Combat Orthopedic Surgery Lessons Learned in Irag and Afghanistan

During the course of the Iraq and Afghanistan Wars, military orthopedic surgeons have made significant technical and philosophic changes in the treatment of musculoskeletal combat casualties. The widespread use of individual and vehicular body armor, evolution of enemy tactics to include its reliance on improvised explosive devices, and the effectiveness of treatment rendered at military treatment facilities have resulted in a large burden of complex orthopedic injuries. Combat Orthopedic Surgery: Lessons Learned in Iraq and Afghanistan represents and recognizes the latest advances in musculoskeletal surgical care performed to treat today#x19;s US military servicemembers. Editors LTC Brett D. Owens, MD and LTC Philip J. Belmont Jr., MD have brought together the leading military orthopedic surgeons to relay their clinical orthopedic surgery expertise, as well as to discuss how to provide optimal care for combat casualties both initially in theater and definitively at tertiary care facilities within the United States. Combat Orthopedic Surgery: Lessons Learned in Iraq and Afghanistan is divided into five sections, with the first being devoted to an overview of general topics. The second section covers scientific topics and their clinical application to musculoskeletal combat casualties. The final three sections are clinically focused on the upper extremity, lower extremity, and spine and pelvic injuries, with many illustrative case examples referenced throughout. Most Clinical Chapters Contain: " Introduction/historical background " Epidemiology " Management in theater " Definitive management " Surgical techniques " Outcomes " Complications Combat Orthopedic Surgery: Lessons Learned in Iraq and Afghanistan will be the definitive academic record that represents how orthopedic surgeons currently manage and treat musculoskeletal combat casualties.

 LTC Brett D. Owens, MD is a Distinguished Graduate of the United States Military Academy in West Point, New York. He graduated from the Georgetown University School of Medicine in Washington, DC and completed his internship at Walter Reed Army Medical Center. He completed his orthopaedic surgery residency at the University of Massachusetts and the John A. Feagin Jr. Sports Medicine Fellowship at West Point. He is currently an Associate Professor of Surgery (Orthopaedics) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. He served as an orthopaedic surgeon with the 86th Combat Support Hospital in Iraq and is currently Chief of Orthopaedic Surgery Service, Keller Army Hospital, West Point, New York.    

LTC Philip J. Belmont Jr, MD is a Distinguished Graduate of the United States Military Academy in West Point, New York. He graduated from the Duke University School of Medicine in Durham, North Carolina and completed his internship and orthopaedic surgery residency at Walter Reed Army Medical Center in Washington, DC. He is currently an Associate Professor of Surgery (Orthopaedics) at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. He served as an orthopaedic surgeon with the 228th Combat Support Hospital in Iraq and is currently the Chief of Adult Reconstruction and Program Director of the William Beaumont Army Medical Center/Texas Tech University Health Sciences Center Orthopaedic Surgery Residency Program at William Beaumont Army Medical Center, El Paso, Texas.

 

DedicationAcknowledgmentsAbout the EditorsContributing AuthorsPrefaceForeword by LtCol John M. Tokish, MD, MC USAFForeword by John Callaghan, MDIntroductionSection I      PrinciplesChapter 1          The History of Combat Orthopedic Surgery                             MAJ Andrew J. Schoenfeld, MDChapter 2          The Combat Environment and Epidemiology of Musculoskeletal Combat Casualties                             LTC Philip J. Belmont Jr, MD and CPT Gens P. Goodman, DOChapter 3          Echelons of Care                             LTC Mark Pallis, DO and COL Tad Gerlinger, MDChapter 4          The Forward Surgical Team                             MAJ Andrew J. Schoenfeld, MD; MAJ Dirk L. Slade, MD; and LTC Philip J. Belmont Jr, MDChapter 5          Combat Support Hospitals                             COL James R. Ficke, MDChapter 6          Landstuhl Regional Medical Center                             COL Joachim Jude Tenuta, MDSection II     AdvancementsChapter 7          Ballistic, Blast, and Burn Injury: Science and Clinical Implications                             COL (Ret) Roman Hayda, MDChapter 8          Management of Complex Combat-Related Soft Tissue Wounds/                             Negative Pressure Wound Therapy                             MAJ Brett A. Freedman, MD and MAJ Leon J. Nesti, MD, PhDChapter 9          Basic Science of War Wounds                             LCDR Jonathan Agner Forsberg, MD; Trevor S. Brown, PhD; and MAJ Benjamin K. Potter, MDChapter 10        Heterotopic Ossification                             MAJ Benjamin K. Potter, MD and LCDR Jonathan Agner Forsberg, MDChapter 11        Irrigation and Debridement                             MAJ Scott Waterman, MD; CDR Mark E. Fleming, DO; and LTC Brett D. Owens, MDChapter 12        Tissue Engineering and Regeneration                             LCDR Jared A. Vogler, DO; Wesley Jackson, PhD; and MAJ Leon J. Nesti, MD, PhDChapter 13        Infection in Orthopedic Extremity Injuries                             LTC Clinton K. Murray, MDChapter 14        Tourniquets                             COL John F. Kragh Jr, MDChapter 15        External Fixation Principles                             LCDR Joseph Carney, MD and CAPT D.C. Covey, MDSection III   Upper ExtremityChapter 16        Upper Extremity Nerve Injuries                             CAPT Eric P. Hofmeister, MD; LT Kathryn H. Hanna, MD; and LCDR Leo T. Kroonen, MDChapter 17        Upper Extremity Amputations                             LTC(P) Kenneth F. Taylor, MD and COL Gerald L. Farber, MDChapter 18        Upper Extremity Coverage: Management of Combat-Related Soft Tissue Injury of the                             Upper Extremity                             CDR (Ret) Anand R. Kumar, MD; CAPT Alan A. Lim, MD; LT Scott Tintle, MD; and
                             James P. Bradley, MDChapter 19        Complex Reconstructive Challenges in Hand and Forearm Wounds                             LTC(P) Martin F. Baechler, MD; LT Scott Tintle, MD; COL Chester C. Buckenmaier III, MD; and
                             MAJ Matthew L. Drake, MDChapter 20        Complex Elbow and Shoulder Injuries                             Capt Robert McGill, MD and Col Damian Rispoli, MDSection IV    Lower ExtremityChapter 21        Lower Extremity Limb Salvage                             CPT Michael J. Beltran, MD; LTC(P) Romney C. Andersen, MD; and LTC Joseph R. Hsu, MDChapter 22        Combat-Related Lower Extremity Amputations                             MAJ Benjamin K. Potter, MD; LT Scott Tintle, MD; and LCDR Jonathan Agner Forsberg, MDChapter 23        Prostheses for Major Extremity Amputations                             Zach Harvey, BS, CPO and MAJ Benjamin K. Potter, MDChapter 24        Long-Bone Fracture Management                             MAJ Travis C. Burns, MD; CPT Daniel J. Stinner, MD; and LTC Joseph R. Hsu, MDChapter 25        Lower Extremity Coverage: Management of Combat-Related Soft Tissue Injury of the                             Lower Extremity                             CDR (Ret) Anand R. Kumar, MD; CAPT Alan A. Lim, MD; LT Scott Tintle, MD; and
                             James P. Bradley, MDChapter 26        Complex Foot and Ankle Injuries                             LTC Scott B. Shawen, MD; CPT Jonathan F. Dickens, MD; CPT Kelly G. Kilcoyne, MD; and
                             MAJ Benjamin K. Potter, MDSection V     Spine/PelvisChapter 27        Combat Injuries to the Pelvis and Acetabulum                             LtCol Wade Gordon, MD; CPT Matthew Kluk, MD; CDR Joseph E. Strauss, DO;
                             and LTC(P) Romney C. Andersen, MDChapter 28        Spine Fractures                             CPT Daniel G. Kang, MD and LTC Ronald A. Lehman Jr, MDChapter 29        Spine Neurologic Injury                             CDR David E. Gwinn, MD and LTC Michael K. Rosner, MD Financial DisclosuresIndex