Orthopedic Trauma

Our work in the Department of Orthopedic Trauma Research at St. Michael’s Hospital spans the testing of devices (e.g. plates, surgical techniques) or treatments in randomized controlled trials to developing and testing outcome measures and their statistical modeling.

We also have expertise in qualitative and quantitative methods to explore these areas, and place a strong emphasis on the application of the results in clinical practice and health policy. We work with researchers and co-ordinators across Canada, collaborating to produce some of the best orthopaedic trauma research in the country.

Core Researchers

Research Staff

  • Lynn (Milena) Vicente
  • Jennifer Hidy
  • Paril Suthar

Featured Studies

The team is actively enrolling and studying patients with periprosthetic fractures, flail chest injuries, long bone non-unions, rotator cuff injuries, hip fractures, humeral fractures and ankle fractures, among others. Below is a brief overview of some of our ongoing clinical trials.

Reamer Irrigator Aspirator versus Autogenous Iliac Crest bone graft for the Treatment of Non-Unions: A Multi-Centre Randomized Controlled Trial

The objective of this study is to compare RIA bone grafting to the current gold standard of AICBG for the treatment of nonunions in a randomized, multi-centre clinical trial. The specific question we will seek to answer is: can the RIA provide a bone graft source for the treatment of nonunions that is equally effective to AICBG while resulting in a decreased amount of post-operative pain and a lower rate of complications? Our primary outcome measure will be post-operative pain at the graft harvest site with secondary outcomes including harvest site related complications, volume of graft obtained, union rates at the bone graft recipient site, patient-based functional outcomes, and cost effectiveness of bone graft harvest using the RIA versus AICBG.

Isolated locked compression plating versus cable plating and strut allograft with cerclage wiring for Vancouver B1 periprosthetic femoral fractures: A Randomized Controlled Trial

The purpose of this study is to compare two different but standard treatments for the fixation of Vancouver B1 periprosthetic fractures .We aim to compare open reduction internal fixation using a locked plating system versus plating and strut allograft with cerclage wiring to determine which treatment results in faster return to function. Secondary outcomes will include rates of union, malunion, infection, re-operation and implant failure as well as patient reported functional outcomes.

Operative versus Non-operative Treatment of Acute Unstable Chest Wall Injuries: A Multi Centered Randomized Controlled Trial

This is a multi-center, prospective, randomized controlled trial comparing surgical treatment of carefully selected, acute, unstable chest wall injuries with the current gold standard of non-operative management. This study is being conducted by a trauma organization (Canadian Orthopaedic Trauma Society) with extensive experience in the initiation, conduct, completion, and publication of multi-center randomized orthopaedic clinical trials. Our primary objective is to compare early surgical fixation versus conventional, non-surgical treatment of unstable chest injuries on the basis of our primary outcome measure of days spent free from a mechanical ventilator in the first 28 days following injury. We will also compare other important outcomes between treatment groups including days in ICU, rates of pneumonia and sepsis, need for tracheostomy, mortality, general health outcomes, objective assessment of pulmonary function, and other complications of treatment.

Treatment of Periprosthetic Distal Femur Fractures: A Randomized Controlled Trial of Locking Plate Osteosynthesis versus Retrograde Nailing

With the number of total knee arthroplasties being implanted increasing over a year by year basis, it is anticipated there will be a corresponding increase in the rate of distal femoral periprosthetic fractures. There is currently a lack of high level evidence to guide management of these complex fractures. The specific aim of this study is to compare locking plate osteosynthesis versus retrograde railing for the fixation of periprosthetic distal femur fractures after total knee arthroplasty and evaluate for any differences in patients’ return to function. Secondary aims include comparing rates of nonunion, malunion, hardware failure, infection, and revision surgery. A further aim of the proposed study is to compare outcomes of each implant in a subgroup of patients with a known diagnosis of osteoporosis.