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Centennial milestones: Expanding expertise in Level I Trauma Center, sports medicine, PM&R, and hand surgery

Mayo Clinic Department of Orthopedic Surgery celebrates its 100th anniversary this fall. Notes department chair Daniel J. Berry, M.D., as he surveys a century of orthopedic care at Mayo Clinic: "The steady growth and the dedication of a collegial, multidisciplinary staff has enabled Mayo orthopedists to provide the highest-quality orthopedic care on a daily basis for 100 years—that was the original vision, and that remains the vision we work to fulfill everyday."

In 1910, the fledgling Mayo orthopedics department made a bold move to send its brace maker to New York for training to improve care for polio, tuberculosis, and farm injury patients. "But by 2010, the leadership and presence of the Mayo Clinic Department of Orthopedic Surgery are truly international," explains Dr. Berry. "Our presence around the world spans a broad spectrum of clinical, surgical, research, educational, and training initiatives. We focus our care on regularly performed procedures and on complex, less common problems. In most patients, we can achieve excellent recovery of function with a low risk of complications—which is tremendously gratifying for us all."

Growth areas

Two recent areas of growth stand out:

Images of Physical Medicine and Rehabilitation Center service areas

Physical Medicine and Rehabilitation Center service areas

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  • The addition of staff to further strengthen Mayo's commitment as a Level I Trauma Center and add depth to the department's subspecialties
  • The final integration in winter 2010 of Mayo's physical medicine and rehabilitation (PM&R) service areas into the W. Hall Wendel Jr. Musculoskeletal Center, which opened in 2007. The Department of Physical Medicine and Rehabilitation celebrates its 75th anniversary year in 2010.

Centennial milestones: Expanding PM&R

With the centralized design integrating PM&R into the musculoskeletal center, patients now have the convenience of one-stop access to all musculoskeletal specialties, including:

  • All orthopedic subspecialties
  • PM&R
  • Rheumatology
  • Bone endocrinology
  • Radiology
  • Anesthesiology

Explains PM&R department chair Kathryn A. Stolp, M.D.: "From the point of view of strategic design, integration of PM&R into the musculoskeletal center is central to providing the highest-quality service and care."

Her colleague Jonathan T. Finnoff, D.O., agrees. He sees the integration of PM&R with the musculoskeletal center as an ideal platform to assure patients receive state-of-the-art, comprehensive nonsurgical care before progressing to or after surgical solutions: "The center functions ideally as a gatekeeper," Dr. Finnoff says.

If a patient does require surgery, it is easily accommodated—often starting as a hallway chat with a colleague in orthopedic surgery. "Seeing professional interactions between specialists gives patients confidence in the quality and continuity of care they receive at Mayo," Dr. Finnoff explains.

From green screen to patient education

Advanced technology in the gym, including use of a green screen virtual reality motion trainer, is one of the new assets used to guide PM&R exercises. Common in major sports clinics, this training technology gives patients freedom to work on range-of-motion and other exercises in a simulated setting projected on a wall using green screen technology.

The lobby area is designed to support patient education. Anatomic models help patients visualize their injuries. Electronic education kiosks answer questions about postprocedure safety and independent living.

Dedicated to restoring function

Through its many expanded services, the full integration of PM&R within the musculoskeletal center provides comprehensive care for maximal healing and recovery of function. Says Dr. Stolp: "Our job is to restore patients to their fullest mental, emotional, physical, vocational, and avocational function. While most of medicine is organized along organ systems, we like to think that the organ systems we address are function and quality of life. We never say to a patient, 'We can't help you.' There is always something we can do to improve function and thereby enhance quality of life."

Image of preoperative 3-dimensional reconstruction for hip injury

Preoperative 3-dimensional reconstruction for hip injury

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Preoperative CT image of impaction of the articular surface

Preoperative CT of impaction of the articular surface

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Postoperative follow-up radiograph image revealing healed fractures

Postoperative follow-up radiograph revealing healed fractures

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Adding expertise in Level I Trauma, subspecialties

With the arrival of orthopedic surgeon William W. Cross III, M.D., Mayo's orthopedics department now has 4 full-time staff trauma surgeons—a reflection of the practice's ongoing commitment to providing Level I Trauma Center care. Dr. Cross is particularly interested in acetabular fractures in the elderly, which tend to be the result of low-energy falls from standing height in patients with poor bone quality.

Says Dr. Cross: "A great strength of Mayo orthopedics that I highly value is its commitment to innovation in improving the treatment of the elderly with these types of fractures." Dr. Cross' research interests include studying outcomes, epidemiology, and mortality of traumatic conditions.

The addition to the staff of epidemiologist Hilal Maradit Kremers, M.D., will be helpful in developing comprehensive outcome reports. Other additions to the staff also deepen the department's expertise and ability to contribute outcome data. They include:

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