For Patients : Trauma

Trauma

The Trauma Division manages the orthopaedic trauma at Jackson Memorial Hospital and the University of Miami Hospital and is made up of six surgeons who each have a subspecialty focus. We treat everything from simple fractures that need a brace or cast, to complex multi-trauma that is best handled at a Level 1 trauma center. The orthopaedic trauma attending surgeons meet every weekday morning to review the surgical cases from the day prior, plan the surgeries for that day, and coordinate care for the more complex cases that require multiple surgeries or multiple surgeons. There is not a single case that is not scrutinized by the trauma attending surgeons as a group, and therefore we have come to demand and expect an extraordinarily high level of performance from each other. It is a collegial and skilled group and we work together to formulate surgical plans, and operate together on the more complicated cases. This high level of expertise, cooperation, and peer review is a unique environment that you will not find anywhere else in Florida. While it may be a single highly specialized trauma surgeon who is selected to perform your surgery, the whole group has first scrutinized your case.

Minimally-invasive techniques have evolved over the past decade, and in many respects, we have been at the forefront of these trends. Oftentimes an injury can be treated in more than one way and it is very important that the surgeon has a full skill set to properly choose the best approach. Our group is highly skilled due to their training and experience at our busy trauma center, and our faculty members are frequently asked to handle the most challenging of cases. We routinely present our research and techniques at national meetings and courses.

If you or a loved one has sustained a broken bone (which we call a “fracture,” but it means the same thing), and you would like to contact us for treatment, please call our appointment line at (305)243-3000 or our orthopaedic office at (305)585-7275, or email us at miamiorthortrauma@med.miami.edu. We try to monitor this email address frequently, but if your case is urgent and you do not hear back from us within a day or your case is urgent, please call.

The following are some of the specific fracture types that we routinely treat:

Shoulder, humerus shaft, and clavicle (collar bone) fractures

While many of these fractures can be treated without surgery, it requires a sophisticated and experienced surgeon to decide the best way to treat these injuries. Treatment must be individualized to the unique needs of each patient. Dr. Steven Kalandiak is our shoulder (proximal humerus), clavicle, and elbow expert and has been at the University of Miami for more than 10 years. Dr. Steven Quinnan, Dr. Fernando Vilella, and Dr. Gregory Zych also are skilled at handling these injuries.

Ankle fractures (“broken ankle”) and foot fractures

Non-operative treatment is often the best choice for simple foot and ankle fractures, either with casting or a walking boot. For more significant injuries, repair of the fracture may be necessary to restore the anatomy and improve function. These fractures can be deceptively complex. All of our traumatologists handle these injuries.

Tibial plateau fractures and pilon fractures

These fractures involve the joint surface of the knee (tibial plateau) and ankle (pilon). When surgery is necessary, our goal is to restore the integrity of the joint surface and allow for early knee or ankle motion. Dr. James J. Hutson has a particular interest in this type of injury, although all of our traumatologists are skilled in these injuries because we see them so commonly at our Level 1 trauma center.

Elbow and forearm fractures

These injuries must be treated precisely because of the impact they can have on the function of the arm and hand. Dr. Steven Kalandiak and Dr. Steven Quinnan handle most of the elbow fractures, and all of our traumatologists routinely take care of forearm fractures.

Pelvis, sacrum, and acetabular fractures

The pelvis and acetabulum are a complex array of bones and ligaments that connect the legs to the spine and upper body. Treatment is highly individualized to the needs of the patient. Dr. Gregory Zych, Dr. Steven Quinnan, and Dr. Fernando Vilella handle these injuries and Dr. Quinnan when the injury extends into the lumbar spine region.

Hip fractures

Hip fractures almost always require surgery, and can be complicated by osteoporosis. If the injury occurs in an elderly patient, medical problems must be taken into account when managing the injury. A multi-disciplinary team consisting of the orthopaedic surgeon, internal medicine doctor, and anesthesiologist must collaborate to maximize the chance of surgery and rehabilitation a success. All of our traumatologists handle these injuries, although Dr. Fernando Vilella is our main surgeon when a total hip replacement is necessary with certain types of fractures.

Spine fractures

Dr. Seth Williams handles much of the spine trauma, and provides input when multiple injuries must be treated and a spine fracture must be taken into account. Oftentimes bracing can be used to treat spine fractures, but at times surgery is necessary. Dr. Williams prefers to use minimally-invasive techniques whenever possible to treat spine fractures.

Femur and tibia fractures

The femur is the strongest bone in the body, and it usually takes quite a bit of force to break this bone. The tibia is also very strong and this injury usually occurs from similarly high-energy mechanisms. All of our traumatologists handle these injuries. Dr. James J. Hutson has particular experience and expertise in managing complex injuries that would end up in amputations at most hospitals. Dr. Steven Quinnan has also become an expert at these techniques. We are currently involved in a study funded by the Department of Defense involving severe limb-threatening tibia fractures.

Fractures that do not heal (non-unions)

Broken bones sometimes do not heal. This can be very frustrating because it delays recovery. Treatment can be very challenging, especially if surgery has already been performed, and is best done in the hands of an experienced traumatologist. We have extensive experience with this problem.

Fractures that heal crooked (mal-unions)

Broken bones that heal crooked are called mal-unions. Sometimes this can make normal function impossible, and surgery is necessary to fix the alignment of the bone. These surgeries must be precisely planned and executed, and are best done by one of our traumatologists who have particular expertise in mal-unions.

Fractures near a hip or knee replacement (peri-prosthetic fractures)

Hip and knee replacement surgery is increasingly common and has a high success rate, but poses great challenges when a fall or accident results in a fracture around the prosthesis. Dr. Fernando Vilella routinely performs elective hip and knee replacements, and so he is particularly helpful with these types of injuries, although all of our traumatologists have a great deal of experience with peri-prosthetic fractures.

Bone loss and limb lengthening

Specialized techniques using external ring fixators are used to manage these complex cases. Dr. James J. Hutson is one of the world’s experts in these techniques, and several years ago he was joined by Dr. Steven Quinnan who also has unique training and experience with these techniques.

Hand and wrist fractures

The injuries are handled by our Hand Surgeons. Please refer to the Hand Surgery divisional website for further information.

Doctors