The Montefiore Approach

The Division of Orthopedic Trauma at Montefiore provides comprehensive treatment for both fractures and fracture-related conditions. With one of the busiest emergency departments in the nation, Montefiore possesses extensive experience in treating a range of injuries.

Our fellowship-trained specialists are dedicated to the diagnosis and management of various orthopedic injuries and conditions, including fragility fractures, non-unions, mal-unions, and bone infections. Together, with our team of geriatricians, endocrinologists, pain management specialists, and orthopedic nurses, we work to ensure an intelligent and comprehensive approach for our patients.

As an academic medical center, we engage in a variety of research projects with the aim of better understanding conditions such as post-traumatic arthritis, geriatric fractures, and osteomyelitis. Our participation in these research efforts allows us to explore exciting new methods for the advancement of care within our own health system and beyond.

  • Our Patient-Centered Care

    The experience of our patients and their loved ones—not simply their ailments—demands our full attention. Your dedicated care team will be there to discuss your condition, answer questions, assess treatment options, and develop a treatment strategy that works for you.

  • Our Expertise

    Orthopedic traumas present unique challenges. At Montefiore, we believe that optimal outcomes are achieved through diligent evaluations, precise diagnoses, and individualized treatment plans developed through years of clinical experience.

    With experience in both conventional surgery and cutting-edge surgical techniques, our board-certified orthopedic traumatologists carefully select the most appropriate management strategy for each patient. Prior to any procedure, our surgeons will always consider a patient’s unique needs, expectations, and surgical goals.

  • Our Dedication to Research

    Our status as an academic medical center puts us at the forefront of our field. Together with our Albert Einstein College of Medicine, one of the highest NIH-funded institutions in the country, we work towards the advancement of orthopedic trauma study and care. Our research efforts endeavor to better understand why patients develop orthopedic injuries and, importantly, improve operative and non-operative treatments for these conditions. We routinely present our research findings in both national and international arenas as well as publish our study results in well-respected medical journals so that patients everywhere can benefit from what we learn and discover at Montefiore.

Conditions We Treat

Montefiore treats a vast spectrum of conditions, a selection of which you will find listed below. In addition to these, we have experience treating many other conditions that might not be found here. Please contact us today to schedule a consultation so that we can review and discuss your specific healthcare needs.

Some Common Conditions

  • Fractures of the forearm
  • Fractures of the elbow
  • Fractures of the humerus
  • Fractures of the shoulder
  • Fractures of the pelvis
  • Fractures of the acetabulum
  • Fractures of the hip
  • Fractures of the femur
  • Fractures about the knee
  • Fractures of the distal femur
  • Fractures of the tibial plateau
  • Fractures of the tibia
  • Fractures about the ankle
  • Fracture of the distal tibia (pilon fractures)
  • Fractures of the talus
  • Fractures of the calcaneus
  • Fragility fractures

Our Treatments

Not every fracture requires surgery. There are instances, such as when a fracture involving a joint is displaced or is likely to heal in poor alignment, when surgery represents the best treatment option. In these cases, the purpose of surgery is to speed up recovery time, promote proper healing, and allow for early joint motion.

Trauma surgery has evolved tremendously in recent decades. In the past, surgeries required long incisions and extensive soft-tissue dissection. Today, it is frequently possible to employ much smaller incisions that protect or spare surrounding soft tissue.

Our surgeons carefully select cases that can be treated using minimally invasive techniques. When possible, broken bones are realigned using pins and clamps placed through minimally invasive incisions. With the assistance of imaging, the bone is aligned. An appropriate implant, such as a metal plate, is then guided through the small incisions and screwed into place.

There are many benefits to using minimally invasive techniques, including reduced pain, improved healing, shorter recovery time, and minimal scarring.

Highlighted Treatments

  • Ilizarov and Taylor Spatial Frame

    When a limb is threatened by trauma or infection, conventional plates or rods may not be a viable treatment option. Ilizarov or Taylor Spatial Frames are techniques that offer alternative approaches. These approaches place the majority of the implant outside the patient’s body and only pass very thin wires or pins through the bone. Ring fixators like these are an invaluable treatment method for fractures that don’t heal, heal in poor alignment, develop post-surgical infections, or have large associated wounds.

    Using pins placed through the skin, rings are affixed to bone above and below the fracture. These external rings can be manipulated to compress fractures, gradually realign limbs, or even “grow” bone that has been lost due to trauma or infection.

    These techniques are instrumental in managing particularly complex clinical cases in which routine approaches may yield suboptimal results. Expertise in these techniques allows for limb salvage and improved quality of life for many patients with either extensive injury or chronic post-traumatic conditions.

  • Lengthening Rods

    Improper healing may result in malalignment or shortening of the limbs, which can impact ambulation, recreational activity, and quality of life. In these cases, either realignment of the bone, lengthening of the bone, or both can greatly restore a patient’s functional abilities.

    Improved alignment is obtained by first creating a planned break in the bone, called an osteotomy. In certain situations, once realigned, bones can be held in place with plates and screws or an internal rod.

    In cases where the bone is also shortened, a growing metal rod, which lengthens over time, can be placed within the center of the bone. The rod is reliably controlled or activated by an external magnet placed on the skin, allowing the bone to lengthen along with the rod. In rare circumstances, these rods can also be used in reverse to compress broken bones that have failed to heal over time, or to move a segment of bone to an area of bone deficiency.

  • Pelvic and Acetabular Fracture Plate Reconstruction

    Fractures of the pelvis are one of the most complicated trauma conditions to treat. Our orthopedic traumatologists are trained in the most modern techniques and surgical approaches to pelvic and acetabular fracture reconstruction.

    In certain cases, screws can be inserted using a minimally invasive approach, offering patients improved stability and pain relief while minimizing surgical risk. Detailed planning is achieved with 3D CT scans, which allow for optimal positioning of these pelvic screws. This provides a surgical option for many patients who might otherwise need to choose between either non-operative treatment and longer recovery times or larger surgeries with added risk.

    When necessary, a traditional “open” approach is used to address fractures of the pelvis. X-rays and CT scans are routinely used for injury assessment and preoperative planning. Incisions are then made either to the front or the back of the pelvis to realign or reduce the injured bones. Plates and screws are employed to secure the bones in their proper position until they have united or healed.

    Recovery time is extremely variable and dependent upon a host of patient-specific and injury-specific factors. These surgeries are complex and require attention to detail, experience with challenging anatomy, and advanced training. Our surgeons have been specifically trained to manage these difficult cases and to guide patients through the postoperative recovery period.