Advancing Upper Extremity Research at the Western Hand and Upper Limb Facility

Western Hand and Upper Limb Facility Team

The Western Hand & Upper Limb Facility, WULF, at the Sturgeon Community Hospital is one of the few specialized upper extremity centres in Canada. Seven fellowship-trained orthopaedic surgeons (Drs. Armin Badre, Joseph Bergman, Robert Chan, Matthew Furey, Aleem Lalani, Michael Lapner, and Yibo Li), together with nurses, orthopaedic technicians, physiotherapists and occupational therapists, serve the Edmonton zone along with parts of northern Alberta, Saskatchewan, British Columbia, and the Northwest Territories. The centre records more than 15,000 outpatient visits and performs over 2,000 major surgeries and 1,500 minor procedures annually. Research is overseen by Dr. Armin Badre, the Research Director, and coordinated by a dedicated research associate whose position is funded by a generous donation from the Sturgeon Hospital Foundation, research grants and the Edmonton Orthopaedic Research Committee.

Randomized controlled trials. The group's clinical research program is anchored by randomized controlled trials in conditions where practice patterns remain divided. WULF leads a study entitled “PARTE”, a national multicentre randomized controlled trial comparing two variations of partial wrist fusion in patients with post-traumatic wrist arthritis. This study is funded by a $384,725 Strategic Operating Grant from Arthritis Society Canada and will be the largest trial of its kind on completion. Recruitment has also concluded for a WULF-led randomized trial assessing intra-articular corticosteroid versus saline injections in thumb carpometacarpal osteoarthritis, one of the most prevalent causes of hand pain and functional loss. The trial was selected for the Chair's Choice Paper Session at the 2026 Canadian Orthopaedic Association Annual Meeting, reserved for the most exceptional work presented at the meeting.

Coronoid fractures.  WULF is an international leader in coronoid fracture research, addressing an area of persistent clinical uncertainty. WULF surgeons developed and validated a novel method of interpreting three-dimensional CT using humeral subtraction and a novel method of image acquisition using a gravity varus stress CT protocol capable of unmasking instability missed by conventional imaging. Combined with studies of surgical risk to the ulnar nerve and of outcomes in fractures with associated injuries, this work has produced a reliable, reproducible algorithm for deciding which of these injuries require operative treatment. These findings appear in the Journal of Shoulder and Elbow Surgery, JSES International and Hand Clinics, and have generated invitations to lecture at the annual meetings of the American Academy of Orthopaedic Surgeons, the American Shoulder and Elbow Surgeons and the American Society for Surgery of the Hand, with presentations in 2026 to the Global Elbow Network and the International Congress of Shoulder and Elbow Surgery. The algorithm now forms the basis of a national multicentre study, led by WULF, that will test it prospectively across Canadian centres.

Other traumatic elbow and wrist conditions. In distal biceps tendon repair, WULF surgeons reported the largest direct clinical comparison to date of unicortical and bicortical button fixation, work recognized with the Best Poster Award at the 2026 Canadian Orthopaedic Association Annual Meeting, and the first matched comparison of objectively measured strength between patients treated by acute repair and those requiring delayed allograft reconstruction, which demonstrated a substantial strength deficit after delay and supports prompt referral and early repair.

In olecranon fractures, the group has evaluated a novel application of suture-based fixation as an alternative to plating. Roughly one quarter of patients require plate removal after the fracture has healed, while almost no cases of suture repair require further surgery. That study was also selected for the 2026 Chair's Choice Paper Session, and the group has since evaluated a further technical modification intended to improve early healing.

In the wrist, WULF work on in-situ fixation of scaphoid non-unions challenges the long-held view that every non-union requires bone grafting and complex reconstruction, offering a simpler and less resource-intensive option in appropriately selected patients. That work earned Dr. Grant Greaves, a PGY-4 orthopaedic surgery resident, the Dr. Robin Richards Award for Upper Extremity Research from the Canadian Orthopaedic Foundation.

Collaboration with engineering. WULF surgeons collaborate with several engineering research groups at the University of Alberta, co-supervising graduate students across a portfolio of translational and biomechanical projects. Current themes include robot-assisted elbow arthroscopy, image-guided implant positioning in total elbow arthroplasty, the biomechanics of different tendon repair techniques, and the biomechanics of suture tension band constructs for olecranon fixation. This work has been published in engineering and biomechanics journals and presented at international robotics and biomechanics conferences, and it allows questions that cannot be answered in the operating room to be tested in the laboratory before they reach patients.

National collaborations. In addition to the studies it leads, WULF has contributed as a participating site to a number of national and international multicentre trials over the past several years, working with the Canadian Orthopaedic Trauma Society, the Wrist and Elbow Society of Canada and collaborating centres across Canada and abroad.

Every WULF study is built around a trainee, with fellows, residents and medical students contributing to the work alongside the surgeons who lead it. Through its clinical volume, national trial leadership and growing international profile, WULF continues to advance the evidence base for upper extremity surgery in Canada.

The Western Hand & Upper Limb Facility (WULF) at the Sturgeon Community Hospital is one of the few specialized upper extremity centres in Canada, where seven fellowship-trained surgeons serve northern Alberta, Saskatchewan, British Columbia and the Northwest Territories. Its research program, led by Dr. Armin Badre, spans randomized controlled trials, novel imaging and decision-making in elbow instability, techniques that reduce complications and secondary surgery, and biomechanical and robotics work with engineering.

WULF leads a study entitled “PARTE”, a national randomized controlled trial in post-traumatic wrist arthritis funded by Arthritis Society Canada, and a new national multicentre study testing the group's algorithm for elbow instability after coronoid fracture. At the 2026 Canadian Orthopaedic Association Annual Meeting, two WULF studies were selected for the Chair's Choice Paper Session, the group received the Best Poster Award, and the Canadian Orthopaedic Foundation's Dr. Robin Richards Award for Upper Extremity Research.