Harvard Orthopedic Trauma Research Division

Harvard Orthopedic Trauma Research Division

The Harvard Orthopedic Trauma Research Division is an inter-institutional, multi-disciplinary team dedicated to understanding the human biological and clinical processes associated with traumatic orthopedic injuries.

Overview

The Harvard Orthopedic Trauma Service Research Unit is an inter-institutional effort between four core institutions: Massachusetts General Hospital, Brigham & Women’s Hospital, Beth Israel Deaconess Medical Center, and Children’s Hospital. It is our mission to improve the clinical, functional and quality of life outcomes of patients with traumatic musculoskeletal injuries through novel and innovative clinical research. The Harvard Orthopedic Trauma Service has a history of successful research collaborations with investigators from many Medical and Surgical specialties including Emergency Medicine, General Surgery, Endocrinology, Physical therapy, Biomechanics, and Psychometrics.

Group Members

Faculty:

Program Director:

  • Suzanne Morrison, MPH

Research Project Manager:

  • Michael McTague

Research Coordinator:

  • Robert Lucas

Research Projects

Evaluating the recovery process in patients 65 and over after a pelvic fracture

The goal of this study is to assess how elderly patients with a pelvic fracture heal and recover. These fractures will usually heal without surgery.

If you decide to participate in this study, you will complete a series of questionnaires about how you are recovering from your pelvic fracture. You will complete these questionnaires when you are first seen for your pelvic fracture; six weeks after your injury, three months after your injury, six months after your injury, and one year after your injury. It will take you about 15 minutes to answer these questions, and you can do this over the phone and at your convenience. Your answers will help us to understand how patients fare after sustaining this injury so that we can provide patients and their families with better information about the recovery process.

To learn more about “Functional Outcomes of Geriatric Low-Energy Pelvic Fractures,” please contact Michael McTague at 617-643-3653 or mmctague@partners.org

Is surgery required to treat small wounds near the joint?

We believe that small wounds or cuts near a joint such as the knee or elbow do not require a kind of surgery called “irrigation and debridement” to clean out the wound of any dirt or infection. These wounds, which are called arthrotomies, can be treated with stitches and antibiotics in the Emergency Department.

Patients with these types of wounds are eligible for this study. All patients who have these injuries will receive a washing of the wound in the Emergency Department and stitches, antibiotics, and x-rays of the wound. If you decide to participate in this study, you will receive a telephone call 48 hours after you leave the hospital and we will ask you about your wound. You will need to come back to the hospital for appointments with your orthopedist two weeks, four weeks, and three months after your first treatment. The only parts of this study that are not part of the normal way we treat patients with this injury is the phone call and the three month appointment.

To learn more about “Occult Traumatic Arthrotomies: Is Clinical Confirmation and Surgical Management Really Necessary?”, please contact Michael McTague at 617-643-3653 or mmctague@partners.org

A new technique to measure healing in the bone

We are conducting this research study to examine how your knee bone fracture (distal femur fracture) heals. In this study, we will use Radiostereometric Analysis (RSA) to look at how the pieces of your bone move. RSA is a special x-ray that can be used to measure very small movements in bone over time. Patients that are eligible for this study will have surgery using a metal plate to fix their fracture.

If you were to enroll in this study, we would place 9 to 27 tiny metal beads (made of tantalum) in the bone above your knee. The beads would mark the location of your bone to see how it moves and knits together over time. The beads do not move and you will not feel them. The beads are permanent and will not be removed.

After your surgery, we will take RSA x-rays at your regular follow-up appointments: two weeks after your surgery, six weeks after your surgery, three months after your surgery, six months after your surgery, and one year after your surgery. The RSA x-rays will show the beads in the bone in your thigh just above your knee. A computer program will measure how your bone is healing and whether it has moved since your surgery.

To learn more about “Radiostereometric Analysis of Fracture Healing in Distal Femur Fractures,” please contact Michael McTague at 617-643-3653 or mmctague@partners.org

Does extra oxygen during surgery lower the risk of infection after surgery?

We are conducting this research study to see if giving a patient more oxygen during surgery results in a lower risk for infection during their recovery. This will help determine the best treatment for severe lower leg injuries. Some broken bones are more likely to get an infection after surgeries, due to the way they were injured. These injuries include: a break at the top or bottom of the larger bone in your lower leg (tibia) or a break in the weight-bearing bone in your foot (calcaneus). Patients with these types of fractures are eligible for this study.

If you participate in this study, you will be assigned by chance to one of two groups. One group would receive extra oxygen during surgery. The other group would receive the normal amount of oxygen during surgery. After surgery, you will be asked to come back to the clinic and follow up with us at two weeks, three months, and six months. These visits would part of your routine follow-up with your treating physician. At the six-month visit, we would ask you questions about your recovery. At 12 months, we would call you for a final follow-up.

To learn more about “Supplemental Perioperative Oxygen to Reduce Surgical Site Infection After High Energy Fracture Surgery,” please contact Michael McTague at 617-643-3653 or mmctague@partners.org

Orthopedic Trauma patients’ opinion on medical marijuana

The aim of this study is to evaluate the opinions of the orthopedic trauma patient population about the new Massachusetts medical marijuana laws. Any patient who was injured 1 month to 6 months ago is eligible for this study. We would ask you questions about medical marijuana and about your state of mind during your recovery from your injury. This confidential questionnaire takes about 5-10 minutes to complete.

To learn more about “Stance of Orthopedic Trauma Population on Medical Marijuana: A Prospective Analysis,” please contact Michael McTague at 617-643-3653 or mmctague@partners.org

Research Positions

Publications

Select Publications:

  1. Chaus GW, Heng M, Smith RM. Occult internal iliac arterial injury identified during open reduction internal fixation of an acetabular fracture: a report of two cases. Injury. 2015 Jul;46(7):1417-22. doi: 10.1016/j.injury.2015.04.030. Epub 2015 May 8.
  2. Karadsheh MS, Weaver MJ, Rodriguez K, Harris MB, Zurakowski D, Lucas R. Mortality and Revision Surgery Are Increased in Patients With Parkinson's Disease and Fractures of the Femoral Neck. Clin Orthop Relat Res. 2015 Oct;473(10):3272-9. doi: 10.1007/s11999-015-4262-5. Epub 2015 Mar 24.
  3. Karim L, Van Vliet M, Bouxsein ML. Comparison of cyclic and impact-based reference point indentation measurements in human cadaveric tibia. Bone. 2015 Apr 7. pii: S8756-3282(15)00109-X. doi: 10.1016/j.bone.2015.03.021.
  4. Nazarian A, Entezari V, Villa-Camacho JC, Zurakowski D, Katz JN, Hochman M, Baldini EH, Vartanians V, Rosen MP, Gebhardt MC, Terek RM, Damron TA, Yaszemski MJ, Snyder BD. Does CT-based Rigidity Analysis Influence Clinical Decision-making in Simulations of Metastatic Bone Disease? Clin Orthop Relat Res. 2015 May 29. [Epub ahead of print]
  5. Okike K, Lee OC, Makanji H, Morgan JH, Harris MB, Vrahas MS. Comparison of locked plate fixation and nonoperative management for displaced proximal humerus fractures in elderly patients. Am J Orthop (Belle Mead NJ). 2015 Apr;44(4):E106-12.
  6. Rajab TK, Weaver MJ, Havens JM. Videos in clinical medicine. Technique for temporary pelvic stabilization after trauma. N Engl J Med. 2013 Oct 24;369(17):e22. doi: 10.1056/NEJMvcm1200383
  7. Rodriguez EK, Boulton C, Weaver MJ, Herder LM, Morgan JH, Chacko AT, Appleton PT, Zurakowski D, Vrahas MS. Predictive factors of distal femoral fracture nonunion after lateral locked plating: a retrospective multicenter case-control study of 283 fractures. Injury. 2014 Mar;45(3):554-9. doi: 10.1016/j.injury.2013.10.042. Epub 2013 Nov 4.
  8. Ting B, Zurakowski D, Herder L, Wagner K, Appleton P, Rodriguez EK. Preinjury ambulatory status is associated with 1-year mortality following lateral compression Type I fractures in the geriatric population older than 80 years. J Trauma Acute Care Surg. 2014 May;76(5):1306-9. doi: 10.1097/TA.0000000000000212
  9. Vranceanu AM, Bachoura A, Weening A, Vrahas M, Smith RM, Ring D. Psychological factors predict disability and pain intensity after skeletal trauma. J Bone Joint Surg Am. 2014 Feb 5;96(3):e20. doi: 10.2106/JBJS.L.00479.
  10. Weaver MJ, Owen TM, Morgan JH, Harris MB. Delayed Primary Closure of Fasciotomy Incisions in the Lower Leg: Do We Need to Change Our Strategy? J Orthop Trauma. 2015 Jul;29(7):308-11. doi: 10.1097/BOT.0000000000000278.

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