History of the rotation
Our trauma orthopaedic service is one of the best in the nation. It has a well-deserved reputation for excellence. In 1966, the University of Washington assumed control of the King County Medical Center, which then became Harborview Medical Center. Donald Gunn, M.D. was the Chief of Orthopaedics at Harborview Medical Center in 1968-9, and Sigvard T. Hansen, Jr., M.D. was the Chief Resident in Orthopaedic Surgery. In 1971, Dr. Hansen visited Gerhardt Kuntscher and learned advanced techniques of medullary nailing. He was involved in the early North American AO/ASIF development and, in particular, worked with Hans Willenegger. In 1972, Dr. Hansen became Chief of Orthopaedics at Harborview Medical Center and established the roots of aggressive management of long bone and pelvic fractures. In 1973 Drs. Clawson and Hansen attended the AO Course in Davos, Switzerland. Thereafter, stable fixation became the treatment of choice at Harborview. Dr. Robert A. Winquist began his six year Harborview tenure in 1974. He gained extensive clinical experience with closed medullary nailing of femur fractures, as well as open reduction and internal fixation of metaphyseal and articular fractures.
About the rotation
The trauma rotation offers an excellent experience under the supervision of fellowship-trained faculty including: Christopher H. Allan, M.D., David P. Barei, M.D., Daphne M. Beingessner, M.D., Carlo Bellabarba, M.D., Stephen K. Benirschke, M.D., Richard J. Bransford, M.D., Douglas Hanel, M.D., Robert P. Dunbar Jr., M.D., Reza Firoozabadi, M.D., Sigvard T. Hansen Jr., M.D., M. Bradford Henley, M.D., Conor P. Kleweno, M.D., Sean E. Nork, M.D., H. Claude Sagi, M.D., Bruce J. Sangeorzan, M.D., Douglas G. Smith, M.D., and Lisa A. Taitsman, M.D.
R2s rotate through three six-week blocks on each of the three orthopaedic trauma teams at Harborview where they take primary call in the ER. This is truly a rite of passage. It is here that one perfects such skills as reducing fractures and dislocations, applying skeletal traction, and splinting. One also learns how to work efficiently with attention to detail, in even the most demanding of circumstances. Interns and nurse practitioners help complete the day to day work on the floor, however, it is the R2s responsibility to take a leadership role by knowing the events and plans for each of the patients on the floor.
The R5s return to the HMC trauma rotation acting as chief during two eight-week blocks. In addition, they spend an eight-week block as the night float chief. There is also time for research during this rotation.
Goals & Objectives
The goals are to teach the essentials of orthopaedic trauma relevant to a general orthopaedic practice as well as the foundation for fellowship training.
On the trauma services at Harborview, R2s learn: injury patterns and classification schemes of fractures; how to prioritize the treatment of patient injuries; and gain an understanding of the management algorithms for straightforward to complex trauma. There are four morning teaching conferences each week for both residents and attendings. In addition, traumatology teaching rounds are held weekly.
When R5s return to Harborview as a chief, they are responsible for learning the nonoperative and operative management of orthopaedic trauma. In addition, it is their duty to educate the juniors.
Harborview Medical Center is a very special place for residents. The excellent support provided by the faculty and staff, the challenging cases, and heavy work load make it an ideal place to learn orthopaedic trauma.