Orthopaedic Traumatology Fellowship

Orthopaedic Traumatology Fellowship 2014-15



Saint Louis University is an ACS designated Level 1 trauma center for both the states of Missouri and Illinois. It is the largest trauma center in the state of Missouri in numbers of patients seen. The fellowship provides the fellow with a diverse experience incorporating 9 full time traumatologist all with designated areas of interest and expertise. The Trauma service at SLU Hospital has a chief resident, a senior resident, 3 junior residents, an ortho intern, a surgical rotator, and varying numbers of medical students. Additionally, there is a trauma nurse practitioner and clinical trauma nurse that help manage the service.

In addition, we run the Orthopaedic trauma service at Mercy Medical Center, a 900+ bed State verified Level 1 Trauma center in suburban West county St. Louis.  A full service trauma team has been assembled with a chief resident, 3 junior residents, full time 24/7 P.A. coverage and a traction /cast tech.

The Fellowship has been training fellows since 1993 with the same core faculty , beginning in Detroit, Michigan. The fellowship is accredited by the Orthopaedic Trauma Association and participates in the ortho trauma match for the selection of candidates.

An active spine trauma, and microvascular hand service is also available if the fellow has an interest in these areas …This is optional but you are certainly welcome, and these faculty would be happy to have you scrub and assist in their trauma cases.

Obviously the fellow assumes a very crucial role in the management of patients at both institutions. The fellow runs the trauma service in conjunction with the chief residents on the service. Our total daily census ranges between 35 and 45 patients. With 2 trauma centers, running 3 ortho trauma O.R.’s every day, the volume of cases the fellow has to choose from is substantial.

The fellow is able to select the cases that he/she feels will benefit their interests and future goals, and thus has the “pick of the litter”, in terms of cases to scrub. There is NO assigned fellow service. The fellowship is definitely a surgical fellowship and the fellow is 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 (always direct supervision). For the more sub specialized complex trauma or reconstruction cases, the attending will be the primary surgeon with the fellow as first assistant..(or primary surgeon depending on the skill level.) The fellow is free to pick the most appropriate case throughout the day and is NOT married to one particular staff. If necessary or available, the fellow may be asked to staff a routine trauma case if additional rooms become available during the course of a day. I.e. washout, ankle fx, femoral nail etc. but this is NOT in lieu of a primary trauma case of interest to the fellow.

Total number of ER Orthopaedic Trauma Admissions for the combined institutions’ for the 2012-13 academic year…4046 admissions.

Total operative procedures performed by the trauma service during 2012-13 > 3200 procedures.….
The most recent case numbers submitted to the OTA for accreditation are as follows:
Fellow cases 2012-13
Pelvic and Acetabular surgery : 124 cases.
Humerus and Elbow: 42 cases
Femur and Knee: 104
Leg and Ankle: 159
Foot and Toes: 31
The fellow scrubbed a total of 823 cases

In addition to the large numbers of acute poly and monotrauma patients treated, a large volume of post-traumatic reconstruction surgery is performed including: Ilizarov reconstruction for nonunions, malunions, post-tramatic osteomyelitis and leg length discrepancy. Complex hindfoot and ankle reconstruction and hip related osteotomies.
The trauma fellow is expected to be able to actively teach the residents basic tenets of trauma care, the evaluation and management of trauma patients and operative principles of long bone fracture fixation. The fellow will co-ordinate clinic participation amenable with the fellows desire to learn the basics of managing a busy clinical outpatient setting and is expected to attend at least one specialty trauma clinic per week.

The specialty clinics are designed to give a concentrated clinic experience in one select area of orthopedic traumatology. These include the Trauma Foot and ankle clinic, nonunion / deformity / Ilizarov clinic, Pelvis and Acetabular fracture clinic and general trauma clinic. The fellow will participate with the appropriate faculty where surgical indications are emphasized as well as the subtleties of management are reviewed.

CALL RESPONSIBILITIES: There is no call for the first month, supervised call the 2nd month and then the call is monitored supervision beginning the 3rd month of the fellowship. Thus, 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 on call if the fellow has questions or problems and can call the faculty in at any time deemed necessary Call averages approx. 5-7 times per month depending on trauma staff schedules, and is divided between the two institutions.

In addition to the vast clinical experience, ample opportunity exists for basic science research opportunities in the areas of Fracture Biomechanics and Orthobiologics. Our biomechanics and cellular biology labs are staffed by full time PhD’s with their masters and doctoral candidates with their labs dedicated to collaborative orthopaedic research projects.

Previous fellows have obtained a wide variety of positions, including academic traumatologists’ running trauma services’ at the Naval Medical Center , San Diego; State Univ. New York, Buffalo; LSU, New Orleans; and University of Colorado , Denver. Other previous fellows are heading trauma services for large orthopaedic groups practicing in community based Level I or II institutions…. In Walnut Creek and Sacramento, CA; Athens, Georgia; Hollywood and Ft. Lauderdale FL; Bangor MA; and Suburban Winsor CN.

Fellowship Director and Chief of the Orthopaedic Traumatology Service
J. Tracy Watson M.D.

For more information contact our departmental administrator
Janell Britton 314-577-8850 ext.21355