In March, Reps. Tammy Duckworth (D-Ill.) and Duncan Hunter (R-Calif.) presented a bipartisan letter to the House Appropriations Committee’s Subcommittee on Defense requesting inclusion of $30 million for the Peer-Reviewed Orthopaedic Research Program (PRORP) in the Defense Appropriations legislation for fiscal year (FY) 2016. The American Association of Orthopaedic Surgeons was instrumental in the establishment of the PRORP, which provides support for focused basic and clinical research through direct grants to research institutions and aims to provide all military personnel affected by orthopaedic injuries sustained in the course of their duties the opportunity for optimal recovery and restoration of function.

According to the letter, extremity injuries are the number one battlefield injury. Most of these wounds are caused by improvised explosive devices, rocket-propelled grenades, and high-velocity gunshot wounds. Unfortunately, amputation following these types of battlefield injuries occurs at twice the rate of past wars.

“[The PRORP program has] become critical to the treatment of our wounded servicemen and women returning from Iraq and Afghanistan, and an increase in program funding is essential to fulfilling the debt of gratitude we owe to those who protect our freedom,” the legislators wrote. “The need for this research has never been greater and more immediate.”

A U.S. Army analysis of soldiers injured in Iraq and Afghanistan shows that extremity injuries account for the greatest proportion of medical resource utilization and causes the greatest number of disabled soldiers. In fact, soldiers with extremity injuries had the longest average inpatient stays and accounted for 65 percent of total inpatient resource utilization. In addition, it is projected that they will account for 69 percent of warriors who are deemed medically unfit to return to duty. Exclusive of any short or long-term medical costs, the projected disability cost for extremity injuries sustained in these conflicts to date is approximately $1.2 billion.

“Leg and arm wounds account for the greatest number of disabled soldiers so the need for Orthopaedic research has never been greater and more immediate,” said Rep. Duckworth, who is herself a double amputee due to injuries sustained in the Iraq war. “I am hopeful that the Subcommittee will provide $30 million in the FY 2016 Defense Appropriations legislation to ensure this important work can continue to assist those who have made tremendous sacrifices while defending the United States of America.”

The AAOS partners with military orthopaedic surgeons to support several research events and programs aimed at advancing the care of wounded military. Extremity War Injuries (EWI), a focused symposium held annually since 2006, has served to define current knowledge regarding management of extremity war injuries for the National Institutes of Health, Congress, the Department of Defense, orthopaedic surgeons, researchers, industry, and other relevant governmental agencies. The EWI, which is sponsored by the AAOS, the Orthopaedic Trauma Association, the Society of Military Orthopaedic Surgeons, and the Orthopaedic Research Society, has also resulted numerous publications on various aspects of military trauma and treatment. To learn more, visit www.aaos.org/ewi