Collaborative Orthopaedic Research (CORe)

Hip Fracture and Trauma Projects

Current projects

  • Strategies Targeting Osteoporosis to Prevent recurrent Fracture (STOP Fracture Study) (2015-Present)
    This study is evaluating different approaches to improve the treatment of osteoporosis following fracture across Alberta.  We have partnered with the Senior’s Health and Primary Care Strategic Clinical Networks in Alberta Health Services.  This study is funded by the Partnerships in Research and Innovation in the Healthcare System.
  • Use of Pre-operative Nerve Blocks in Older Women with Hip Fracture: A Pilot Study. (2015-Present)
    Our randomized pilot evaluation is determining the feasibility of a large scale randomized clinical trial to evaluate the effectiveness and appropriateness of preoperative femoral nerve blocks in 75 patients who have fractured their hip. This includes patients with pre-existing cognitive impairment. This is a collaborative initiative between Orthopaedic Surgery and Anesthesiology and Pain Medicine. This study is funded by the University Hospital Foundation.

  • Recovery following Hip Fracture in Geriatric Ambulatory Patients Living In Nursing Homes (REGAIN II): Does an Outreach Rehabilitation Program improve Recovery? (2011-Present)
    This controlled trial is evaluating the feasibility of providing Outreach Rehabilitation to patients from long term care residential settings. Subjects are allocated to receive either usual postoperative care or a rehabilitation program that focuses on returning them to their pre-fracture functional and ambulatory status. This project is funded through Alberta Innovates Health Solutions as an Establishment grant for Dr. Beaupre’s Population Health Investigator Award.

Projects completed in the last five years

  • Does Primary Closure of Long Bone Fractures Reduce Health Service Utilization without Adversely Affecting Patient Recovery? A Pilot Study. (2014)
    This cohort study examined the impact of primary wound closure of long bone fractures. A secondary comparison with a matched series of patients who underwent delayed wound closure demonstrated no increase in either non-unions or deep infections.
     
  • A Prospective Evaluation of Adverse Outcomes in Open Long Bone Fractures. (2013) 
    This is one of the largest prospective cohort studies on compound fractures of long bones (n=736 patients with 791 fractures). We determined that early access to the operating room (ie <8 hours) did not affect the development of either deep infection or non-union. This work has been published in the Journal of Orthopaedic Trauma and presented at the Orthopaedic Trauma Association and Canadian Orthopaedic Association annual meetings.
     
  • Rehabilitation for Long-term Care (LTC) Residents Following Hip Fracture: A Systematic Review and Survey of Current Practices, Barriers and Facilitators to Care. (2012) 
    We undertook a systematic review to determine the body of evidence for outcomes following hip fracture for those living in residential care settings or who had cognitive impairment.  Our review found that patients with dementia are able to respond to rehabilitation after a hip fracture.  We followed our review with a survey of reported rehabilitation practices after hip fracture in residential care settings in Alberta.  Our survey found that rehabilitation professionals who worked in long term care settings also believed that residents could respond to rehabilitation.  However, they reported that they were hindered in their ability to provide adequate rehabilitation because of limited resources, both time and personnel.  Both components of this study have been published in Physiotherapy Canada and the Journal of Geriatric Physical Therapy.

  • Multimodal Pain Management for Postoperative Hip Fracture Surgery: Systematic Review. (2011) 
    This was a Comparative Effectiveness Review sponsored by the Agency for Healthcare Research and Quality that examined the evidence base for management of pain after a hip fracture. Our review found that the evidence for pain management of this common fracture was limited; in particular, there was virtually no evidence for pain management in patients with cognitive impairment or for those who were admitted from long term care residential settings.  This work was published in the Annals of Internal Medicine.

  • Recovery after Hip Fracture in Geriatric Ambulatory Patients Living In Nursing Homes (REGAIN I Study). (2010) 
    This prospective cohort study is one of the few studies that specifically examined recovery following hip fracture of patients who were residing in long term care residential settings at the time of fracture. We found that ambulation reduced from 70% pre-fracture to 22% at 6-months post fracture that mortality was almost 50% within the first year following fracture. This work was published in the Journal of the American Geriatrics Society.