Barnes-Jewish Hospital and Washington University maintain a Level I Trauma Center accredited by the American College of Surgeons in St. Louis, MO. The trauma center is serviced by city and county EMS and two local emergency helicopter services.
The Orthopaedic Trauma Service (OTS) at Barnes-Jewish Hospital is under the direction of William Ricci, MD. Together with his partner, Michael Gardner, MD, the OTS is involved in the care of all multiple injured patients admitted to Barnes-Jewish Hospital and the vast majority of patients admitted with isolated fractures.
The goals of the OTS are to first and foremost provide superb patient care in a humane and efficient fashion, educate and train the physicians of tomorrow and advance medical knowledge through clinical and basic science research.
Dr. Ricci has a particular interest in the treatment of complex fractures and fracture/dislocations of the upper extremity and knee. He has ongoing research interests in the treatment of nonunions and diaphyseal fractures, as well as less invasive skeletal stabilization systems (LISS).
The Orthopaedic Trauma Service works closely with the Department of General Surgery/Division of General Surgery Trauma, directed by Timothy Buchman, M.D., Ph.D., as well as the Division of Plastic Surgery and the Department of Anesthesiology. To maximize patient care all Level I trauma patients are initially admitted to the General Surgery Trauma Service for a minimum of 24 hours and only after thorough evaluation are they eligible for transfer to the consultant services.
The Orthopaedic Trauma Service is staffed by an orthopaedic chief resident (PGY-5) as well as first, second and third year (PGY 1, 2, and 3) orthopaedic junior residents A second year Emergency Department resident (PGY-2) is also part of the orthopaedic trauma team and participates in the assessment and care of outpatients. The chief resident completes a ten week rotation. Junior residents complete rotations from four to ten weeks in length depending upon their level of training. During the 2001-2002 academic year, a Night Float system was implemented whereby a designated PGY-2 trainee participates in one-half day of clinical activities and provides call coverage of the Barnes-Jewish Hospital emergency room during the week. All operative procedures are attended by an attending physician . The chief resident is responsible for staffing the hospital's orthopaedic clinic each week and the junior residents gain experience in out-patient care in the hospital's orthopaedic clinic as well as the attending physician's private office.
Monthly orthopaedic trauma Journal Club and cadaveric dissections are attended by all trauma residents, as well as residents from the Foot and Ankle Service and from the John Cochran VA Hospital. Monthly psychomotor skill exercises are held for all orthopaedic residents and these sessions include dinner, video demonstrations and hands-on Saw Bone exercises. Weekly preoperative and postoperative conferences are held on Mondays and Fridays, respectively in the radiology reading room located on the orthopaedic ward.
Resident participation in surgical procedures is graduated and dependent upon the demonstration of proficiency in basic techniques and interest. The most commonly treated injuries by the orthopaedic trauma service include bimalleolar ankle fractures, hip fractures, fractures of the femur and tibia, fractures of the humerus, radius and ulna, acetabular and pelvic ring fractures and calcaneal fractures. A large number of nonunions and malunions are also treated. Numerous patients with chronic osteomyelitis are treated each month in conjunction with faculty from the Department of Internal Medicine and Division of Infectious Diseases.