Request for Funding
Medical Student Research Fellowship for Summer 2011

All descriptions must contain enough detail to permit an assessment of the problem that is to be addressed and the methodologies that are to be employed. Please be careful to outline the role that the student will play in the project that is described. Please ensure that all relevant approval numbers (IRB, IACUC) are provided.

Mentor:                       Christine Ho, MD     
Department:               Pediatric Orthopedic Surgery
Room number:           E2.300
Mail Code:                 CMC E2.300
Phone number:          214-456-9389
E-mail:                        Christine.Ho@childrens.com
Project title:                Nonunions in Single-Bone Fixation of Pediatric Both-Bone Forearm Fractures

Human subjects IRB approved project number (where applicable)
eIRB no: STU 112010–065  (092007 – 053)

Project Type
Patient-based research

Brief Description of Project:
Design of the Study: This is a retrospective chart review of patients treated at CMC with a diagnosis of both-bone forearm fracture who were treated with single-bone fixation using an intramedullary nail and were followed to clinical endpoint. Patients who had a delayed union or nonunion (no evidence of healing at six month postoperatively) will be compared to patients who did not have a nonunion or delayed union. Both paper and electronic charts and radiographs will be reviewed. Preoperative, postoperative, and final follow-up radiographs will be reviewed, with special attention to fracture location, skeletal maturity, degree of comminution, adequacy of reduction, maintenance of reduction, and time to union. Information to be obtained from the chart will include indication for surgical fixation, Gustilo grade for open fractures, patient age, mechanism of injury, length of surgery, surgical complications, estimated blood loss, type and size of intramedullary nail used, length of hospital stay, time to return to full activities, final range of motion, need for subsequent surgeries, and any postoperative complications.
Comparisons between groups will be done using Fisher exact tests, two-sample t-tests, and ANOVA. Standard statistics will be used for all other analyses.
This study will help Orthopedic surgeons understand the risk of nonunion and delayed union after single-bone fixation of pediatric patients with both-bone forearm fractures which future patients may benefit from.

Previous Research Activities or Publications with Medical Students:

Ho, C.A., Wilson, P.W. A Comparison of Fracture Reductions Performed by Physician
Extenders and Orthopaedic Residents in the Acute Pediatric Orthopaedic Practice.
Journal of Orthopaedic Trauma, accepted August 2009, pending publication.

Ho C.A., Karol L.A. The Utility of Knee Releases in Arthrogryposis. Journal of Pediatric
Orthopaedics, 2008 April/May; 28(3): 307-313.

Ho C.A., Skaggs D.L., Weiss J.M., Tolo V.T. Management of Infection After Instrumented
Posterior Spine Fusion in Pediatric Scoliosis. Spine, 2007 Nov 15; 32(24): 2739-2744.

Ho C.A., Richards B.S., Sucato D.J. Risk Factors for the Development of Delayed Infection
Following Posterior Spinal Fusion and Instrumentation in Adolescent Idiopathic Scoliosis

Patients. Spine, 2007 Sept 15; 32(20): 2272-2277.
Ho C.A., Herring J.A., Ezaki, M.B. Long Term Follow-up of Progressive Macrodystrophia
Lipomatosa. Journal of Bone and Joint Surgery-A. 2007 May; 89A(5): 1097-1102.