War Injuries “Dear Colleague” Letter (Senate).
• Comments (All in PDF format):
• June 2008: AAOS Letter to National Disaster Medical System (Fitzgerald): Comments Regarding Enhancing Healthcare Provider Preparedness
• June 2008: AAOS Letter to National Disaster Medical System (Davis): Comments Regarding Enhancing Healthcare Provider Preparedness