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), the Society of Military Orthopaedic Surgeons (SOMOS), and the Orthopaedic Research Society (ORS) has sponsored annual symposia and subsequent publications:

• 2013 AAOS/OTA/SOMOS/ORS Extremity War Injuries VIII: Sequelae of Combat Injuries
• 2012 AAOS/OTA/SOMOS/ORS Extremity War Injuries VII:
  A Decade at War: Evolution of Orthopaedic Combat Casualty Care
• JAAOS Special Issue: Extremity War Injuries: Current Management and Research Priorities (August 2012)
• 2011 AAOS/OTA/SOMOS/ORS Extremity War Injuries VI:
  Data-Driven Progress in Combat Casualty Care
• 2010 AAOS/OTA/SOMOS/ORS Extremity War Injuries V:
  Barriers to Return of Function and Duty
• JAAOS Special Issue: Extremity War Injuries V: Barriers to Return of Function and Duty (February 2011)
• 2009 AAOS/OTA/SOMOS Extremity War Injuries IV:
  Collaborative Efforts in Research, Host Nation Care, and Disaster Preparedness
• JAAOS Summary Article: Extremity War Injuries: Collaborative Efforts in Research, Host Nation Care, and Disaster Preparedness (January 2010)
• 2008 AAOS/OTA/SOMOS Extremity War Injuries III:
  Challenges in Definitive Reconstruction
• JAAOS Summary Article: Extremity War Injuries: Challenges in Definitive Reconstruction (November 2008)
• 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)
• 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)

The Extremity War Injuries and Disaster Preparedness Project Team (EWIDP) was formed in 2006 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 (August 2012): AAOS Treasurer Testifies on Behalf of Injury Research: Tells Senate committee that failure to fund PRORP would constitute abandoning military
• AAOS Now (May 2012): Story Behind PSA Shows Value of Military Orthopaedics: Public service announcement highlights challenges facing surgeons and patients
• AAOS Now (March 2012): Measuring the Success of EWI in Dollars and Sense
• AAOS Now (March 2012): Evolving Care During a Decade at War: Progress made in treating war injuries, but questions remain
• AAOS Now (September 2011): Three AAOS activities receive awards: Community service, EWI, and AAOS Now are honored
• AAOS Now (August 2011): AAOS approves disaster preparedness plan
• AAOS Now (March 2011): Military, civilians partner at EWI symposium
• AAOS Now (February 2011): SOMOS leads way in wartime and disaster response
• AAOS Now (October 2010): Combat Casualty Care Conference highlights advancements in care
• AAOS Now (March 2010): Getting soldiers back into action
• AAOS Now (January 2010): Extremity War Injuries: More Research is Needed
• AAOS Now (December 2009): EWI V to examine challenges facing soldiers after injury
• AAOS Now (April 2009): Trauma care links military, civilian surgeons
• AAOS Now (March 2009): Developing a predictive model for wound healing
• AAOS Now (March 2009): EWI-IV highlights advances in combat care
• AAOS Now (February 2009 – Annual Meeting Edition): AAOS honors Distinguished Visiting Scholars
• AAOS Now (February 2009 – Annual Meeting Edition): War injuries drive orthopaedic advances
• AAOS Now (February 2009): A salute to orthopaedics and the military
• AAOS Now (December 2008): EWI-IV continues tradition of advancing orthopaedic care
• AAOS Now (December 2008): What will you do when disaster strikes? Disaster preparedness: What every surgeon needs to know
• AAOS Now (December 2008): The ultimate volunteer experience: Serving at LRMC
• AAOS Now (November 2008): Orthopaedic trauma research receives $66 million
• Washington Post (July 2008): Books: 'Fighting to Report - and Survive - the War in Iraq'
• AAOS Now (June 2008): AAOS, OTA voice support for funding AFIRM
• AAOS Now (March 2008): Symposium fuels support for research
• Grand Rapids Press (March 2008): Grand Rapids surgeon learns medical advances can be products of war
• AAOS Now (March 2008): EWI III continues a tradition
• AAOS Now (February 2008): Harkin: Increase funding for trauma research
• AAOS Now (October 2007): Iraq: A week in theater - Living in a bunker, treating civilians
• AAOS Now (October 2007): Serving wounded warriors
• AAOS Now (July 2007): Wound management, evacuation key in treating battlefield injuries
• AAOS Now (June 2007): AAOS fellow testifies on war injuries
• AAOS Now (March/April 2007): Orthopaedic surgeons wage war against extremity injuries
• AAOS Now (March/April 2007): A brief background of combat injuries
• AAOS Now (January/February 2007): What shall we do with the wounded

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