Broken Bones Care and Treatment:

1
Broken Bones Care and Treatment

• A Role for Research at the
• InMotion Musculoskeletal Institute

2
Broken Bones

• A broken bone requiring orthopaedic treatment
  occurs approximately every 14 seconds in the U.S.
• Half of all Americans will break a bone and
  receive treatment for it prior to their 65th
  birthday

3
Broken Bones Treatment Techniques

• Traditionally conservative treatment
• of broken bones involved casting
• and/or fracture bracing
• techniques to achieve healing.

A broken leg bone (tibia) treated with a fracture
brace shows healing with callus formation at 4-6
months.
4
Broken Bones Treatment Techniques

• Internal Fixation with plates, screws, and rods
  (6 million cases annually in the U.S.) has
  increased survival from major trauma by a factor
  of three and has shortened the length of hospital
  stays by a factor of five
• Undisputed benefits of progressive fracture
  treatment
• Improved quality of life
• More effective rehabilitation
• Faster return to work

5
Need for Research, Discovery and Improved
Fracture Treatments

• Osteoporosis and Hip Fractures
• The increasing number of
• hip fractures
• in the elderly constitutes
• a health care burden.
• Templeman, et. al.
• AAOS Inst. Course Lecture, 2005
• Incidence
• In 1990 1.7M Hip Fractures worldwide
• By 2050 Hip fracture could exceed 21M worldwide
• For white women 1 in 6 lifetime risk of
  sustaining a hip fracture compared to 1 in 9
  lifetime risk of developing breast cancer

6
Need for Research, Discovery and Improved
Fracture Treatments

• Osteoporosis and Hip Fractures
• Cause
• Falls and Low Bone Mineral Density
• (Osteoporosis)
• Current Treatment
• Surgery within two days of Injury
• Internal Fixation Devices
• Partial Hip Replacement
• Total Hip Replacement
• Costs to Society
• U.S. Annual treatment costs for hip fractures --
  9B
• Liporace, et. al.
• Am. J. Orthopaedic, 2005
• England hip fractures consumed 20 of all
  orthopaedic beds
• Cummings and Melton,

7
Need for Research, Discovery and Improved
Fracture Treatments

• Osteoporosis and Hip Fractures
• Outcomes
• Overall mortality rate is approximately
  20
  within the first year
• Fixation failure rates as high as 56
• Templeman, et. al.
• AAOS Institute Comm Lecture, 2005
• Ultimately, up to a third of individuals who
  have hip fracture can become
  totally dependent.
• Cummings and Melton
• The Lancet, 2002

8
Need for Research, Discovery and Improved
Fracture Treatments

• Researchers must continue
• to focus on hip fractures and on improving
• functional outcomes to help
• our seniors regain
• their quality of life
• Liporace, et. al.
• Am. J. Orthopaedic
• Osteoporosis also leads to fragility fractures of
  the spine and wrist in addition to hip fractures.

9
Need for Research, Discovery and Improved
Fracture Treatments
Osteoporosis and Vertebral Compression Fracture

• Vertebral Compression Fractures (VCF) are a
  worldwide problem
• 700,000 annually in U.S.
• 500,000 annually in Japan
• 350,000 annually in Europe
• Osteoporosis is believed to account for
• up to 85 of vertebral compression fractures
• Seventy-five percent of VCFs in the U.S. occur
  in women

Osteoporosis-Related Fragility Fractures
Other 17
Spine 46
Wrist 17
Hip 20
Source National Osteoporosis Foundation
10
Goal of Musculoskeletal Care

• Relieve Pain
• Return Function/Mobility
• Minimize Surgical Trauma

Musculoskeletal Research in Fracture Management
and the treatment of broken bones can
provide ? Innovative Discoveries ?
Better Materials ? New Treatment
Options ? Biologic Solutions ?
Economic Benefits
11
InMotion a Partnership / Collaboration for
ResearchHospitals Clinics Universities -
Industry
Translational Research Model
Patient Care
Fundamental Research
Applied Research
Clinical Research
12
Realizing the Dream

• Your Support and Assistance to InMotion will Help
  us Realize our Dream
• InMotion Funding Priorities
• Clinician Scientists - to connect the patients
  problems to
  laboratory solutions
• Biomechanics Expertise - to rapidly verify the
  strength of the solutions
• Clinical Research Team - to evaluate treatment
  options and determine best patient
  care practices
• World-Class Scientific Facilities - to enable
  breakthrough discoveries
• Collaborative Environment to foster an
  Interdisciplinary Approach to solve
  Major Clinical Problems