Geriatric Inpatient Fracture Service (GIFTS)

Overview

The Geriatric Inpatient Fracture Service (GIFTS) is a program that aims to better manage patients 65 yearsold and above, who are admitted to the hospital with orthopedic injuries, such as hip fractures, but who often have additional medical issues as well. GIFTS provides the best possible care throughout hospitalization. Along with more specialized care, the program also decreases wait time for surgery, reduces length of stay in the hospital for fracture care and improves geriatric-specific communication with families and receiving rehabilitation facilities. Our goal is to restore quality of life to our patients. Through GIFTS, physicians from Geriatric Medicine work closely with physicians from the Orthopedic Trauma Service along with staff from the Departments of Nursing, Anesthesia, Endocrinology, Physical Therapy and Nutrition. The main goals are to help patients avoid complications following surgery, address underlying medical needs, strengthen overall health and provide patient- and family-centered education.

What to Expect

Upon a patient's arrival in the Emergency Department, our GIFTS physician works with the Orthopedic Trauma Service to evaluate and determine the best course of treatment. Patients who are 65 and older and are admitted to the orthopedic trauma service will be automatically co-managed by the GIFTS team.

Broken bones from falling from your own height are often associated with known or undiagnosed osteoporosis. After these fractures, it is critically important to assess your bone health to prevent future fractures. Patients on the GIFTS service will receive an initial bone health workup and evaluation by the Fracture Liaison Service and, with the help of Endocrinology experts, an initial treatment and prevention plan will be established.

Patients and referring physicians, please visit Mass General Imaging for information on exams, treatments and scheduling.

Conditions & Diseases

Fractures

A fracture is a partial or complete bone break. When a fracture occurs, it is classified as either open or closed.

Hip Fracture

A hip fracture is a break in the femur (thigh bone) of the hip joint.

Osteoporosis

Osteoporosis is a disease that causes weak, thinning bones. This leaves the bones at greater risk of breaking. The bones most often affected are the hips, spine, and wrists.

Clinical Trials

The following clinical trials are available through the Orthopedic Trauma Service.

To learn more about each study, please contact Michael McTague at 617-643-3653 or mmctague@partners.org.

Evaluating the recovery process in patients 65 and over who have a broken pelvis

This study focuses on elderly patients who have fallen and broken their pelvis (called a pelvic fracture). The goal of this study is to assess how they heal and recover from their injury.

If you decide to participate in this study, you will complete a series of questionnaires about how you are recovering from your pelvic fracture. You will complete these questionnaires when you are first seen for your pelvic fracture; six weeks after your injury, three months after your injury; six months after your injury; and one year after your injury. It will take you about 15 minutes to answer these questions, and you can do this over the phone and at your convenience. Your answers will help us to understand how patients who have this kind of fracture heal so that we can provide future patients and their families with better information about the recovery process.

Is surgery required to treat small wounds near the joint?

We believe that small wounds or cuts near a joint such as the knee, ankle, hip, shoulder, or elbow may not require a kind of surgery called “irrigation and debridement” to clean out the wound of any dirt or infection. These wounds, which are called arthrotomies, can also be treated with stitches and antibiotics in the Emergency Department. We want to know which treatment is better and under what circumstances.

Patients with these types of wounds are eligible for this study. All patients who have these injuries will receive a washing of the wound in the Emergency Department and stitches, antibiotics, and x-rays of the wound. If you decide to participate in this study, you will receive a telephone call 48 hours after you leave the hospital and we will ask you about your wound. You will need to come back to the hospital for appointments with your orthopedist two weeks, four weeks, and three months after your first treatment. The only parts of this study that are not part of the normal way we treat patients with this injury is the phone call and the three month appointment.

A new technique to measure healing in the knee bone

We are conducting this research study to examine how your knee bone fracture (distal femur fracture) heals. In this study, we will use a special x-ray called Radiostereometric Analysis (RSA) to look at how the pieces of your bone move. RSA can be used to measure very small movements in bone over time. Patients who are eligible for this study will already be having surgery using a metal plate to fix their fracture.

If you were to enroll in this study, we would place 9 to 27 tiny metal beads (made of tantalum) in the bone above your knee during your regular surgery. The beads would mark the location of your bone to see how it moves and knits together over time. The beads do not move and you will not feel them. The beads are permanent and will not be removed.

After your surgery, we will take RSA x-rays at your regular follow-up appointments: two weeks after your surgery, six weeks after your surgery, three months after your surgery, six months after your surgery, and one year after your surgery. The RSA x-rays will show the beads in the bone in your thigh just above your knee. A computer program will measure how your bone is healing and whether it has moved since your surgery.

Does extra oxygen during surgery lower the risk of infection after surgery?

We are conducting this research study to see if giving a patient more oxygen than normal during surgery results in a lower risk for infection during their recovery. This will help determine the best treatment for severe lower leg injuries. Some broken bones are more likely to get an infection after surgeries, due to the way they were injured. These injuries include: a break at the top or bottom of the larger bone in your lower leg (tibia) or a break in the weight-bearing bone in your foot (calcaneus). Patients with these types of fractures are eligible for this study.

If you participate in this study, you will be assigned by chance to one of two groups. One group would receive extra oxygen during surgery. The other group would receive the normal amount of oxygen during surgery. After surgery, you will be asked to come back to the clinic and follow up with us at two weeks, three months, and six months. These visits would part of your routine follow-up with your treating physician. At the six-month visit, we would ask you questions about your recovery. At 12 months, we would call you for a final follow-up.

Orthopedic Trauma patients’ opinions about medical marijuana

The aim of this study is to evaluate the opinions of the orthopedic trauma patient population about the new Massachusetts medical marijuana laws. Any patient who was injured 1 month to 6 months ago is eligible for this study. We will ask you questions about your opinion of medical marijuana and about your state of mind during your recovery from your injury. The questionnaire takes about 5-10 minutes to complete. Your answers are confidential.

To learn more about each study, please contact Michael McTague at 617-643-3653 or mmctague@partners.org.