Medical Student Research Fellowship for Summer 2007

Mentor: Lisa K. Cannada, MD
Department: Department of Orthopaedic Surgery - Traumatologist
Room number: G07.206
Mail Code: 8870
Phone number: 214-648-8768
E-mail: lisa.cannada@utsouthwestern.edu

Project I title: Childbirth After Pelvic Ring Disruption

Human subjects IRB approved project number (where applicable): 062006-027

Animal subjects IRB approved project number (where applicable): NA

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects)

Patient Based

Brief Description of Project:

This a multi-center study evaluating childbirth after pelvic fractures.

Each year in the United States, over 100,000 patients are treated for pelvic fractures with more than 40,000 involving women. The pelvis is a stabilizing structure between the major weight bearing structures of the lower extremity and the trunk. Major structures pass through it including genitourinary, vascular, neurologic and gastrointestinal. Pelvic fractures represent sever injuries with mortality rates ranging from 5-25%. There can be significant problems for patients in terms of functional recovery. Female patients, in particular, are concerned about the future ability to bear children and participate in sexual activity.

The hypothesis of the current investigation is that women who have been treated non-operatively for pelvic fracture, and those treated surgically with fixation sparing the sacroiliac joints and/or the pubic symphysis can deliver children vaginally. We hope to identify risk factors for obstetrical complications with respect to injury patterns, residual deformity, associated injuries and types of stabilization in order to develop clear indications for attempted vaginal delivery versus CS after pelvic fracture.

Project II title: The Natural History Following Femoral Head Fractures

Human subjects IRB approved project number (where applicable): #052007-044

Animal subjects IRB approved project number (where applicable):

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects)Patient based.

Brief Description of Project
Femoral head fractures (FHF's) are relatively infrequent injuries encountered in orthopaedic traumatology, and therefore the literature is lacking in large clinical studies reviewing outcomes. A review of the literature reveals two major classification systems, the Pipkin system and the Brumback system. This has several limitations including an inability to classify shear type FHF's as well as FHF's associated with anterior dislocations. As a consequence of the rarity of this injury, the ambiguity or overcomplexity of the two major classification systems, poor follow-up in most studies and the lack of a consistent system to measure outcomes, the optimal treatment for these fractures is controversial. The primary purpose of this study will be to determine survivability of the femoral head following the different injury patterns and treatment options to determine the natural history following this injury and to improve understanding of mid- to long-term follow-up. Patients treated for femoral head fractures between 2001 and 2005 will be identified for closed or open treatment of femoral head fractures. Their charts will be reviewed to determine demographics and treatment. Injury x-rays be reviewed to classify femoral head fractures according to the Pipkin and Brumback Classification Systems. Available follow-up films will be reviewed to determine rates of union, collapse, heterotopic ossification, and revision surgery. The data will then be analyzed to determine if a difference in these outcomes exists based on treatment as well as classification. Incidence of pain and range of motion will be determined from chart review. A database will then be assembled so that these patients may be followed over time to determine more long-term outcomes, which have not previously been reported. This is part of a multi-center study so our results will be part of the largest study to date in the literature.

Previous Research Activities or Publications with Medical Students:

See Attached CV.

- Highlighted medical student projects.
Including project with medical students at Emory University, my previous employer

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