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Caring for soldiers humbles ortho surgeon

by Cindy Abole
Public Relations
The mission to provide care for America’s injured soldiers in today’s combat zones is not limited to the U.S. military; it’s also supported by a team of civilian medical specialists who are committed to improving patient care.
For two weeks in June, Langdon Hartsock, M.D., chairman of MUSC’s Department of Orthopaedic Surgery, travelled 4,600 miles away from MUSC to Landstuhl Regional Medical Center in western Germany and home to the largest American military hospital outside of the United States. Hartsock assisted military orthopaedic surgeons and helped treat casualties coming from Iraq and Afghanistan. He supported efforts in military medicine and improved knowledge and research with war-related injuries.
Hartsock was selected among a group of national orthopaedic surgeons to participate in the American Academy of Orthopedic Surgeons (AAOS) and Orthopedic Trauma Association’s (OTA) Distinguished Visiting Scholars Program launched in 2007. The selection committee, composed of tri-service military members, a Landstuhl hospital representative and a civilian board member, reviewed each candidate’s credentials. Criteria focused on fellowship-trained orthopedic trauma specialists (possessing 10-plus years in trauma care medicine and education), demonstrated leadership, and a dedication to teaching..
“I consider it a great honor to be among colleagues picked for this program. I wanted to go and serve and do my part in providing the best care for America’s brave fighting men and women,” said Hartsock, himself a military veteran of the Navy Medical Corps. When he asked his military physician-friends what more could civilian doctors do to support America’s military abroad, one suggested the visiting scholars program.

Coordinated care approach
Hartsock was contacted last fall and, subsequently, reported for duty June 1 at Landstuhl Medical Center’s Orthopedic Clinic. He worked alongside a staff of eight military physicians and nursing staff. Two physicians were always dedicated to the care of incoming Iraq and Afghanistan casualties. The team focused on providing specialized care for major extremity wounds and helped stabilize and prepare patients for their flight home. Hartsock spent time teaching battlefield surgeons and physicians about new orthopaedic procedures and exchanged knowledge and experiences.
Landstuhl is the military’s only Level 4 tertiary care referral facility, supporting more than 400,000 active duty service men and women and their dependents stationed in Europe, Africa and Southwest Asia, including Iraq and Afghanistan combat zones.  
Throughout the experience, Hartsock was struck by the Landstuhl hospital staff’s commitment and unwavering dedication of care for each patient. “There was this amazing sense of purpose and positive morale everywhere,” he said. “These people were completely dedicated to the mental and physical care of each soldier and Marine.”

Realities of war
A trained orthopaedic trauma surgeon for 15 years, Hartsock was more familiar treating victims of car crashes, falls and sports-related injuries than repairing the effects of blast injuries; often combined with the loss of limbs and severe fractures caused by roadside bombs or improvised explosive device or IEDs, gun fire, etc. He saw it a blessing that many wounded warriors were young, healthy and in outstanding physical shape, which helped their chances of survival and recovery.
In 2003, the military streamlined their medical care system for transporting injured soldiers from the battlefield home. In the first level of care, a solider wounded in a combat zone would receive battlefield first aid. If the injuries were serious, the soldier’s care would be transferred to a forward surgical team, whose responsibility is to control any bleeding and stabilize the patient for helicopter transport to a combat surgical hospital (CSH) within the theater. Today’s CSH, or Cash, are equipped with high-tech scanners and advanced imaging equipment to help assess the patient’s condition. Seriously injured patients are transported to a fixed hospital facility (Landstuhl) via specially-equipped C-17 aircraft. At Landstuhl, patients are triaged for either surgery, other treatment or assigned to a room where they can recover and return to their unit or go stateside for recovery and rehabilitation at American military hospitals in Maryland, the District of Columbia and other locations.
As part of the facilities’ commitment to quality patient care, orthopaedic specialists regularly participate in weekly video link-up conferences with battlefield physicians and medical colleagues in Iraq, Afghanistan, Walter Reed Army Hospital (Washington, D.C.) and the National Naval Medical Center (Bethesda, Md.) to discuss care and follow-up details on patients. The meetings demonstrate a priority for health care team collaboration and communication with participants located more than half-way around the world.
This fall, Hartsock will present at the AAOS/OTA’s extremity war injuries research symposium. The gathering allows orthopaedic surgeons, who support related research, the chance to share and discuss new knowledge and treatments developed for wound care, bone healing, prosthetic technology and furthering basic science in understanding the body’s injury repair processes.
“It was humbling to see what our military health care teams are doing,” Hartsock said. “I feel I’ve gained a better appreciation of our country’s military perspective and mission. We owe a debt of gratitude to these men and women for their service, and when they get hurt, we should do what we can to assist them in the best way possible.”


Friday, Aug. 21, 2009

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