AAOS February 6, 2018
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13th Annual Extremity War Injuries (EWI) and Hill Visits

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13th Annual Extremity War Injuries (EWI) and Hill Visits

The 13th annual EWI symposium is the latest installment in the annual symposium series, which has served to define current knowledge and identify areas for future research regarding the management of extremity trauma for NIH, Congress, the Department of Defense, orthopaedic surgeons, researchers, industry, and other relevant government agencies since 2006. For the 2018 event, general sessions highlighted government funded research output, prolonged field care, amputee care and management, disaster preparedness and intentional violence, precision orthopaedics and rehabilitation, and pain and opioid dependence. The symposium also featured updates from the Army, Air Force, and Navy consultants and how the National Academies of Sciences, Engineering, and Medicine (NASEM) is maintaining readiness on the Homefront by calling for a National Trauma System.

EWI XIII Planning Team (L-R): Andrew Schmidt, MD (EWI XIII Oversight Chair), MAJ Jonathan Dickens, MD (EWI XIII Scientific Director), MAJ Daniel Stinner, MD (EWI XIII Military Co-Chair), and Robert O’Toole, MD (EWI XIII Civilian Co-Chair)

Small group discussions addressed multiple topics throughout the meeting, including optimization of existing registries to prepare for future conflicts, examining capacity for disaster preparedness through education, and patient-specific treatments. New research was featured throughout the meeting in a dedicated poster session as well as a scientific podium session. Symposium faculty drafted a gap analysis from the small group discussions, identifying future research directions in the area of prolonged field care, amputation and limb salvage, mitigation of complications, pain control, readiness, outcomes in the military health system, and rehabilitation following extremity injury. An article in the Journal of the American Academy of Orthopaedic Surgeons is forthcoming.

In addition to the symposium, Drs. Andrew Pollak, Robert O’Toole and Andrew Schmidt met with staff of senior appropriations members on January 24th to discuss defense health appropriations for FY2019. Each year, AAOS staff and members advocate for $30 million for the peer reviewed orthopaedic research program, funded by the Department of Defense congressionally directed medical research program (CDMRPs). This important fund helps orthopaedic researchers study the unique and complex injuries military personnel sustain in U.S. war efforts. These injuries are sustained in harsh environments where access to optimal acute care can be limited, and they are distinct from those seen in the civilian setting, frequently involving multiple limb trauma, open fractures, major tissue loss, and a high degree of wound contamination. The members, along with staff, emphasized the need for this research to be continued and, if at all possible, for the funds to be increased to $45 million. Because of the continued use of continuing resolutions for FY2018, the final numbers for funding all CDMRPs has not been released, but AAOS staff will continue to monitor these numbers and emphasize the importance for this research to continue.