Conflicts, military medicine and war casualties in international Orthopaedics

Abstract

The recent SICOT world orthopaedic surgery and traumatology congress in Oman was a great meeting with thousands of attendees, brilliant talks, educational lectures, instructional courses and seminars, symposia and many free papers presented by speakers from five continents. The International Council of the SICOT is formed by orthopaedic surgeons who represent their respective countries. At the Annual Assembly of the Council some countries were missing. A few colleagues were unable to attend for specific reasons that are not related with scientific or academic issues. Some colleagues live in places that are in state of war or have no freedom to circulate. Some others belong or work in places where the airports or roads were recently destroyed. Finally, some colleagues were unable to attend due to restrictions of circulation or visa delivery in their local or regional areas. However, the art of Orthopaedic Surgery is a part of our society, everywhere on the planet our colleagues are treating wounded people, military or civilian from every population group of, including their enemies. During difficult times, combat, terror attacks or war our colleagues manage specific casualties, terrible and disabling limb wounds, catastrophic trauma, partial or total limb loss, chemical, thermic burns, penetrating injuries from high-velocity weapons and many other conditions. During these particular periods of time civilians may be "collateral damage" and often they represent more cases than the military personnel. Trauma was considered for many years as the "poor child" of orthopaedics and scheduled routine surgery was the main option in every general hospital except in dedicated trauma centres. The picture changes obviously in time of war or after natural catastrophies when mass causalities become a priority and every orthopaedic surgeon will eventually become a trauma care provider.International Orthopaedics publishes every year papers related to war traumatology and secondary treatment of sequellae. This chapter was started during Mr. Maurice Hinsenkamp presidency of SICOT and was supported by many countries and institutions, including military hospitals from different countries and "Médecins sans Frontières" a powerful International organization started in France and dedicated to helping people in difficult situations, including war, natural disasters and terror attacks on civilians.The December issue of the Journal published the "war and catastrophy" chapter and included four relevant papers that present different conditions of the osteo-articular system after combat trauma and the different methods of management.The treatment of war wounds is based on a sequential surgical strategy, which frequently faces therapeutic failures, which could compromise or complicate the final functional result. The study published by the French specialty centres [1] is a valuable piece of research that identifies potential risk factors and provides solutions for the management of those specific cases.A paper authored by specialists working wit...

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