Orthopaedic Trauma Care: Finding the Evidence
Trauma is the leading cause of death in the first four decades of life surpassed only by cancer and atherosclerosis as the major cause of death in all age groups. For every death attributable to trauma, three patients survive but are permanently disabled. With over 60 million injuries per year in North America, approximately 50 percent require medical care, of which 8.7 million patients are temporarily disabled. Trauma-related care costs over 100 billion dollars annually. Yet, despite these staggering costs, only four cents for every dollar is spent on trauma research.
The care of patients with musculoskeletal injuries has been guided by physician opinion since quality research in this area has been limited. Dr. Mohit Bhandari and his colleagues at McMaster University are changing the paradigm of "eminence-based practice" to "evidence-based practice."
In his search for evidence, Dr. Bhandari has been co-leading a collaborative multicentre randomized trial of alternative operative techniques in patients with tibial shaft fractures - the most common long fracture. The study is setting a benchmark in the conduct of orthopaedic trials worldwide.
As the Canada Research Chair in Musculoskeletal Trauma and Surgical Outcomes, Dr. Bhandari has developed a research program that meets the need for high quality surgical research aimed at answering clinical questions of international importance.
His research includes the design and conduct of large, multicentre randomized trials that evaluate interventions in patients with musculoskeletal injuries. In addition, his program explores the methodological issues specific to the conduct of surgical trials and involves the application and evaluation of evidence-based methods to guide the care of patients with musculoskeletal trauma. In the process, his program is attracting and educating new surgical trainees as career academic surgeons.