Saint Louis University’s orthopaedic traumatology fellowship offers a diverse experience incorporating nine full-time traumatologists all with designated areas of interest and expertise.
The trauma service at SSM Health Saint Louis Hospital has a chief resident, a senior resident, three junior residents, an orthopaedic intern, a surgical rotator, and varying numbers of medical students from SLU. Additionally, a trauma nurse practitioner and clinical trauma nurse help manage the service.
An American College of Surgeons designated Level 1 trauma center for Missouri and Illinois, the hospital also sees the largest number of patients of any trauma center in Missouri.
In addition, our division runs the orthopaedic trauma service at Mercy Hospital St. Louis, a more than 900-bed state verified Level 1 Trauma center in St. Louis County. A full-service trauma team has been assembled with a chief resident, three junior residents, P.A. coverage, and a traction/cast technician.
SLU’s orthopaedic traumatology fellowship is accredited by the Orthopaedic Trauma Association and participates in the orthopaedic trauma match for the selection of candidates.
An optional active spine trauma and microvascular hand service is also available if the fellow has an interest.
Fellows assume a crucial role in the management of patients at SSM Health Saint Louis University Hospital and Mercy Hospital St. Louis and run the trauma service in conjunction with the chief residents on the service. Daily census ranges between 35 and 45 patients. With two trauma centers running three orthopaedic trauma operating rooms every day, the number of cases to choose from is substantial.
There is no assigned fellow service. Fellows can select the cases that they feel will benefit their interests and future goals. This is a surgical fellowship and fellows are expected to take full advantage of all the operative opportunities afforded.
During the day, the fellow is scrubbed as the operating surgeon with the faculty scrubbed as the first assistant and providing direct supervision. For more subspecialized, complex trauma or reconstruction cases, the attending will be the primary surgeon with the fellow as the first assistant (or primary surgeon depending on the skill level).
Fellows are free to pick the most appropriate case throughout the day and is not tied to a particular staff surgeon. If necessary or available, fellows may be asked to staff a routine trauma case if additional rooms become available during the day (e.g., washout, ankle fracture, femoral nail, etc.) but not in lieu of a primary trauma case of interest to the fellow.
Our trauma fellows are expected to be able to actively teach residents basic tenets of trauma care, the evaluation and management of trauma patients and operative principles of long bone fracture fixation. Fellows coordinate clinic participation and are expected to attend at least one specialty trauma clinic per week.
The most recent case numbers submitted to the OTA in 2012-2013 for accreditation are as follows:
The fellow scrubbed in for a total of 823 cases.
In addition to the large numbers of acute polytrauma and monotrauma patients treated, a large volume of posttraumatic reconstruction surgery is performed including Ilizarov reconstruction for nonunions, malunions, posttraumatic osteomyelitis and leg length discrepancy. Complex hindfoot and ankle reconstruction and hip related osteotomies.
Our specialty clinics are designed to give a concentrated clinic experience in a select area of orthopedic traumatology. They include the Trauma Foot and Ankle Clinic, Nonunion/Deformity/ Ilizarov Clinic, Pelvis and Acetabular Fracture Clinic and the General Trauma Clinic. Our fellows participate with the appropriate faculty where surgical indications are emphasized and the subtleties of management are reviewed.
There is no call for the first month, supervised call for the second month and then the call is under monitored supervision beginning the third month of the fellowship.
After the second month, the fellow will take independent night call as an attending on the trauma service with full operative privileges. There is always a backup faculty member on call if the fellow has questions or problems and fellows can call the faculty in at any time deemed necessary. Call averages approximately five to seven times per month depending on trauma staff schedules and is divided between the two institutions.
In addition to the vast clinical experience offered in the course of this fellowship, there are many basic science research opportunities in the areas of fracture biomechanics and orthobiologics. Our biomechanics and cellular biology labs are staffed by full-time Ph.D.s and their master’s and doctoral candidates. The labs are dedicated to collaborative orthopaedic research projects.
Our previous fellows have obtained a wide variety of positions, including academic traumatologists running trauma services at the Naval Medical Center in San Diego, State University New York in Buffalo, Louisiana State University in New Orleans, and the University of Colorado in Denver.
Other previous fellows are heading Level One or Two trauma services for large orthopaedic groups practicing in community-based institutions nationwide.