Andrew N. Pollak, MD, (left) and Col. James R. Ficke, MD (right), co-chairs of the Extremity War Injuries III symposium, converse with U.S. Air Force Surgeon General Lt. Gen. James Roudebush, MD. Photo
courtesy of Robert Knudsen


Published 3/1/2008
Lindsay Law

Symposium fuels support for research

Approximately 82 percent of battlefield-injured U.S. soldiers serving in Iraq and Afghanistan sustain extremity injuries. Many of these injuries, which are distinct from standard trauma, are made more challenging by the effects of improvised explosive devices or vehicle-borne improvised explosive devices.

To address the increasing number of extremity war injuries sustained by soldiers serving in Iraq and Afghanistan, the AAOS, in conjunction with the Orthopaedic Trauma Association (OTA) and the Society of Military Orthopaedic Surgeons (SOMOS), brought together the nation’s top orthopaedic and trauma surgeons and researchers for Extremity War Injuries III: Challenges in Definitive Reconstruction (EWI III). The symposium, held Jan. 23-24, 2008, in Washington, D.C., focused on research findings in the areas of soft-tissue defects, segmental bone defects, open tibial shaft fractures, and massive periarticular reconstructions.

Research essential to improving treatment
“The Orthopaedic Extremity Trauma Research Program (OETRP) is a vital tool in our efforts to improve treatment and outcomes of battlefield extremity injuries,” said Andrew N. Pollak, MD, symposium co-chair and chief of orthopaedic trauma at the R Adams Cowley Shock Trauma Center at the University of Maryland. “Each year reinforces the importance of making significant investments in research to help our military orthopaedic surgeons discover new and innovative ways to best treat these complex injuries.”

AAOS and OTA have supported OETRP, a Congressionally funded peer-reviewed program under the Department of Defense, since its initiation, noting the importance of the program to troops serving in Iraq and Afghanistan. The competitively awarded research program is operated by the U.S. Army’s Medical Research and Materiel Command. It is designed to address urgent medical challenges by involving military and civilian orthopaedic surgeons and researchers in these efforts.

Iowa’s Sen. Tom Harkin, who delivered the keynote presentation, spoke in favor of extending research efforts, saying, “The American people have a profound moral obligation to support those who have served with skill and selflessness.”

Sen. Harkin noted that the current $4.8 million budget for OETRP is clearly inadequate. He pledged to continue advocating for including $50 million for extremity war injury research in the supplemental budget for fiscal year 2008. Other members of Congress and symposium attendees echoed his sentiments.

“A new type of patient”
After attending the EWI III symposium, Sen. Harkin issued a Congressional call of support for additional federal funding for extremity war injury research through OETRP through a “Dear Colleague” letter circulated to every member of Congress. Joining Sen. Harkin in the effort were Sen. Kay Bailey Hutchison and Reps. Tom Latham and C.A. “Dutch” Ruppersberger.

They urged their colleagues to sign a letter to the leadership of the Senate and House Appropriations Subcommittees on Defense requesting support for an annual operating level of $50 million in fiscal year 2008 through supplemental appropriations for OETRP.

“There is a profound need for focused medical research to help military surgeons find new limb-saving techniques to avoid amputations and preserve and restore the function of injured extremities,” reads the letter. “With dramatic increases in survivability on the battlefield compared with past conflicts, these wars are producing a new type of patient—a warfighter with multiple and severely mangled extremities who is often free of other life-threatening injuries to the torso. Military surgeons are presented with injuries not often seen in civilian medical practice. A significant increase in funding for the peer-reviewed Orthopaedic Extremity Trauma Research Program is warranted, given the urgent importance of this research to our troops in Iraq and Afghanistan, and the strong interest in capacity of the U.S. research community.”

Pushing the envelope
“I am constantly amazed at the dedication of our military surgeons,” noted Col. James R. Ficke, MD, EWI III co-chair, chief of orthopaedic surgery services at Brooke Army Medical Center and orthopaedic surgery consultant to the U.S. Army Surgeon General. “Military surgeons and patients are pushing the envelope on the treatment, research, and knowledge of blast injuries every day. Our research findings in extremity injuries and infection, reconstruction, amputation, and rehabilitation have and will continue to dramatically improve our treatment of trauma patients in the civilian population as well as on the battlefield.”

The AAOS Office of Government Relations will continue to lobby for support of OETRP on Capitol Hill. For more information, contact Bob Jasak, senior regulatory advisor at

Lindsay Law is communications manager in the AAOS Washington, D.C., office of government relations. She can be reached at