Research Projects

Study Overview

Factors Predicting Orthopaedic Trauma Volumes, Weekends vs Weekdays

Orthopaedic trauma does not present in a linear fashion. Fluctuations in trauma volumes, after-hours surgery and surgical wait times impact orthopaedic surgeons and patients. There is little research focusing on how surgical trauma volumes change throughout the week. This study investigated the relationship between day of the week and surgical orthopaedic trauma volumes, after-hours surgery, and wait times for orthopaedic trauma patients.

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Weekends were associated with increased surgical wait times despite decreased surgical trauma volumes. Surgical orthopaedic trauma volumes were elevated on weekdays and decreased on weekends. With a lack of dedicated trauma resources on the weekend, a significant increase in after-hours surgery and surgical wait times was identified following surgical volumes peaking on Thursday and Friday. We suggest adapting resource allocation to reflect surgical volumes. Dedicated weekend orthopaedic trauma resources or an adaptable schedule during increased orthopaedic trauma have the potential to ease this bottleneck, improve patient care, and decrease hospital costs.

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Current Status

Completed and published in Injury.

https://doi.org/10.1016/j.injury.2022.03.010

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Lead Principal Investigator

Dr. Neil White

Study Overview

Factors Predicting Orthopedic Trauma Volumes (FROST)

Orthopaedic surgeons often speculate how weather and season impact the nature and volume of surgical orthopaedic trauma; however, prior to this study, little evidence had existed to support these claims. Our most experienced research assistant, Martina Vergouwen set out to establish this relationship between weather variables and the impact it has on orthopaedic medical care. 

Surgical orthopaedic trauma cases between January 1 of 2008 to December 31 of 2018 were retrospectively reviewed at four major adult hospitals in  Calgary, Alberta. Weather variables for each day was collected using Government of Alberta Environmental Sensing Systems (ESS) and Environment Canada weather stations (CALGARY INTL’A). Our results showed that ice or snow on the ground two days prior was predictive of increased orthopaedic trauma volumes. Furthermore, our analysis concluded that orthopaedic trauma volumes increased in the winter and summer seasons and decreased during the spring and fall. Finally, surgical wait times also increased in the summer and winter months. 

These results have critical implications on resource allocation in health care. Our data provides a compelling argument for a restructuring of resources to accommodate predicted influxes and nulls of orthopaedic trauma volume during specific times of year and weather variables. 

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Current Status

Completed and published in Injury.

https://doi.org/10.1016/j.injury.2021.02.076

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Lead Principal Investigator

Dr. Neil White

Study Overview

Scaphoid fracture treatment is heavily reliant on the interpretation of diagnostic images.  Traditionally, plain film X-ray images have been used to diagnose scaphoid fractures and assess the extent of healing.  

With the advancement of 3D imaging technology, leading to the increased use of CT, the method of communicating scaphoid fracture healing has shifted from categorical descriptions to percentage of cortical bridging across the fracture site.  Scaphoid fractures which fail to heal are categorized as scaphoid non-union.  Left untreated, scaphoid non-unions have a natural history of developing scaphoid non-union advanced collapse(SNAC) , where patients will likely experience pain, and progressively lose function in the wrist. 

The purpose of this study is to evaluate the value of X-ray and CT in scaphoid fracture management, and determine the extent of variation in image interpretation.

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Current Status

Completed. Under review for publication. 

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Lead Principal Investigator

Dr. Neil White