Fellowship

FELLOWSHIP ON SURGICAL LIMB LENGTHENING AND RECONSTRUCTION OF EXTREMITIES

DESCRIPTION AND INSTRUCTIONS

Directed to Orthopedic Traumatologists 

Positions: One

Duration of Program:   6 - 12-month rotation, or 3-month internship

Requirements: Having completed a residency program in orthopedic surgery, certified work experience of at least 2 years, letter from the institution where you work approving the rotation.  Full time on-site rotation with 100% availability for surgical, consultaion or academic activities.

Scholarship Administrator: León Mora H. MD.

Objetive of the Scholarship Program: Provide training in the diagnosis, management, decision making, and surgical techniques associated with limb lengthening, deformity correction and bone reconstruction and infections.

Description:

The fellow will acquire both clinical and research skills in limb lengthening and reconstruction, with wide experience and exposure to The Ilizarov method, in addition to the more conventional approaches with circular and monolateral tutors, hybrid techniques and state-of-the-art implant management. This will include pre-operative, surgical and post-operative care. There will also be opportunities for basic and clinical research. The preoperative planning system will be implemented as a fundamental part of the process and surgical tactics, pathologies in orthopedics and traumatology will be managed. The fellow will have the opportunity to be in adult and pediatric upper and lower limb lengthenings and correction of deformities.

Lower limb requiring reconstruction:
Hip, femur, knee, tibia, ankle, and foot.
Post-traumatic reconstruction:
Defective unions (malunion), septic and aseptic nonunions, segmental bone defects.
Common congenital conditions:
Congenital short femur, hemiatrophy, dwarfism, short stature, postaxial hypoplasia.
Developmental conditions:
Growth disorders secondary to trauma or infection Limb lengthening with the Ilizarov method (Study and analysis of the technique and method), Selection of articulated circular or monolateral MLRS, or hybrid tutors.
Knee reconstruction:
Monocompartmental realignment osteotomies, arthrodesis, arthroscopic surgery, circular or monolateral MLRS ligament reconstruction, articulated or with hybrid stents. Correction of Deformities with the complete analysis, alignment test and surgical decision making.
Foot and ankle reconstruction:
Complex ankle injuries, deformity correction, arthrodesis, realignment and lengthening osteotomies, tendon transfers, tendon lengthenings, regional flaps.
Upper extremity:
Humeral lengthening, forearm and wrist deformity correction, complex elbow injuries, arthrofibrosis release.

The techniques used are the Ilizarov method, circular external fixation, hexapod space frame, monolateral external fixation, intramedullary nails, posterior lengthening nails, LCP plate fixation, early exchange from external to internal fixation, Pin-Fit technique with wires, or HA-coated schanz.

Postoperative and rehabilitation care in its different stages, individual follow-up of each case, evaluation of results with the different techniques.

Management and solution of Complications:

Pin problems, soft tissue, nerve decompression technique, residual deformity correction.

Participation in research projects with the objective of presenting in diffrent Scientific Meetings including the Colombian Orthopedic Society (SCCOT), the Limb Lengthening and Reconstruction Society (LLRS), Orthopedic Trauma Association (OTA), and the American Academy of Orthopedic Surgeons (AAOS).

The techniques used are the Ilizarov method, circular external fixation, hexapod space frame, monolateral external fixation, intramedullary nails, posterior lengthening nails, LCP plate fixation, early exchange from external to internal fixation, Pin-Fit technique with wires, or HA coated schanz.

Postoperative and rehabilitation care in its different stages, individual follow-up of each case, evaluation of results with the different techniques.

Description of the Scholarship Program

Accreditation

This scholarship program is supported by the El Rosario Clinic. It is based on a training program that is certified for Graduate Medical Education (ACGME). However, the Limb Reconstruction Scholarship is a program that is not specifically accredited and currently, there are no published ICFES guidelines for this type of scholarship program. This is due to the relatively recent nature of the techniques and methodologies involved. However, we have modeled the guidelines for the fellowship program after existing guidelines for similar orthopedic subspecialty programs. Therefore, in-house certification and supervision is provided by our Comprehensive Advanced Orthopedics program.

Application and Tenure

The Limb Reconstruction Scholarship is a program offered in 6- and 12-month terms. We offer two types of scholarships. The first is our paid clinical fellowship, and the second is unpaid. These scholarships are offered to graduates of accredited orthopedic surgical residency programs in Colombia; for surgeons trained in orthopedic surgery outside of Colombia, equivalent training and experience will be considered for acceptance on a case-by-case study. All foreign students must have successfully completed the requirements of their medical graduate program and be eligible for a medical training license to apply for a clinical fellowship (paid position). These applicants must obtain their study visas, and the center will assist in this process. For international fellows involved in non-patient contact research (unpaid position), the center will provide assistance. The the various application requirements for each type of fellowship are listed in Annex 1.

Each applicant to the scholarship program must submit a current resume, photograph, and at least three recomendation letters. These are reviewed by program directors, and an interview is required. If accepted, the applicant will receive an offer letter. Once the applicant formally accepts the scholarship, medical documents, and applications for accreditation of medical privileges are sent from the Limb Reconstruction and Lengthening Clinic. Each applicant must pass current established medical accreditation standards and must provide diplomas and certificates of medical training in orthopedics and traumatology.

Education Program

The educational program in limb reconstruction includes treatment of a wide range of congenital, developmental, degenerative, and traumatic disorders of the upper and lower limbs. Typical clinical problems include limb length discrepancy, fracture malunion and nonunion, osteomyelitis, angular limb deformities, joint contractures, and congenital deficiencies. The educational program is organized to provide advanced experience to the specialist and to acquire the competence of a specialist in the field of limb lengthening and deformity correction. There are academic and technical skills that the specialist must acquire. The academic component emphasizes an academic approach to clinical problem solving, deformity analysis, self-directed study, teaching, and research. The technical component includes the ability to competently perform the surgical procedures necessary for limb lengthening and reconstruction. The specialist must develop an understanding of the indications, risks, and limitations of the corresponding procedures. The Fellow must prepare a weekly presentation on a bone reconstruction topic. Attendance to general orthopedic decision-making staff rounds and monthly journal club meetings is mandatory.

Education Program

The educational program in limb reconstruction includes treatment of a wide range of congenital, developmental, degenerative, and traumatic disorders of the upper and lower limbs. Typical clinical problems include limb length discrepancy, fracture malunion and nonunion, osteomyelitis, angular limb deformities, joint contractures, and congenital deficiencies. The educational program is organized to provide advanced experience to the specialist and to acquire the competence of a specialist in the field of limb lengthening and deformity correction. There are academic and technical skills that the specialist must acquire. The academic component emphasizes an academic approach to clinical problem solving, deformity analysis, self-directed study, teaching, and research. The technical component includes the ability to competently perform the surgical procedures necessary for limb lengthening and reconstruction. The specialist must develop an understanding of the indications, risks, and limitations of the corresponding procedures. The Fellow must prepare a weekly presentation on a bone reconstruction topic. Attendance to general orthopedic decision-making staff rounds and monthly journal club meetings is mandatory.

The individual must assume a significant role in the ongoing care of patients and must maintain ongoing responsibility for patient evaluation and treatment decisions, preoperative evaluation, operative experience, nonsurgical treatment, rehabilitation, and long-term follow-up.  Each fellow shall keep a written record of each surgery that they assist or perform. A copy of this record will be included in their personal permanent file.

The specific operative skills that the orthopedic surgeon is expected to acquire, but are not limited to, include the following:

By the end of the training period, the fellow should have acquired the skills, knowledge, and judgment with which to establish a Limb Lengthening and Reconstruction program like the one at The Limb Lengthening and Reconstruction Clinic.

Download Instructions and application form

Contact Form

Fellowship for Orthopedic Traumatologists in the Limb Lengthening and Limb Reconstruction Clinic.