Orthopaedic researchers at Wake Forest University School of Medicine have received two grants totaling nearly $5 million from the Department of Defense to study the most effective treatments for femur and heel fractures.
A $2.4 million grant will support a 4-year, randomized clinical trial that will examine patient outcomes following heel fractures treated with two different surgical procedures.
Joseph Hsu, M.D., an orthopaedic trauma surgeon and vice chair of quality at Atrium Health Musculoskeletal Institute, and associate dean for research at Wake Forest University School of Medicine, is the principal investigator. Meghan Wally, Ph.D., research assistant professor at Atrium Health Musculoskeletal Institute and assistant professor of orthopaedic surgery at Wake Forest University School of Medicine, is the co-principal investigator.
“Heel fractures aren’t common, but they are challenging to treat,” Hsu said. “Our goal is to determine if one of the procedures gets patients back to work or active duty faster.”
The trial will compare an open reduction and internal fixation (ORIF) method with and without primary subtalar arthrodesis, which is surgical fusion. According to Hsu and Wally, when ORIF is performed, patients can develop painful post-traumatic subtalar arthritis, which requires an additional fusion surgery. The researchers believe there may be a benefit to performing the fusion with initial surgery.
The second grant, which is $2.5 million, will support a 4-year, randomized clinical trial to study whether a single implant or a dual implant fixation repair of distal femur fractures is more effective. These injuries can occur from falls, especially in cases with osteoporosis, but they are also seen with substantial trauma such as car accidents or during active military duty.
Laurence Kempton, M.D., clinical associate professor of orthopaedic surgery at Wake Forest University School of Medicine and orthopaedic trauma surgeon at Atrium Health’s Musculoskeletal Institute, is the principal investigator. Rachel Seymour, Ph.D., associate dean of research for Wake Forest University School of Medicine and vice chair for research for the department of orthopaedic surgery at Atrium Health's Musculoskeletal Institute, is the co-principal investigator.
Kempton and Seymour said there is limited research on single vs. dual implant fixation, but some data suggest that dual implant fixation might reduce the need for future surgeries, but more research is needed to determine the degree of benefit.
“With this funding support, we will advance much-needed research,” said Claude T. Moorman, M.D., president of the Atrium Health Musculoskeletal Institute and chair of the department of orthopaedic surgery at Atrium Health. “These studies will provide evidence-based guidelines to improve outcomes in orthopaedic care and continue to allow us to provide the best care to patients.”
Both trials are being conducted at multiple sites across the Southeast and with partners across the country, including Atrium Health Carolinas Medical Center in Charlotte Atrium Health Wake Forest Baptist in Winston-Salem, Atrium Health Cabarrus in Concord and Atrium Health Navicent in Macon, Georgia.
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