Editorial Comment: Selected Proceedings from the Society of Military Orthopaedic Surgeons 2020 Annual Meeting

The Society of Military Orthopaedic Surgeons (SOMOS) was developed to integrate our members’ knowledge, experience, and leadership across all three US military services: Navy, Army, and Air Force. Our mission is to advance the practice of military and disaster musculoskeletal medicine, and it remains our goal to be the recognized global authority in military, veteran, and disaster musculoskeletal care.

As we attempt to provide the best possible care to our servicemen and servicewomen, SOMOS and its members must also devise ways to translate our discoveries to a civilian patient population. SOMOS is honored to continue our collaboration with CORR® to highlight our members’ high-level musculoskeletal research and care in this year’s selected proceedings.

Like the rest of the world, the extensive planning done in the winter of 2019 for the 2020 SOMOS annual meeting was upended by the COVID-19 pandemic. Tentatively, we continued to develop content and invite guest speakers to the meeting; however, the uncertainty about the course of the pandemic forced a pivot to a virtual format by the summer of 2020.

The shift was dramatic. The virtual format was a marked departure from the traditional SOMOS annual meeting. The 4-day full meeting was compacted down to two evening sessions with prerecorded research paper presentations available to view at each member’s own pace. Despite these changes, one of the highpoints of the meeting was the Allgood Panel, which is named for Colonel Brian Allgood MD, an orthopaedic surgeon, leader, and educator who died in combat in Iraq in 2007. The Allgood Award is the highest honor extended by the SOMOS society, and although the award was not given out at this meeting, the panel featured four prior Allgood Award winners: Drs. Ed Arrington, Ted Parsons, Matt Provencher, and Dean Taylor.

The subspecialty breakout sessions were also a resounding success. The virtual format allowed true giants in each orthopaedic surgery subspecialty to interact with our members in a way that is not possible at in-person meetings.

The lack of a full scientific program this year made the SOMOS Proceedings in this month’s CORR® even more important; the published proceedings enable the best research at the meeting to reach the widest-possible audience. Whether this research is on single-stage primary closure for large flap donor sites, flap-based limb salvage [1], or a passive dynamic ankle-foot orthosis in military members after complex battlefield lower extremity injuries [3], our members examined unique practices, emphasized lessons learned, and detailed how such lessons can be translated to civilian trauma practice.

Our civilian partnerships are underscored by Lindsey et al. [2], who found a high mortality rate of 15% at 1 year and 34% at 5 years after injury for medial clavicle fractures. Additionally, they found favorable functional outcomes and pain relief a minimum 1-year post-follow-up for those patients who survived the trauma. Still, there was a high proportion that will die within 3 years of the injury, demonstrating that these are often high-energy injuries [2].

Zalneraitis et al. [4] evaluated the accuracy of our commonly used outcome score “return to duty” and found that of those service members who reported “return to duty” at final follow-up, 67% had a lower level of physical activity, and 32% were considered unable to deploy. This study is relevant to all military orthopaedic surgeons and underscores the need to include validated patient-reported outcome measures in military studies for calibration against the existing civilian research.

As of this writing, the United States’ war in Afghanistan is in the midst of a turbulent end after two decades of conflict. Over the years, SOMOS has been instrumental in supporting its deployed members while simultaneously promoting leading orthopaedic education and research. As our soldiers, airmen, sailors, and Marines return from the nation’s longest war, SOMOS is already looking to improve care for this population while maintaining our institutional knowledge and specialized expertise in combat casualty care.