Review Committee for Orthopaedic Surgery

New Application: OrthopaedicTrauma

Review Committee for Orthopaedic Surgery

ACGME

Fellows and Other Postgraduate Trainees

Enter the number of any type of residents and/or fellows assigned to each sitefor any type of orthopaedic surgery training each year.Add rows as necessary.

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Type of Orthopaedic Training / Site #1 / Site #2 / Site #3 / Site #4 / Site #5
Total/ Year / Present at any one time / Total/ Year / Present at any one time / Total/ Year / Present at any one time / Total/ Year / Present at any one time / Total/ Year / Present at any one time
Clinical / # / # / # / # / # / # / # / # / # / #
Research / # / # / # / # / # / # / # / # / # / #
Other / # / # / # / # / # / # / # / # / # / #

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Provide the following information regarding orthopaedic surgery residents who are assigned to each sitefor training in orthopaedictrauma each year.Add rows as necessary.

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Name of Program / Site #1 / Site #2 / Site #3 / Site #4 / Site #5
Total/ Year / Present at any one time / Total/ Year / Present at any one time / Total/ Year / Present at any one time / Total/ Year / Present at any one time / Total/ Year / Present at any one time
Program / # / # / # / # / # / # / # / # / # / #
Program / # / # / # / # / # / # / # / # / # / #
Program / # / # / # / # / # / # / # / # / # / #

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Narrative Summary of Compliance with Accreditation Requirements

The questions thatfollow provide programs with an opportunity to systematically describe the manner in which they comply with accreditation requirements.Responses should be concise and focused.During the site visit, fellows, faculty members, and others will be asked for comment on the information provided.As such, those who will be interviewed should read the application form prior to their meeting with the site visitor.

Fellow Appointment

Howwill theprogram demonstrate itscommittment to promoting the inclusion of qualified women and under-represented minorities in the profession through its recruiting?[PR III.A.2.]

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Responsibilities of the Program Director

How will the program director select, supervise, and evaluate the teaching staff members and other program personnel at each site participating in the program?How will the program director monitor fellowsupervision at each site?

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How will the program monitor fellowstress, including mental or emotional conditions inhibiting performance or learning?What arrangements does the program have for the provision of counseling and psychological support services for fellows?

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How many months of night float will fellowsbe assigned in each year of the program? [PR VI.F.6.a)]..(#)

Resources

Describe the facilities available at the primary hospital to support fellow education. Include a concise description of the trauma center, operating rooms, and facilities for acute and emergency surgery [PR II.D.1.]

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List the other educational aids available to fellows, such as videotapes, sound/slide programs, movies, x-ray teaching files, computer-aided instruction, laboratory facilities, etc. [PR II.D.2.]

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Describe the other clinical services that will support fellow clinical education. [PR II.D.3.]

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Summarize fellow access to (a) a major medical library, including orthopaedic references, (b) electronic retrieval of information and medical databases, and (c) an on-site collection of texts and journals at each program site. [PR II.D.4.-5.]

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Describe the contribution of each site to the fellowship program. Include reference to personnel, facilities, administrative services, and financial support.

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Educational Program

Provide a concise description of how the program will ensure that fellows are provided with adequate instruction in each of the following:

a)Medical, surgical, and psycho-sociological skills in the management of the severely injured patient [PR IV.A.2.a).(1).(a)]

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b)Diagnosis and management of complications of musculoskeletal trauma [PR IV.A.2.a).(1).(b)]

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c)The indications, risks, and limitations of the commonly-performed procedures in the subspecialty [PR IV.A.2.b).(1).(a)]

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d)The basic sciences related to orthopaedic trauma[PR IV.A.2.b).(1).(b)]

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e)An understanding of the integration of the orthopaedictraumatologist in a trauma team, and an appreciation of the importance of the timing of orthopaedic procedures in the overall care of the severely injured patient[PR IV.A.2.b).(1).(c)]

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f)Pathophysiology of severe musculoskeletal trauma and secondary organ failure [PR IV.A.2.b).(1).(d)]

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g)Psychiatric and psychological implications of severe musculoskeletal trauma for the patient and family members [PR IV.A.2.b).(1).(e)]

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h)Recuperative and rehabilitation techniques and use of physical and occupational therapy designed to return the patient to normal activities and work [PR IV.A.2.b).(1).(f)]

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i)Indications for various types of internal and external fixation devices and their applications in multiple trauma situations both in the axial and appendicular skeletons[PR IV.A.2.b).(1).(g)]

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j)Treatment protocols for severe soft tissue injuries, including compartment syndrome and secondary organ failures in polytrauma[PR IV.A.2.b).(1).(h)]

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k)Indications for early or immediate amputation rather than salvage attempts in severely injured limbs[PR IV.A.2.b).(1).(i)]

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l)Sufficient familiarity with current research methods to enable fellows to critically analyze research reports and design and implement clinical or basic research in the field of musculoskeletal trauma[PR IV.A.2.b).(2)]

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m)Teaching skills and lecture techniques and materials in orthopaedic traumatology[PR IV.A.2.d).(1)]

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Describe the program conference schedule, including comment on the planned levels of teaching staff member participation and fellow attendance. Describe related educational activities, such as journal clubs. [PR IV.A.3.c)]

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Concisely describe opportunities for fellows to provide consultation with faculty member supervision. In addition, describe fellows’ educational responsibilities for residents, medical students, and allied health personnel. [PR IV.A.3.d)]

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Describe how the program will ensure that fellows are provided with adequate opportunities to assume a major role in the continuing care of patients, and that they will have progressive responsibility for patient assessment, pre-operative evaluation, post-operative intensive care, other post-operative management, rehabilitation, and other outpatient care.[PR IV.A.4.b)]

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Describe the responsibilities of the fellows for inpatients, emergency rooms, outpatient clinics, operating rooms, and private offices.How will supervision be provided in each area?

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Scholarly Activity

Summarize program activity in research and other scholarly activity.

List the staff member(s) who will provide stimulation and supervision of clinical or laboratory research activity by fellows and identify their particular area(s) of expertise.

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Describe how the program is designed to promote fellows’ability to evaluate medical literature and research. How will instruction in experimental design, hypothesis testing, and research methods be provided? [PR IV.B.1.-2.]

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Describe the facilities and resources (including space, equipment, support personnel, funding) that will be utilized to support fellows’research.[PR IV.B.3.]

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Describe the time free of clinical responsibilities that will be provided for fellows’participation in clinical or laboratory research. [PR IV.B.3.]

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Institutional Operative Data

Report the number of operative procedures in the categories below performed by faculty member at each participating site, as listed in the ACGME’s Accreditation Data System (ADS),during a recent consecutive 12-month period. Site numbers must correspond to information provided in ADS. [PR II.D.1.]

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Site #1 / Site #2 / Site #3 / Site #4 / Site #5 / Total
Adult / Peds / Adult / Peds / Adult / Peds / Adult / Peds / Adult / Peds / Adult / Peds
Spine / # / # / # / # / # / # / # / # / # / # / # / # /
Hip/Pelvis / # / # / # / # / # / # / # / # / # / # / # / # /
Knee / # / # / # / # / # / # / # / # / # / # / # / # /
Ankle/Foot / # / # / # / # / # / # / # / # / # / # / # / # /
Shoulder / # / # / # / # / # / # / # / # / # / # / # / # /
Elbow / # / # / # / # / # / # / # / # / # / # / # / # /
Wrist/Hand / # / # / # / # / # / # / # / # / # / # / # / # /
Long Bones 1 / # / # / # / # / # / # / # / # / # / # / # / # /
Soft Tissues 2 / # / # / # / # / # / # / # / # / # / # / # / # /
Other / # / # / # / # / # / # / # / # / # / # / # / # /
TOTAL / # / # / # / # / # / # / # / # / # / # / # / # /
Amputation 3 / # / # / # / # / # / # / # / # / # / # / # / # /
Oncologic / # / # / # / # / # / # / # / # / # / # / # / # /
Microsurgery / # / # / # / # / # / # / # / # / # / # / # / # /
Arthroscopic / # / # / # / # / # / # / # / # / # / # / # / # /
Closed Manipulation 4 / # / # / # / # / # / # / # / # / # / # / # / # /

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Long Bones:Includes humerus, ulna/radius, femur, tibia/fibula.Excludes periarticular.
Soft Tissues:Includes surgery of muscles, tendons, fascia, skin, nerves and vessels.Excludes periarticular, hand, and those listed as microsurgery.
Amputation:Excludes oncologic amputations.
Closed Manipulation:Includes manipulative reduction of dislocations/fractures and treatment of non-traumatic contractures and deformities.

Defined Case Category Procedures

Report the number of defined case category procedures in the categories below performed by faculty members at each participating site,as listed in ADS, during a recent consecutive 12-month period.Site numbers must correspond to information provided in ADS. [PR IV.A.2.a).(2).(a)]

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Procedure / CPT Code / Site #1 / Site #2 / Site #3 / Site #4 / Site #5 / Total
Shoulder - Fracture and/or Dislocation
Closed treatmentof clavicular fracture; without manipulation / 23500 / # / # / # / # / # / # /
Open treatment ofclavicular fracture, includes internalfixation whenperformed / 23515 / # / # / # / # / # / # /
Closed treatmentof sternoclavicular dislocation; without manipulation / 23520 / # / # / # / # / # / # /
Open treatment ofsternoclavicular dislocation, acuteor chronic / 23530 / # / # / # / # / # / # /
Open treatment ofsternoclavicular dislocation, acuteor chronic;with fascialgraft (includes obtaininggraft) / 23532 / # / # / # / # / # / # /
Closed treatment ofacromioclavicular dislocation;without manipulation / 23540 / # / # / # / # / # / # /
Open treatment of acromioclavicular dislocation,acute or chronic / 23550 / # / # / # / # / # / # /
Open treatment of acromioclavicular dislocation,acute or chronic; with fascialgraft (includes obtaininggraft) / 23552 / # / # / # / # / # / # /
Closed treatmentof scapularfracture; without manipulation / 23570 / # / # / # / # / # / # /
Open treatment ofscapularfracture (body, glenoidoracromion),includesinternal fixationwhenperformed / 23585 / # / # / # / # / # / # /
Closed treatment of proximal humeral(surgicalor anatomical neck) fracture;without manipulation / 23600 / # / # / # / # / # / # /
Open treatment of proximal humeral(surgicalor anatomical neck) fracture,includes internal fixation, whenperformed, includes repairof tuberosity(s)whenperformed / 23615 / # / # / # / # / # / # /
Open treatment of proximal humeral(surgicalor anatomical neck) fracture,includes internal fixation, whenperformed, includes repairof tuberosity(s)whenperformed; withproximalhumeralprostheticreplacement / 23616 / # / # / # / # / # / # /
Closed treatment of greaterhumeral tuberosity fracture;without manipulation / 23620 / # / # / # / # / # / # /
Open treatment of greaterhumeral tuberosityfracture,includes internal fixation when performed / 23630 / # / # / # / # / # / # /
Open treatment of acute shoulder dislocation / 23660 / # / # / # / # / # / # /
Open treatment ofshoulder dislocation, with fractureofgreater humeraltuberosity, includes internal fixation whenperformed / 23670 / # / # / # / # / # / # /
Open treatment ofshoulder dislocation, with surgicaloranatomical neckfracture, includes internal fixation whenperformed / 23680 / # / # / # / # / # / # /
TOTAL / # / # / # / # / # / # /
Humerus/Elbow - Fracture and/or Dislocation
Closed treatmentofhumeralshaftfracture; without manipulation / 24500 / # / # / # / # / # / # /
Open treatmentof humeralshaftfracturewithplate/screws, withor without cerclage / 24515 / # / # / # / # / # / # /
Treatment of humeral shaft fracture,with insertionof intramedullaryimplant, withor withoutcerclageand/orlocking screws / 24516 / # / # / # / # / # / # /
Closed treatmentof supracondylar or transcondylarhumeral fracture, withorwithout intercondylarextension; without manipulation / 24530 / # / # / # / # / # / # /
Percutaneous skeletal fixationofsupracondylar ortranscondylarhumeralfracture, withor without intercondylarextension / 24538 / # / # / # / # / # / # /
Open treatmentof humeralsupracondylar or transcondylarfracture,includes internal fixation, whenperformed; withoutintercondylar extension / 24545 / # / # / # / # / # / # /
Open treatmentof humeralsupracondylar or transcondylarfracture,includes internal fixation, whenperformed; with intercondylar extension / 24546 / # / # / # / # / # / # /
Closed treatmentofhumeral epicondylarfracture, medialorlateral;without manipulation / 24560 / # / # / # / # / # / # /
Percutaneous skeletal fixationofhumeralepicondylar fracture, medial or lateral,with manipulation / 24566 / # / # / # / # / # / # /
Open treatmentof humeralepicondylarfracture, medialorlateral, includes internal fixationwhenperformed / 24575 / # / # / # / # / # / # /
Closed treatmentofhumeralcondylar fracture, medialor lateral;withoutmanipulation / 24576 / # / # / # / # / # / # /
Open treatmentof humeralcondylar fracture, medialor lateral,includes internal fixationwhenperformed / 24579 / # / # / # / # / # / # /
Percutaneous skeletal fixationofhumeral condylarfracture, medial or lateral, with manipulation / 24582 / # / # / # / # / # / # /
Open treatmentof periarticularfracture and/or dislocationofthe elbow(fracturedistal humerusand proximalulnaand/or proximalradius) / 24586 / # / # / # / # / # / # /
Open treatmentof periarticularfracture and/or dislocationofthe elbow(fracturedistal humerusand proximalulnaand/or proximalradius);withimplant arthroplasty / 24587 / # / # / # / # / # / # /
Open treatment of acuteor chronic elbowdislocation / 24615 / # / # / # / # / # / # /
Open treatment ofMonteggia typeoffracturedislocationatelbow (fractureproximal end ofulna withdislocationofradialhead), includes internalfixation whenperformed / 24635 / # / # / # / # / # / # /
Closed treatmentof radialheador neck fracture; without manipulation / 24650 / # / # / # / # / # / # /
Open treatment ofradial heador neck fracture, includes internal fixationor radial headexcision whenperformed; / 24665 / # / # / # / # / # / # /
Open treatment ofradial heador neck fracture, includes internal fixationor radial headexcision whenperformed; with radialheadprostheticreplacement / 24666 / # / # / # / # / # / # /
Closed treatment of ulnar fracture, proximalend(e.g.,olecranonor coronoidprocess [es]); without manipulation / 24670 / # / # / # / # / # / # /
Open treatment of ulnar fracture,proximalend (e.g.,olecranonor coronoidprocess [es]), includes internal fixation whenperformed / 24685 / # / # / # / # / # / # /
TOTAL / # / # / # / # / # / # /
Forearm/Wrist - Fracture and/or Dislocation
Closed treatmentof radial shaft fracture; without manipulation / 25500 / # / # / # / # / # / # /
Open treatment ofradial shaft fracture,includesinternal fixationwhenperformed / 25515 / # / # / # / # / # / # /
Open treatment ofradial shaft fracture,includesinternal fixationwhenperformed, and closed treatmentofdistal radioulnarjointdislocation (Galeazzifracture/ dislocation),includes percutaneous skeletal fixation whenperformed / 25525 / # / # / # / # / # / # /
Open treatment ofradial shaft fracture,includesinternal fixation,whenperformed, andopen treatment of distal radioulnarjoint dislocation (Galeazzifracture/ dislocation),includes internal fixation whenperformed, includes repair of triangular fibrocartilagecomplex / 25526 / # / # / # / # / # / # /
Closed treatment of ulnar shaft fracture; without manipulation / 25530 / # / # / # / # / # / # /
Open treatment of ulnar shaft fracture,includesinternal fixationwhenperformed / 25545 / # / # / # / # / # / # /
Closed treatmentof radialandulnarshaftfractures; without manipulation / 25560 / # / # / # / # / # / # /
Open treatment ofradial ANDulnarshaft fractures,with internal fixationwhen performed; of radius ORulna / 25574 / # / # / # / # / # / # /
Open treatment ofradial ANDulnarshaft fractures,with internal fixationwhen performed; of radius ANDulna / 25575 / # / # / # / # / # / # /
Closed treatment of distal radialfracture(e.g., CollesorSmithtype)orepiphyseal separation,includes closedtreatment of fracture of ulnar styloid whenperformed; without manipulation / 25600 / # / # / # / # / # / # /
Percutaneous skeletal fixation ofdistalradial fractureorepiphysealseparation / 25606 / # / # / # / # / # / # /
Open treatment of distalradialextra-articular fractureorepiphysealseparation,with internal fixation / 25607 / # / # / # / # / # / # /
Open treatment of distalradial intra-articular fractureorepiphyseal separation;with internal fixationof 2 fragments / 25608 / # / # / # / # / # / # /