Summer - United States Special Operations Command

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Summer 09 Volume 9, Edition 3FEATURE ARTICLESField Evaluation and Management of Non-Battle Related 1Knee and Ankle Injuries by the ATP in the AustereEnvironment: Part ThreeJ.F. Rick Hammesfahr, MDNATO SOF Transformation and the Development of 7NATO SOF Medical Doctrine and Policy.LTC G. Rhett Wallace, MD FAAFPDamage Control Resuscitation for the Special Forces 14Medic: Simplifying and Improving Prolonged TraumaCare: Part OneCOL Gregory Risk MD; Michael R. Hetzler 18DReview Article of the Use of Early Hypothermia in the22Treatment of Traumatic Brain InjuriesJess Arcure BS, MSc; Eric E. Harrison MDEmergency Lateral Canthotomy and Cantholysis: 26A Simple Procedure to Preserve Vision from SightThreatening Orbital HemorrhageCPT Steven Roy Ballard, MD; COL Robert W. Enzenauer,MD, MPH; Col (Ret) Thomas O’Donnell, MD; James C.Fleming, MD; COL Gregory Risk, MD, MPH, FACEP;Aaron N. Waite, MDTinnitus, a Military Epidemic… Is Hyperbaric Oxygen 33Therapy the Answer?LCDR Thomas M. Baldwin, MD, MPTBrain Natriuretic Peptide Levels in Six Basic UnderwaterDemolitions/SEAL Recruits Presenting with SwimmingInduced Pulmonary Edema (SIPE)LCDR Damon Shearer (DMO/UMO) MDCDR Richard Mahon (DMO/UMO) MDAbstracts from Current Literature 51Previously Published 59Contents● Central Retinal Vein Occlusion in an Army Ranger withGlucose-6-Phosphate Dehydrogenase Deficiency● Should We Teach Every Soldier How to Start an IV?● Psychological Resilience and Postdeployment Social SupportProtect Against Traumatic Stress and DepressiveSymptoms in Soldiers Returning From Operations EnduringFreedom and Iraqi Freedom● Psychosocial Buffers of Traumatic Stress, Depressive Symptoms,and Psychosocial Difficulties in Veterans of OperationsEnduring Freedom and Iraqi Freedom: The Role ofResilience, Unit Support, and Postdeployment SocialSupport44Editorials 79LTC Craig Myatt, PhD; Douglas C. Johnson, PhDBook Reviews 81● Blackburn’s Headhunters● The Battle of Mogadishu: Firsthand Accounts from the Menof Task Force RangerFrom the USSOCOM Command Surgeon 86COL Tom DealComponent Surgeons 87COL Peter BensonBrig Gen (S) Bart IddinsCAPT Jay SourbeerCAPT Anthony GriffayUSASOCAFSOCNAVSPECWARMARSOCTSOC Surgeons 92COL Rocky FarrSOCCENTCOL Frank NewtonUSASFC Surgeon 96LTC Andrew LandersSOCPACNATO Surgeon 97LTC Rhett WallaceUSSOCOM Psychologist 99LTC Craig Myatt, PhDUSSOCOM Veterinarian 101LTC Bill Bosworth, DVMNeed to Know 104Navy Safe HarborSOF Reading List 105Educational Resources 121Photo Gallery 127Meet the JSOM Staff 129Submission Criteria 130Journal of Special Operations Medicine Volume 9, Edition 3 / Summer 09
Field Evaluation and Management of Non-BattleRelated Knee and Ankle Injuries by the ATP in theAustere Environment — Part ThreeJF Rick Hammesfahr, MDEditor’s Note: Part Three consists of ankle injury evaluation and taping.Part Two (taping procedures for the various knee injuries) was published in the JSOM Spring 09, Vol 9 Ed 2.Part One (evaluation of knee injuries) was published in the JSOM Winter 09, Vol 9 Ed 1.ANKLEThe most commonly injured ankle ligament isthe anterior talo-fibular ligament (ATFL) located at theanterolateral aspect of the ankle (Figure 58).Figure 59: Plantarflexion and inversion ofthe ankle leads to abnormal stretching andtearing of the anterior talo-fibular ligament(ATFL).Figure 58: Anterior talo-fibular ligament locationat the anterolateral aspect of the ankle.With respect to ankle sprains and injury to theATFL, the typical mechanism of injury involves a forcedmotion that is best described as a plantarflexion – inversiondeforming force (Figure 59).This injury is often accompanied by a history ofa pop; the patient often states that they rolled their ankle;there is pain and swelling with the most intense area ofsymptoms located at the anterolateral aspect of the ankle.When intact, the ATFL goes from the distal aspectof the fibula to the talus. In this position, it acts asa checkrein to prevent abnormal posterior subluxationof the tibia relative to the talus (Figure 60).Figure 60: Intact AFTL preventssubluxation of the tibia and fibularcomplex relative to the talus.Field Evaluation and Management of Non-Battle Related Knee and Ankle Injuries by the ATP in theAustere Environment — Part Three1
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ABSTRACTS FROM CURRENT LITERATUREMa
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tourniquet times are less than 6 ho
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tal from July 1999 to June 2002. In
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Operation Sadbhavana: Winning Heart
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CENTRAL RETINAL VEIN OCCLUSION IN A
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of the X chromosome. Notable is tha
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AUTHORS*75th Ranger Regiment6420 Da
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Casualties presenting in overt shoc
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PSYCHOLOGICAL RESILIENCE AND POSTDE
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spondents without PTSD (M = 4.6, SD
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patients, whereas the mean score of
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29. Whealin JM, Ruzek JI, Southwick
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average, time between return from d
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ing functioning in both PTSD (Zatzi
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Editorial Comment on “Psychologic
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Blackburn’s HeadhuntersPhilip Har
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The Battle of Mogadishu:Firsthand A
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Task Force Ranger encountered enemy
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Peter J. Benson, MDCOL, USACommand
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Numerous military and civilian gove
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Anthony M. Griffay, MDCAPT, USNComm
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This is a great read that speaks di
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and twenty-eight. Rabies immune glo
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Rhett Wallace MD FAAFPLTC MC SFS DM
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LTC Craig A. Myatt, Ph.D., HQ USSOC
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LTC Bill Bosworth, DVM, USSOCOM Vet
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Europe, Mideast, Africa and SWAU.S.
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SOF and SOF Medicine Book ListWe ha
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TITLE AUTHOR ISBNCohesion, the Key
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TITLE AUTHOR ISBNI Acted from Princ
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TITLE AUTHOR ISBNRats, Lice, & Hist
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TITLE AUTHOR ISBNThe Healer’s Roa
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TITLE AUTHOR ISBNGuerilla warfare N
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TITLEAUTHORBlack Eagles(Fiction)Bla
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TITLE(Good section on Merrill’s M
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GENERAL REFERENCESALERTS & THREATSB
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Aviation Medicine Resources: http:/
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LABORATORYClinical Lab Science Reso
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A 11 year old boy whose tibia conti
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Meet Your JSOM StaffEXECUTIVE EDITO
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Special Forces Aidman's PledgeAs a
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Summer - United States Special Operations Command

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