The majority of the trauma that occurs in Operation Iraqi Freedom and Operation Enduring Freedom is orthopaedic-related, particularly involving the upper and lower extremities.  In an effort to provide better treatment and outcomes from these injuries, the Orthopaedic Trauma Research Program (OTRP) was created.  The OTRP is part of the Medical Research and Materiel Command´s medical research program and will fund both peer-reviewed intramural and extramural orthopaedic trauma research.  The purpose of OTRP is to complement, expand, and broaden the research in orthopaedic trauma that is currently funded by the Department of Defense, National Institutes of Health, and industry.  This is directed towards improvement of clinical outcomes in combat casualties.

Proposals should be goal-oriented with clearly defined milestones and endpoints and should address the Research Topic Areas of Interest.  Multi-year studies are permitted but must have annual milestones.  Follow-on funding will be based on the success at the annual milestone and the availability of funding.  Translational and clinical research proposals are strongly encouraged.  Basic science proposals will be considered but must demonstrate future clinical significance.  Translational research and clinical studies should utilize relevant trauma models and patient populations.  The strongest consideration will be given to proposals that can improve the care of battlefield-injured soldiers within five years by providing an improved treatment, product, or change of guidelines.  Military and civilian collaboration is encouraged.  Academic, industry, and government organizations are encouraged to apply.  Pre-proposals and proposals will be evaluated using the following criteria:

Develop a treatment for fractures likely to become non-unions due to the size of the defect, concomitant neural/vascular injury, or lack of soft tissue coverage.  Tissue engineering or regenerative medicine approaches to discover treatments that are capable of working in the face of contamination / infection are desired.

Develop devices, technologies, and treatments to prevent or treat infections in bone and soft tissue traumatic injuries.  Potential grantees should be aware of the challenges and organisms which are of interest in military casualties.  Treatments should be effective against methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella.

Retrospective analysis of trauma records indicates that heterotopic ossification is a more common sequelae in combat casualty injuries than in civilian trauma cases.  The extent of injury, the mechanism of injury, and attempts to preserve limb length through the zone of injury are suspected to play a role.  Describe the mechanisms of the disease, develop a means of minimizing the disease process while allowing normal healing to occur, or determine the burden of the disease.

Develop a treatment through tissue engineering or regenerative medicine technologies to improve healing and return function to patients who have sustained a significant loss of muscle tissue, nerve, blood vessels, or skin.

Develop systems or evidence-based guidelines for the assessment of injured tissue and optimal timing and techniques of irrigation and debridement that will reduce infection rates.

Implement innovative research methods to evaluate the translation of orthopaedic trauma research into clinical practice that result in measurable improvements in clinical outcomes.  Three specific priorities for these projects are:

1. Determine the extent of evidence-based medicine that is being performed in the orthopaedic trauma community.  Emphasis should be on the military population or injuries that are relevant to the military population.
2. Compare the use of various interventions that successfully translate orthopaedic trauma research findings into practice.
3. Measure the impact of translation activities and interventions that foster measurable and sustainable quality and patient safety improvement or consistent quality and patient safety at a lower cost.