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The Newsletter of the Orthopaedic Trauma Association Winter 2013

Message from the President Robert A. Probe, MD

Inside (p. 1) President’s Message From the Editor (p. 2) 2013 Educational Opportunities (p. 3) NEW OTA Acute Course Resident’s Courses (p. 4) 2013 Specialty Day (p. 6) 2013 Webinar Calendar (p. 7) OTA Research Fund Campaign Thank You Donors (p. 8) Annual Meeting Highlights (p. 11) Membership Research Basic Science (p. 12) Public Relations (p. 14) OTA Mentorship Pgms NEW Committee (p. 15) Fellows Corner Become a Part of METRC (p. 17) 2013 OTA Annual Meeting (p. 18) Announcements

The Best Holiday Party The Holiday Season provides us a much anticipated time for family and Seasonal Gatherings. Many of these become construed as obligatory “drop bys” while a few get highlighted on our calendars as “can’t miss.” This year, my can’t miss party was the annual gathering of current and past Board Members of our Hospital System (Figure 1). Annually, one of the highlights of the season; catching up on the personal and professional lives of colleagues, bowl predictions and speculations on the future of Health Care. For better or worse, this years festivities fell on December 10th, a call night. The Orthopaedic Trauma rooms had been packed all day and despite our valiant efforts to get the days work done, it became apparent the day’s dose of open Figure 1 fractures, compartment syndromes and the like, had pushed our last periprosthetic femur fracture into the evening hours. As we got to work on the last case, my mind wandered with transient thoughts of eggnog, cocktails and the dinner party that was I was missing. This preoccupation didn’t last long and was soon replaced with concerns of a BMI f 38, aortic stenosis, stented coronary artery disease and bleeding from irreparably poisoned platelets. The ensuing hours were testing; reduction challenges, an enormous leg, a vexing ooze of continued on page

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Message From the Editor Hassan R. Mir, MD

Happy Holidays to everyone! This edition of the newsletter reviews some of the highlights from the highly successful 2012 Annual Meeting. Additionally, there are multiple committee reports and columns, including notice of the newly formed Evidence Based Quality Value Committee, a Fellowship Column on electronic case logs, and a great message from Dr. Probe reminding us all why we are part of this field. Some winter reminders: • Sign up for OTA Specialty Day • Abstract Deadline for the 2013 OTA Annual Meeting is February 5, 2013 The next edition of the newsletter will be a brief NewsFlash prior to the AAOS Meeting. Please send any suggestions, content and photos to Hassan.Mir@Vanderbilt.edu.


Educational Opportunities January 29, 2013 “Proximal Humerus Fractures: Decision Making & Methods” * * * Webinar * * * 7:30 p.m. CDT - 8:30 p.m. CDT

Registration Complimentary

Michael J. Gardner, MD, Moderator

February 5, 2013

Annual Meeting Abstract Deadline

February 22 - 23, 2013

March 23, 2013

April 10 - 13, 2013

Advanced Trauma Techniques Course for Residents

Los Angeles, California, USA Brett D. Crist, MD & Matthew A. Mormino, MD, Course Co-Directors

OTA Specialty Day Meeting Chicago, Illinois, USA

OTA Spring Comprehensive Fracture Course for Residents 2.0 Lombard, Illinois, USA

Matt L. Graves, MD & Gregory J. Della Rocca, MD,PhD,FACS, Course Co-Directors

April 18 - 21, 2013

Orthopaedic Trauma Fellows Course

April 25 - 27, 2013

13th Annual AAOS/OTA Trauma Update Course: Current Management Concepts, Techniques & Practical Solutions

May 4, 2013

Boston, Massachusetts, USA Paul Tornetta, III, MD, Course Director

La Jolla, California, USA Steven J. Morgan, MD & Frank A. Liporace, MD, Course Co-Directors

OTA Acute Care Course

Denver, Colorado, USA Wade R. Smith, MD & Philip R. Wolinsky, MD, Course Co-Directors

For Details of All OTA Events:

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OTA website: http://www.ota.org Phone: 847.698.1631 Fax: 847.823.0536 Email: ota@aaos.org


OTA Acute Course

Wade R. Smith, MD and Philip R. Wolinsky, MD

The Orthopedic Trauma Association will NEW present brief talks followed by case based discussions relevant to the challenges facing offer a course entitled Acute Ortho Trauma Care on call surgeons in every setting. Course chair (AOTC) in Denver, May 4, 2013. The purpose is Philip Wolinsky, MD notes, “This course is, in to provide up to date, practical information for particular, aimed at assisting on-call Orthopaedic Orthopaedic Surgeons taking Trauma call at level surgeons to do the right things for their patients. 1,2,3 and 4 trauma centers. The focus will be on topics Orthopaedic trauma care has changed greatly in the of ongoing evolution for on call surgeons, such as past years and our goal is to provide the practical timing of open fracture management, emergent vs details of current standards to our colleagues who are urgent operative cases and tips and tricks for efficient taking call throughout the USA.” fracture care. Experienced OTA faculy members will

OTA Residents Advanced Trauma Techniques Course

Advanced Trauma Techniques Course for Residents An Intensive 2-day OTA Symposium for Senior Residents

The Orthopaedic February 22 - 23, 2013 Trauma Association will hold the 9th Annual Advanced Trauma Techniques Course for Residents, February 22 – February 23, 2013 at the Hyatt Regency Century Plaza, in Los Angeles, CA. Being offered in the new modular format, this course is designed for the advanced level orthopaedic resident and will include modules covering Pelvis, Acetabulum & Hip, Knee, Foot and Ankle, Elbow and Shoulder/Wrist, Diaphyseal and Complications/ Challenges. Registration for the course is now open. You may also make your hotel reservations for the Hyatt Regency Century Plaza Hotel online. Questions can be directed to the OTA staff office at 847.698.1631 or email ota@aaos.org. Hyatt Regency Century Plaza Hotel, Los Angeles, California, USA Generous scholarships available!

Program Co-Chairs: Brett D. Crist, MD & Matthew A. Mormino, MD OTA Education Chair: William M. Ricci, MD

For the third year, the OTA is offering a reformatted junior resident comprehensive fracture course.  The Comprehensive Fracture experience will be presented Course for Residents 2.0 in six separate small group Preliminary Program April 10 - 13, 2013 modules, with twenty residents and five experienced faculty educators per module. Westin Lombard Yorktown Center The modules will have a Lombard, Illinois rapid-fire series of minilectures, an extensive open case-based discussion, video demonstrations of techniques, and hands-on skills lab exercises. Modules will cover fundamental principles of fracture care distributed among six topics: diaphyseal, articular, foot & ankle, geriatrics, pediatrics, and pelvis/polytrauma. The course is being held at the Westin Hotel in Lombard, Illinois, April 10-13, 2013.  Thanks to generous industry support, tuition scholarship are available ($600 course fee minus $400 scholarship for a net registration fee of $200).  Travel Scholarships also available covering a 3-nights stay at the hotel.  We encourage PGY 2-4’s to attend.  Please check the OTA website for details about the course as they become available.  Hotel reservation information and scholarship information will be posted as well.   Questions? Contact the OTA Business Office at 847-698-1631 or ota@aaos.org.  WEDNESDAY - SATURDAY

Brett D. Crist, MD, Matthew A. Mormino, MD, Matt L. Graves, MD and Gregory J. Della Rocca, MD, PhD, FACS

Reformatted OTA Residents Comprehensive Fracture Course Being Offered April 10-13, 2013

April 10-13, 2013

Resident’s Courses

Matt L. Graves, MD, Chair Gregory J. Della Rocca, MD, PhD, FACS, Co-Chair

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2013 OTA Specialty Day

OTA Specialty Day

Robert A. Probe, MD

March 23, 2013 Chicago, Illinois

Planning Committee: Robert A. Probe, MD, OTA President

M. Bradford Henley, MD, Clifford B. Jones, MD, Robert F. Ostrum, MD, David C. Teague, MD, David B. Thordarson, MD, Paul Tornetta, III, MD Featuring: To Fix or How to Fix: That Is the Evidence Based Question Moderator: William T. Obremskey, MD Presenters: Michael R. Baumgaertner, MD, Douglas P. Hanel, MD,

J. Lawrence Marsh, MD, Michael D. McKee, MD, Emil H. Schemitch, MD

  Managing Osteoporotic Fractures: How to Be on Top of Your Game and Avoid Complications!

Moderator: Clifford B. Jones, MD Presenters: Charles M. Court-Brown, MD, Paul J. Duwelius, MD,

Michael J. Gardner, MD, Stephen L. Kates, MD, Richard F. Kyle, MD, William N. Levine, MD

Trauma Techniques: Top Videos

Moderator: Robert F. Ostrum, MD

Presenters: Andrew R. Burgess, MD, Michael J. Gardner, MD, Erik Kubiak, MD, David C. Ring, MD, Andrew H. Schmidt, MD

  New Tips and Tricks from the OTA Annual Meeting for your Trauma Practice Moderator: James A. Goulet, MD

  Case-Based Nonunion Management

Moderator: Paul Tornetta, III, MD Presenters: Mark R. Brinker, MD, Roy Sanders, MD,

Heather A. Vallier,  MD,  Donald A. Wiss, MD

Combined Session: Controversies and Complications in Trauma of the Foot and Ankle Lisfranc Injuries: Fusion vs ORIF

Moderator: Robert B. Anderson, MD Presenters: J. Chris Coetzee, MD, Ross K. Leighton, MD

Calcaneus: - Extensile vs Minimally Invasive Moderator: Roy Sanders, MD Presenters: Stephen K. Benirschke, MD,

Dr. med. Stefan Rammelt, Bruce J. Sangeorzan, MD

Ankle: Syndesmosis Controversies Moderator: William C. McGarvey, MD Presenters: John S. Early, MD,

Paul Tornetta, III, MD, William C. McGarvey, MD,

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Ankle: Posterior Malleolus: To Fix or Not to Fix

Moderator: Robert A. Probe, MD Presenters: Dean G. Lorich, MD, David B. Thordarson, MD

Do not miss the 2013 OTA Specialty Day! The agenda offers engaging and relevant topics, and will include case discussions, top trauma techniques video and discussion, and the use of the Audience Response System (ARS) to facilitate audience participation throughout the day. The American Academy of Orthopaedic Surgeons designates this live activity for a maximum of 8 AMA PRA Category 1 Credits™. Click on this link for the complete preliminary program. Educational Objectives: • Utilize current evidence to direct the treatment of common fractures. • Acquire techniques that improve the management of osteoporotic fractures. • Improve surgical skills through video demonstration by experts • Discern nuances of presentation and management of nonunions • Compare and contrast operative treatment strategies and approaches to traumatic injuries of the foot and ankle. • Develop insight into the most current recommendations for fracture care Planning Committee: Robert A. Probe, MD, OTA President; M. Bradford Henley, MD, MBA; Clifford B. Jones, MD; Robert F. Ostrum, MD; David C. Teague, MD; David B. Thordarson, MD; and Paul Tornetta, III, MD. AOFAS / OTA Combined Session: Controversies and Complications in Trauma of the Foot and Ankle AOFAS Program Co-Chairs: John G. Anderson, MD and Donald Bohay, MD


While Attending the AAOS Annual Meeting and OTA Specialty Day...

From the President, continued from pg. 1

blood from any incised surface and a team of residents who had already put in a long day. This constellation of circumstances would seem to provide the background for miserable evening. Nothing could be further from the reality. From somewhere within that operating room came forth the true sense of the holiday spirit. A group of individuals, bringing their collective talents to bear, so that our patient would spend his holidays up and on his way to recovery. This patient’s extended family had waited late into the night to see how “grandpa� had come through the surgery. As I related the operative challenges and ultimate success (Figure 2) of the evening’s work, I couldn’t help but reflect on the joy of being an Orthopaedic Traumatologist. A profession where our mentors have given us the gifts of skill and judgment that allow us to do what we do. While I hope next season doesn’t bring another “grandpa� in need, I am comforted by knowing that our organization is filled with those who find joy in being there if he does.

There is a myriad of trauma-related educational offerings during the AAOS Annual Meeting. This link has the complete schedule of all trauma events beginning on Tuesday, March 19 through Friday, March 22. Each event within can be selected to obtain extended details.

Robert A. Probe, MD

AAOS Trauma Offerings

Tuesday, March 19, 2013

8:00 AM - 10:00 AM

2-HOUR INSTRUCTIONAL COURSE

8:00 AM - 11:00 AM

3-HOUR INSTRUCTIONAL COURSE

8:00 AM - 6:00 PM

ORTHOPAEDIC VIDEO THEATER

McCormick Place, Academy Hall B

POSTERS

McCormick Place, Academy Hall B

SCIENTIFIC EXHIBIT

McCormick Place, Academy Hall B

McCormick Place, Lakeside, Room E352 109 – Treatment of Tibial Plateau Fractures 181 – Trauma Review Course

Trauma OVT

P466 - P525. Trauma Posters 6(6(7UDXPD6FLHQWLĂ€F([KLELWV

8:00 AM - 10:00 AM

McCormick Place, Room N228



McCormick Place, Room S406 $/RZHU([WUHPLW\1DLOLQJ:KDW&DQ%H1DLOHG :KDW6KRXOGEH1DLOHGDQG7HFKQLFDO3HDUOVIRU6XFFHVV

10:30 AM - 12:30 PM

2-HOUR INSTRUCTIONAL COURSE

SYMPOSIUM

McCormick Place, Room S103a ²,PSURYLQJ2XWFRPHV8QGHUVWDQGLQJWKH Psycho-Social Aspects of the Orthopaedic Trauma Patient

PAPER PRESENTATIONS

016 - 030. Trauma I

1:30 PM - 3:30 PM

2-HOUR INSTRUCTIONAL COURSE

4:00 PM - 6:00 PM

2-HOUR INSTRUCTIONAL COURSE

4:30 PM - 5:30 PM

POSTER TOURS

McCormick Place, Room N427

McCormick Place, Room S104 ²7KH1RW6R6LPSOH$QNOH)UDFWXUH Avoiding Problems and Pitfalls to Improve Patient Outcome McCormick Place, Room S502 169 – Controversies in Management of Tibia Fractures

Trauma Poster Tours

McCormick Place, Academy Hall B

American Academy of Orthopaedic Surgeons Builds Safe, Accessible Playgrounds Hassan Mir, MD Amir Alex Jahangir, MD Help the AAOS transform Faith Community of Saint Sabina in the Auburn-Gresham neighborhood of Chicago, IL, on Tuesday, March 19. Make the gift of a Safe and Accessible Playground a reality for a very deserving community so that children with and without disabilities can play safely together. Since 2000, the Academy’s annual volunteer build project-the award-winning Safe and Accessible Playground building program in partnership with KaBOOM!-has provided an opportunity to visibly support playground safety and give something back to the communities we serve by helping with the construction of a safe and wheelchair-accessible play structure for children. Additional information can be found on the AAOS Website. When: Tuesday, March 19, 2013 Registration: Volunteer Form - Fax to: 847-823-7268

Figure 2

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2013 Webinar Calendar January 29th 7:30 PM (CST) March (day TBD) May (day TBD) July (day TBD) September (day TBD) November (day TBD) January 29th 7:30 PM (CST)

Proximal Humerus Fractures: Decision Making and Methods

Michael J. Gardner, MD

Managing Challenging Hip Fractures

Daniel S. Horwitz, MD

Tibial Shaft Fractures: The State of the Starting Point, Nailing Extreme Proximal and Distal Fractures, and Basics of Open Fracture Management

Robert F. Ostrum, MD

Surviving a Night on Call: The Current State of Orthopaedic Urgencies and Emergencies

Samir Mehta, MD

Periprosthetic Femoral Shaft and Supracondylar Fractures Brett D. Crist, MD Femur Fractures - General Principles and Role for Locked Plates and Revision Arthroplasty? Common Upper Extremity Fractures: The When and How of Surgical Management AAOS/OTA Webinar Proximal Humerus Fractures: Decision Making and Methods

Registration Complimentary for OTA & AAOS Members

TBD

Michael J. Gardner, MD Moderator

The goal of this webinar is to examine new concepts in proximal humerus fractures. The webinar covers the diagnosis and treatment of these injuries, as well as the important technical aspects of locked plating and arthroplasty.

Objectives: • • • •

Arthroplasty Options: Techniques and Evidence

Discuss the important factors in determining which patients would most benefit from surgery. Evaluate patients with proximal humerus fractures and formulate a treatment plan. Compare and contrast various treatment methods for these injuries, including reduction techniques through newer surgical approaches, structural augmentation techniques, and arthroplasty. Identify pitfalls in treatment.

Joshua Dines, MD Hospital for Special Surgery

When and How to Use Structural Augmentation?

Surgical Approach, Reduction, and Fixation Michael J. Gardner, MD Washington University School of Medicine

Evaluation, Imaging, and Decision-Making John D. Wyrick, MD University of Cincinnati

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Dean G. Lorich, MD Hospital for Special Surgery

How To Avoid and Treat Intraarticular Implants

Michael D. McKee, MD University of Toronto


Message from Robert Probe, OTA President 2012 OTA Research Fund Campaign Dear Colleagues, I am reaching out to ask for your support of the OTA Research Grant Program through a research donation. As you know, the OTA Research Grant program is key to the success of our mission, and without support from BOTH industry and our members, this program cannot continue to exist. I am pleased to let you know that each member of the OTA Board of Directors has pledged a donation to this year’s campaign – we hope we can count on your contribution too. I would like to thank those who have already contributed this year – your support is greatly appreciated! If you have not yet made your contribution, please step up and help promote the research campaign!

Ways to Donate... 1. Log-on to your OTA member account 2. Phone the OTA office and donate directly: 847.698.1631 3. OTA Donation Form Print the linked form and fax (847.823.0536), e-mail (ota@aaos.org) or mail to the OTA office: Orthopaedic Trauma Association, 6300 N. River Road, Rosemont, IL 60018 4. Donate through OREF *** 100% of OTA member research fund donations will go towards funding 2013 OTA-approved research studies ***

Why contribute? Your help is needed to continue to fund the numerous outstanding OTA research efforts which include: • Increasing the quality of patient care through multi-center studies • Providing answers and advancement to key questions in orthopaedic trauma • Providing orthopaedic trauma research funding to academic centers, research investigators, and residents • Supporting the research careers and aspirations of young scientists • Formulating and improving high standards for orthopaedic trauma call procedures • Providing long term functional outcome and metrics investigations The OTA has always been a leader in the advancement of orthopaedic trauma care through high quality research, which has been funded since 1990. Because of the importance of this activity, and the success we as a society have had, we urge you to consider making a contribution. This ongoing effort will allow us to maximize the funding directed to trauma related research. Sincerely, Robert A. Probe, MD, OTA President

2012 OTA Research Donor Acknowledgments The Orthopaedic Trauma Association gratefully acknowledges the following individuals for their generous financial support received through OTA and through OREF to fund OTA reviewed research grants. Donations received as of December 14, 2012

Members Award ($1,000 - $4,999)

Peter Athausen, Timothy Bonatus, Tim Bray, Bruce Buhr, Lisa Cannada, Peter Cole, William De Long, Gregory Della Rocca, James Goulet, David Hak, Steven Haman, Alan Jones, Clifford Jones, Ross Leighton, Paul Levin, Douglas Lundy, Simon Mears, Ted Miclau, Steven Morgan, Edward Perez, Andrew Pollak, Robert Probe, Matthew Rudloff, Thomas Russell, Andy Schmidt, Scott Smith, Rena Stewart, David Teague, Dave Templeman, Paul Tornetta, Heather Vallier

Friends Award ($250 - $999)

Daniel T Altman, Jeffrey Anglen, Email Azer, Brett Bolhofner, Christopher Born, Bruce Buhr, Kathleen Caswell, Michael Chapman, Curt Comstock, Brett Crist, Carl DePaula, Mark Dodson, Christopher Doro, Janos Ertl, Darin Friess, Rajeev Garapati, Stuart Gold, David Goodspeed, Thomas Goss, Andrew Green, Gerald Greenfield, Roman Hayda, Darrell Hayes, Paul Lafferty, Gerald Lang, Richard Lange, Joshua Langford, Richard Laughlin, Theodore Toan Le, Steven Louis, Thaun Ly, Randall Marcus, Brent Norris, Timothy O’Mara, William Obremskey, Brendan Patterson, David Polonet, Michael Prayson, Matthew Putnam, Regis Louis Renard, Craig Roberts, Thomas Russell, H. Claude Sagi, Bruce Sangeorzan, Andrew Saterbak, Robert Schultz, Craig Shively, Franklin D. Shuler, Bruce Simpson, Craig Smith, R. Malcolm Smith, Wade Smith, James Stannard, Marc Swiontkowski, Lisa Taitsman, Walter Virkus, David Volgas, J. Tracy Watson, Lewis Zirkle, Robert Zura

Associates Award ($100 - $249)

Gregory Altman, Jose Bernardo Toro Arbelaez, Yelena Bogdan, Gerald Greenfield, Brian Miller, Jeff Schulman, John Scolaro, Nirmal Tejwani, Timothy Weber

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THANK YOU 2012 OTA Research Donors!


Annual Meeting Highlights

James A. Goulet, MD, Program Chair Thank you for attending the 28th Annual Meeting of the Orthopaedic Trauma Association (OTA) October 3 - 6, 2012, in Minneapolis, MN. We hope your experience in Minnesota was worthwhile and informative. If you missed an abstract presentation, poster, breakout session, the Border Lecture or Presidential Address, you can find Annual Meeting content on the Annual Meeting page or linked below. Planning for the 2013 Annual Meeting in Phoenix, Arizona is underway. Look for the abstract application soon (Deadline: February 5, 2013). New this year, attendees had the choice throughout the meeting to attend podium presentations or concurrent mini-symposia. If you did not receive meeting materials or missed a session or pre-meeting event, please visit the link to view, print or save materials.

(L to R) Drs. Steven Olson, Craig Roberts and James Stannard enjoy the BOD Dinner.

2012 Annual Meeting Handouts 2012 Annual Meeting Abstract Link 2012 Annual Meeting E-Posters Dr. Probe’s 2012 Presidential Address 2012 Border Lecture – James F. Kellam, MD, FRCS(C), FACS Evidence Based Medicine Poster with Researcher C. Molina.

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The Orthopaedic Boot Camp was well attended in its inaugural year.


Annual Meeting Award Winners: Bovill Award – Best Paper

Local Hosts Andrew Schmidt and Peter Cole with Jim Goulet, Program Chair.

Δ Operative Versus Nonoperative Treatment of Acute Dislocations of the Acromioclavicular Joint: Results of a Multicenter Randomized, Prospective Clinical Trial Michael D. McKee, MD; Stéphane Pelet, MD, PhD, FRCSC; Milena R. Vicente, RN, CCRP; The Canadian Orthopaedic Trauma Society (COTS) Group; St. Michael’s Hospital, Toronto, Ontario, Canada

Memorial Award – Best Resident/Fellow Paper •Incidence of Posterior Wall Nonunion and Efficacy of Indomethacin Prophylaxis for Heterotopic Ossification After Operative Fixation of Acetabular Fractures: A Randomized Controlled Trial Charles J. Jordan, MD; Rafael Serrano-Riera, MD; H. Claude Sagi, MD; Orthopaedic Trauma Service, Florida Orthopaedic Institute, Tampa, Florida, USA Lisa Cannada guiding the poster tour on Saturday afternoon.

The OTA honors Mexico as the 2012 Annual Meeting Guest Nation.

Best Poster

Preoperative Lactate Does Not Predict Pulmonary Complications in Multiple Trauma Patients With a Femoral Shaft Fracture Treated With Early Total Care Justin E. Richards, MD1; Sean M. Griffin, MD2; Daniel M. Koehler, BS1; Michael J. Bosse, MD2; William T. Obremskey, MD, MPH1; Jason M. Evans, MD1; 1 Vanderbilt University Medical Center, Nashville, Tennessee, USA; 2 Carolinas Medical Center, Charlotte, North Carolina, USA

Best Basic Science Presentation

Inhibiting Macrophage Activation During Fracture Repair Improves Fracture Healing in Aged Mice Yan Yiu Yu, PhD; Theodore Miclau III, MD; Ralph S. Marcucio, PhD; Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, University of California San Francisco, San Francisco, California, USA

192 scientific posters were on display.

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Paul Tornetta (left picture) led Friday’s Pelvis and Acetabulum Guided Poster Tour while Cliff Jones (right) led the concurrent Poster Tour focusing on Lower Extremity.

The Basic Science Focus Forum

Mrs. and Dr. Luigi Andrew Sabal, Dr. Shahab ud Din and son, Faseeh Shahab, MBBS. Congratulations to the SIGN Scholars Dr. Sabal and Dr. Shahab ud Din.

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OTA President Robert Probe delivering his Presidential Address.

The OTA Registration Desk welcomed over 1,800 attendees and vendors to the 2012 Annual Meeting.


NP/PA Membership in the OTA

Membership Committee

I was very excited to be part of the first “Orthopaedic Trauma for NPs and PAs” course at the OTA 2012 annual meeting. Dr. Michael Archdeacon chaired the course, Dr. Clifford Jones and myself co-chaired. These physician chairs were chosen as both their practices work with NPs and PAs. This course was developed to facilitate better integration of OTA members’ NPs and PAs into the OTA programs and membership. The course attendance exceeded our target and received strong evaluations. The American Academy of Physician Assistants practice survey showed that over 10 percent of practicing PAs work in orthopedics, totaling more than 8500. The Physician Assistants in Orthopaedic Surgery is the official subspecialty group within AAPA and it has over a thousand members. Their annual meeting had 500+ attendees. There is a large need for educational opportunities and professional affiliations for NPs and PAs practicing in Orthopaedics. OTA has welcomed PA and NP membership but the path to membership and the benefits have not always been clear. The existing educational opportunities in OTA are very applicable to practicing NPs and PAs. We create the opportunity for greater exposure to practicing orthopaedic NPs and PAs by integrating courses targeted to NP/PAs. I value the benefits of OTA membership including discounts for meetings/education, JOT subscription, and opportunities to participate in special committees. I am excited about what the OTA membership can add to my fellow NP/PAs practices by increasing educational opportunities, which parallel the education of our physicians.

The OTA welcomed 248 new members in 2012. The Membership Committee, Nirmal Tejwani (chair), Richard Buckley, Robert Dunbar, Dave Sanders, and Robert Zura accepted 167 of the applications submitted in November 2012 and 81 applicants in June 2012. The Membership Committee hosted the first New Member’s Luncheon on October 5, 2012, at the OTA Annual Meeting. Thanks to OTA Past President guest speakers, Jeff Anglen and Brad Henley who spoke with over one hundred new or potential OTA members. 
 Important OTA Membership bylaws changes were approved in October 2012. The category for Community membership has been changed to Clinical.
Sponsors for current Community and Associate membersl transitioning to Active membership will not be required. The publication date for first and second authors was changed to sixty months preceeding the application deadline, rather than forty-eight months. International applicants will need two sponsors; the 3rd sponsor letter requirement has been dropped. Would you like to change your five digit OTA user ID to a word that may be easier to remember? OTA database users can now change both 
password and user ID by signing into their account via the OTA website (www. ota.org). The next OTA membership deadline is May 1st. Look for the online application in March of 2013.
 Please support the OTA membership campaign and encourage your colleagues to join.

Research Committee

The eighth annual Basic Science Focus Forum (BSFF) again highlighted state-of-the-art basic research in clinically relevant topics through six symposia that preceded related basic science paper presentations. These topics included Biomechanically Directed Hot Topics; Venous Thromboembolism; Atypical Femur Fractures; Intraoperative Imaging; Institutional Updates: State of Musculoskeletal Research; and Cycle of Innovation. Twenty six abstracts were presented at the BSFF in addition to the eight during the main OTA Annual Meeting sessions, and were selected from 108 submissions. The abstracts were scored by the

Daniel J. Coll, MHS, PA-C

Todd O. McKinley, MD, Chair The OTA is dedicated to promoting and supporting orthopaedic research. To this end, the OTA awards research grants annually. For other sources of funding, please utilize the new link on the OTA website ‘OTA Research Fund Page’. If you have questions about these funding sources, please contact the funders directly. If you have questions about OTA sponsored research grants, please contact the OTA business office at 847-698-1631 or email ota@aaos.org.

Nirmal C. Tejwani, MD, Chair

Basic Science Committee Theodore Miclau, MD, Chair

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continued on page

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Basic Science Committee, cont’d from pg. 11 Theodore Miclau, MD, Chair

Committee, with the top papers being offered fasttrack submission to a special supplemental edition of the Journal of Orthopaedic Trauma, edited by Emil Schemitsch. In addition, the OTA and ORS continue to collaborate on trauma-related basic research, as was evident throughout the OTA Meeting this year. In addition to the highly successful Grant Writing Course organized by the OTA Research Committee, and chaired by Todd McKinley and Brett Crist, the top poster from the Annual ORS Meeting was presented at the OTA Annual Meeting. The poster was entitled, “Conversion from External Fixator to Intramedullary Nail Impairs Fracture Healing Particularly After a Severe Trauma”, and was authored by S. Recknagel et al. from the University of Ulm, Ulm, Germany. In February, 2013, the top basic science presentation from the OTA Annual Meeting in Minneapolis will be presented in poster format at the ORS Annual Meeting in San Antonio, and is entitled “Inhibiting Macro-phage Activation During Fracture Repair Improves Fracture Healing in Aged Mice”, authored by Y. Y. Yu, et. al., from the University of California, San Francisco/San Francisco General Hospital Orthopaedic Trauma Institute. Additionally, OTA Members will also be key participants in the Third Annual Clinical Research Forum, the ORS’s clinical research event in San Antonio. The ORS will also offer a trauma poster section, which will be developed from abstract submissions on polytrauma, systemic response to injury, and clinical trauma research. Edward Harvey and Theodore Miclau, members of the OTA Basic Science Committee, are the trauma topic and President, respectively, for the ORS this year.

Public Relations and Branding Committee Jeffrey M. Smith, MD, Chair

Pelvic & Acetabular Fracture Management ED Poster Over the past several years, your PR Committee has developed an educational/public relations poster titled “Emergency Department Guide for Acute Management of Pelvic and Acetabular Fractures.” While not comprehensive, it is hoped that OTA Members

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would be able to use this poster as a tool to collaborate with ER Physicians, Trauma Surgeons, and others in their community and referral areas to promote quality of care for patients with pelvic and acetabular fractures. These are available to members at no cost via email request. You can also download a copy of the poster: Pelvic Poster Download Emergency Department Guide for Acute Management of Pelvic & Acetabular Fractures ATLS Protocol with Complete Evaluation

AP Pelvis X-Ray

Normal side

Pelvic Injuries

Acute Interventions to Consider ÿObservation ÿPossible External Fixation

ÿ Pelvic binder or sheet ÿ External Fixation ÿ Symphysis plate at laparatomy

Abnormal side

Acetabular Injuries

Pelvis acts as link between spine and lower extremities

Acetabulum provides weight bearing joint surface for femoral head

ÿ Reduction of Hip Dislocation ÿPelvic binder or sheet ÿExternal Fixation ÿSkeletal traction!

ÿ Skeletal Traction

The Orthopaedic Trauma Association presents this information as an educational service to the medical community. While the information is about health care issues and orthopaedic surgery, it is not medical advice. Individuals seeking specific orthopaedic advice or assistance for conditions such as these should contact an orthopaedic trauma surgeon through the Find a Surgeon program at www.ota.org.

Orthopaedic Trauma Consultation Call early and involve the Orthopaedic Surgeon in your decision making

Trauma Prevention Coalition

(Subcommittee of the Public Relations Committee) Philip R. Wolinsky, MD, OTA TPC Representative

The OTA Board of Directors has agreed to participate in the Trauma Prevention Coalition (TPC), an initiative put forth by the American Association for Surgery of Trauma (AAST) that seeks to “combine the resources of major professional organizations addressing the acute healthcare needs of the injured, promote collaborative efforts and develop effective strategies in injury/violence prevention while minimizing redundant and duplicative activities.” The TPC Memorandum of Understanding in full and the Coalition’s Vision, Mission and Objectives are available on the OTA website. If you have any questions about the organization or wish to obtain more information, please contact me via the OTA staff office (ota@aaos.org).


that orthopaedic surgeons keep this nation moving. In an era of healthcare change, now more than ever is a time when orthopaedic surgeons need to stand out to policymakers and the public as THE specialists who provide value. Orthopaedic Surgeon Stories, Orthopinions, and sharing patient stories from each of our members will help us do just that.

AAOS recently launched the A Nation in Motion campaign with the goal of raising awareness and understanding of the value of orthopaedic care among key audiences. To date, almost 600 patient success stories have been submitted to the website, with more added every day. But, as we continue to tell the stories of our patients, and their successes, it is now time to tell our own stories--to illustrate the caring, compassionate, dedicated and interesting people behind our scrubs. Here are three NEW opportunities to market your practice and help show the value that you bring to our orthopaedic specialty: 1. Share Orthopaedic Surgeon Stories
 Promote your orthopaedic practice and share your story. Help us to create a vivid portrait of orthopaedics and include your practice information. Submit answers to questions like Why did you become an orthopaedic surgeon? What do you do in your free time? Share your Orthopaedic Surgeon Story at anationinmotion.org. 2. Ortho-pinions
 Submit surgeon columns, approximately 4001,000 word essays, about various aspects of orthopaedic practice aimed at a patient/public audience, frequently-asked-questions you are asked in your practice, life or medicine that reiterates the well-roundedness and the different specialties within orthopaedics. For more details, column guidelines, and to submit an Ortho-pinion, visit anationinmotion.org.

 3. Share Patient Stories
 Invite patients whose stories embody A Nation in Motion to submit their stories on the campaign website, anationinmotion.org. Or, ask them for permission to use their stories and you or someone on your staff can submit them on their behalf. We’re extremely proud of all of our members who already have participated in the campaign and who continue to take steps to promote our message

Sincerely, John R. Tongue, MD, AAOS President Michael F. Schafer, MD, Chair, AAOS Communications Cabinet

OrthoInfo

(Subcommittee of the Public Relations Committee) Brett D. Crist, MD, FACS & Robert Dunbar, Jr., MD The OrthoInfo Website is being overhauled and articles are being requested. Please email Dr. Crist (cristb@health.missouri.edu) or the OTA staff office (ota@aaos.org) to volunteer.

Tip of the Month

December 2012: The current advances in quality measures and pay for performance models have renewed interest in collecting objective data to identify ways to improve quality and patient care. These influences have in Timothy J. Bray, MD part led to the emphasis on sub-specialization and self-proclaimed centers of excellence. Multiple peer-reviewed publications have either proven or postulated that quality is directly related to the surgical volume of both the surgeon and the health care facility. There is still debate and uncertainty regarding what data to collect. e surgeon. As the healthcare landscape continues to evolve and contract negotiations with both health care delivery entities and payers become increasingly complicated, it is important for each surgeon to collect the most basic and important data; the surgeon’s case log.

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OTA Mentorship Programs

Gregory J. Della Rocca, MD, PhD, FACS Did you know that the Orthopaedic Trauma Association has a network of senior members willing to provide mentorship to junior members interested in jump-starting their clinical and/or research careers? If you are a recently-minted orthopaedic traumatologist or are looking for a career path change, engaging a senior OTA member who has been “through the ropes”, so to speak, may prove beneficial. Many of us in the beginning of our careers move forward based upon trial and error. Perhaps, we don’t know whom to contact for questions. Luckily, most of our fellowship and residency advisors are happy to provide career guidance. However, it is sometimes beneficial to seek new opinions. The career mentor program is designed for OTA members at the start of their careers or at the time of a change in career path. Active, Research, and Associate members are eligible for this program. Candidate members are eligible for this program as well. A description of the program can be found on the ‘Members Only’ page of the OTA website. As private and academic centers throughout the USA and Canada are flooded with the recent multitude of trauma fellowship graduates, future paths may appear daunting. Seasoned OTA members, who have volunteered their time and expertise to participate in this program, have made themselves available for questions regarding (but not limited to) choice of career paths, contract questions, establishing a new trauma practice, or joining a well-established trauma practice. Individual mentors will instruct mentees on how to utilize their “services”; remember, it is difficult for them to provide guidance unless YOU ask the questions. The research mentor program is a separate program for OTA members interested in incorporating research into their careers. All OTA members are eligible for this program. A description of this program can be found on the ‘Members Only’ page of the OTA website. This program is especially valuable to OTA members at the beginning of their careers, to members working in an academic program without extensive pre-existing research infrastructure (at either the departmental or institutional level), and to members in private practices interested in exploring collaborations in research. Research mentors have extensive experience with both clinical and basic science research. The career and research mentor program proved invaluable to me at the start of my career after fellowship, and I highly recommend it. Lists of career

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and research mentors are available at the previouslyindicated websites, and any member can tailor the program to suit his or her needs. Best of luck!

Evidence-Based Quality Value Committee William Obremskey, MD

NEW

The OTA Board of Directors recently endorsed the creation of a new committee from the ad hoc evidenced-based medicine (EBM) committee. The new committee’s name will be Evidence-Based Quality Value (EBQV). This committee will have 8 members and it will work in conjunction with the AOS EBQV committee as well. Members of the committee are Chair Bill Obremskey and Members, Paul Tornetta, Steve Olsen, H. Claude Sagi, Cory Collinge, as well as Bruce Browner. Two other members will be selected from recent volunteers. 1. Maintain “library” of best available articles on a variety of topics on the OTA Members website. See the trauma evidence-based medicine resource list under services on the members only web page. 2. Guideline. Identify current practice and develop guidelines/recommendations on controversial topics. We presented posters at this year’s OTA meeting on open fracture treatment and DVT prophylaxis. We may consider other topics such as sliding hip screw versus cephalomedullary nail and ORIF versus nonoperative clavicle fractures. 3. Quality methods. These will be developed with the AOS. Ongoing projects are: 1. Hip fracture protocol. 2. Data base development for assessment of complication and outcomes of pilon fractures, open tibia fractures, and ankle fractures. As the OTA intends to embrace the challenges of healthcare financing, we are actively involved in our own value enhancing projects within our new Evidence-Based Value, Quality and Safety Committee. We are also supportive of the broader efforts of the AAOS as they develop “appropriate use criteria” for common orthopaedic conditions. As part of this process, the developers of the criteria for rotator cuff disease are interested in feedback from other specialty societies. I hope you would consider review of the linked material with correspondence back to ota@aaos.org. Thanks for your cooperation, Robert A. Probe, MD, President, OTA


Fellows Corner

CPT Daniel J. Stinner, MD We are now approaching the halfway point of our fellowships and as we get closer to starting our own practices, I think it is ever apparent that we fine tune our case logs to make them more useable for us in the future. I encourage everyone to read Dr. Bray and Dr. Hill’s OTA Tip of the Month for December 2012 on the OTA website titled “Surgeon Controlled Case Collection.” The authors do a very nice job detailing four situations where an electronic case log that allows manipulation to identify trends, numbers, etc., is useful. The first is re-certification through the ABOS. The authors detail certain case specifics that are important to include in your log as they are required by the ABOS, which include: age, gender, ICD-9 diagnosis, and CPT codes. The second, credentialing, is obvious to many of us as we all had to submit case logs to be credentialed at are current hospitals. However, now we do not have the ACGME looking over our shoulder, telling us what we need to do so it is up to us to maintain our own logs. The third is for the opportunity to perform future research. The authors emphasize that you should limit the amount PHI in the database to protect patient safety, and keep it on a password-protected device. The final situation described by the authors is perhaps one of the most important, especially as we begin our practices: physician driven quality review. By using an electronic case log, you can filter the data to identify trends, whether good or bad. For this to be effective, you need to include your outcomes, not just CPT codes. You may also be able to identify certain procedures where your outcomes continue to fall short of those that are expected or, on the other hand, those where you excel. By identifying areas of weakness, you may then choose to supplement your education by attending a skills course, or seeking mentorship by one of your colleagues. By identifying strengths you may be able to determine ways that you can translate those outcomes into other areas of your practice. This method of continual quality review works for governments and business, so why not apply it to our practice. Rudolph Giuliani, former mayor of New York City, had success using a computer program referred to as CompStat to decrease crime rates and improve the overall quality of life for New York City. Data was collected on crimes and resource management, among other things, much like the corresponding data important in our profession that

we collect on our cases. Every week the data was reviewed, and changes made accordingly, resulting in a reduction in crime around 60%. Wouldn’t clinic be so much more enjoyable if we could reduce our complication rate by 60%? I will be the first to admit that I do not spend enough time reviewing my previous cases and I would venture to say that I am not alone. Getting in the habit early might just set us up for success in the future, as Dr. Bray and Dr. Hill nicely described. If you have any recommendation for case collection or programs that you would like to share, please send them to (daniel.stinner@gmail.com or ota@aaos.org). Based on feedback, I will work with the OTA to try and get them posted on the website so that we can all try and find a process that works best for us.

About METRC. The Major Extremity Trauma

Research Consortium (METRC) was established in September of 2009 with funding from the Department of Defense (DOD). It is comprised of a network of clinical centers and a data Coordinating Center that work together with the DOD to conduct multi-center clinical research studies relevant to the treatment and outcomes of orthopaedic trauma sustained in the military.

Site Participation. The backbone of the Consor-

tium is a dedicated group of core and satellite clinical centers located throughout the US. Satellite Clinical Centers are civilian trauma centers with an established orthopaedic trauma program. They are invited to participate in individual METRC studies to ensure adequate numbers and appropriate mix of patients. Their participation is supported by a payment provided for each patient screened, enrolled and successfully followed.

METRC Studies. METRC studies are organized into seven core research areas: (1) bone defect reconstruction and fracture healing; (2) prevention and treatment of acute and chronic infections; (3) diagnosis and treatment of compartment syndrome; (4) wound care and closure; (5) prevention and treatment of post-traumatic osteoarthritis; (6) limb salvage and

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continued on page

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cont’d from pg.

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amputation outcomes (7) post-acute care and rehabilitation outcomes. The Consortium has several studies currently funded in need of additional satellite center participation: • APS: Novel therapy to reduce infection after operative treatment of fractures at high risk of infection: a multicenter randomized controlled trial • BIOBURDEN: Assessment of severe extremity wound bioburden at the time of definitive wound closure or coverage: correlation with subsequent post-closure deep wound infection • FIXIT: A randomized controlled trial of ring external fixation vs. locked IM nail as the definitive stabilization of Grade IIIB tibia fractures • OUTLET: Outcomes following severe distal tibia, ankle and/or foot trauma: comparison of limb salvage vs. transtibial amputation • OXYGEN: Supplemental perioperative oxygen to reduce surgical site infection after high energy fracture surgery • PAIN: Comparing the efficacy of standard pain management vs. standard pain management combined with use of perioperative pregabalin or ketorolac in the treatment of severe lower limb fractures • POvIV: A prospective randomized trial to assess oral (PO) vs. intravenous (IV) antibiotics for the treatment of early post-op wound infection after plate fixation of extremity fractures • PTOA: Multi-center investigation of the mechanical determinants of post-traumatic osteoarthritis • TAOS: Comparison of transtibial amputation with and without a tibia-fibula synostosis: A randomized controlled study

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Interested in participating in METRC? METRC

is looking for centers that are interested in becoming involved as satellite centers. If you are interested in applying to become a satellite center, email admin@ metrc.org or talk to Dr. Michael Bosse or Dr. Ellen MacKenzie.

METRC’s goals…

1. Continuously identify the most critical issues that challenge recovery from major orthopaedic trauma; 2. Develop and sustain a research infrastructure to support the conduct of multi-center research studies aimed at the rigorous evaluation of current standards of orthopaedic care; 3. Partner with basic scientists and engineers to facilitate the translation of new and emerging technologies into clinical practice; 4. Mentor young orthopaedic trauma surgeons and rehabilitation specialists in the design and conduct of clinical trials; 5. Contribute to the science of fracture and soft tissue repair; 6. Contribute to the science of conducting clinical trials in a challenging patient population and treatment environment.

www.METRC.org


2013 Annual Meeting Phoenix, Arizona • October 9-12, 2013

The 2013 OTA Annual Meeting will take place at the JW Marriott Desert Ridge and has a spectacular course in its backyard. We are considering organizing a handicap, stroke play event the morning of October 13, 2013, one day following the Annual Meeting. 

If we have enough interested parties we will provide additional information this spring so that proper flight and hotel accommodations can be arranged. If you are unable to participate Sunday, October 13, and wish to play during the week, please select the link below to be placed on a golf contact list. 

Course Description:

Palmer Course
The Palmer Signature Course at Wildfire Golf Club delivers a target golf experience, while the expansive fairways allow golfers to remain in play even on an errant shot. The bunkering on the 7,170-yard, par 72 Arnold Palmer design is superb with four to six tee boxes on every hole, generously sized bent grass greens and sweeping fairways, which create an experience unlike any other. The golf course winds through the rugged Sonoran desert, offering stunning views of the McDowell Mountains, Camelback Mountain and Squaw Peak, making it the perfect setting for golfers of all skill levels. Click this link to express interest!

 Thank you and we hope to see you on the links next fall!
 Thomas A. Decoster, MD and Victor A. de Ridder, MD

Palmer Course The Palmer Signature Course at Wildfire Golf Club delivers a target golf experience, while the expansive fairways allow golfers to remain in play even on an errant shot. The bunkering on the 7,170-yard, par 72 Arnold Palmer design is superb with four to six tee boxes on every hole, generously sized bent grass greens and sweeping fairways, which create an experience unlike any other. The golf course winds through the rugged Sonoran desert, offering stunning views of the McDowell Mountains, Camelback Mountain and Squaw Peak, making it the perfect setting for golfers of all skill levels. Faldo Course Six-time major champion Nick Faldo has carved his signature into Arizona’s desert with his new Faldo Championship Course at Wildfire Golf Club. Featuring generous fairways, the new Faldo design provides ample landing areas for the not-so-straight and narrow golf swing, keeping golfers out of the surrounding desert flora. The course’s unique bunkering is reminiscent of the great Australian sand belt courses, featuring high flashing lips and faces. Every hole on the 6,846-yard, par 71 Faldo Course brings a memorable experience that golfers will not soon forget.

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Announcements • The new OTA website

Home | About Us | Contact Us | Site Map | Search | LOG IN

is just around the corner. Look for a new, dynamic website for the OTA! You will still find all of the same information, but in a user friendly design. There will be new additions too! A sneak peek:

About

Find a Surgeon

• Job Posting

Attention OTA Members….be sure to post your jobs on the OTA website….take advantage of this free membership benefit.

Dr. Mir of @VUMChealth to present Workers Compensation: An Orthopaedic Trauma Perspective @2012OTA.

AAOSA/OTA/SOMOS Disaster Response Course (DRC) is scheduled to coincide with the AAOS meeting scheduled for Chicago in March, 2013.  Details regarding this course is available through the OTA office and this link.  Link to 2013 course

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Medtronic Twin Cities Marathon October 7, 2012

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On February 11, 2011, Dominique Gambale, sustained the most serious injury. This is her story, and how an OTA member who had served in Iraq made sure Dominique's leg would get another chance. Read more

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Upcoming Events Resident Grant Deadline June 25, 2012 Accepted Full Grant Proposal Deadline July 9, 2012 Comprehensive Fracture Course for Residents October 3-6, 2012 OTA Annual Meeting October 4-6, 2012 OTA Membership Applications Deadline November 1, 2012 SOMAS/OTA/AAOS Disaster Response Course December 14-15, 2012

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2013 Landstuhl Volunteers Needed! OTA Volunteer Page Resident Grant Application Deadline: November 30, 2012

FractureLines - 2013 Winter Edition  

Committee Reports ~ Annual Meeting Highlights ~ Specialty Day ~ Educational Opportunities ~ Announcements The mission of the Orthopaedic Tr...

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