Editorial: The French Orthopaedic Trauma Society (GETRAUM). Who are we?

Injury, Int. J. Care Injured 46 S1 (2015) S1

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Injury j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / i n j u r y

Editorial: The French Orthopaedic Trauma Society (GETRAUM). Who are we? It is my pleasure and my honour to present the scientific main research papers compiled on behalf of GETRAUM, the French Society of Bone and Joint Trauma. GETRAUM was born in 2009, as the French Society of Orthopaedic and Trauma Surgery found necessary to highlight Trauma management, and help further development of this part of our work. Before that, Trauma was always completely included within the canopy of the SOciété Française de Chirurgie Orthopédique et Traumatologique (SOFCOT). GETRAUM is still a full part of SOFCOT but with additional objectives. Practice guidelines in Trauma management is one of the major goals of GETRAUM as a lot of surgeons, mainly working in public hospital all around France, would benefit from ongoing exposure to up to date surgical techniques to avoid any medico legal problems. In addition, trauma related work continues to be in the ‘heart’ of trauma surgeons, as it is challenging and very rewarding by seeing patients with difficult clinical problems to have restoration of their functional capacity. GETRAUM meetings are organized twice a year, and are, always, a place where difficult cases are shared between trauma surgeons. Free papers sessions allow presentation of difficult cases and tips and tricks developed by some of our members providing solutions to difficult cases. From those free papers, the editorial board of GETRAUM has selected the most interesting ones, and their publication in this issue will help colleagues from all over the world to get some additional proposals for treatment. Topics have been selected focusing on proximal ulna fractures, upper cervical injury in the elderly, terrible triad management, and acetabular fractures in the elderly with quadrilateral plate involvement. While GETRAUM has closed links with both the AO and OTC foundations, it remains an independent scientific society. Maintenance of a high level of competencies for Trauma surgeons in France is a very challenging purpose. Trauma training is a full part of the Orthopaedics and Trauma residency program, requiring five years, of rotation with an additional two years of fellowship to certify as an orthopaedic and Trauma surgeon. As both competencies are available, the majority of the residents follow an orthopaedic career. Based on the analysis from the Ministry of Health Care and the ONDPS (Observatoire National de la Démographie des Professions de Santé) [1], 2,300 orthopaedic and trauma surgeons are working in France, with 60% in private practice, and 40% in the public hospital sector. Private practice is more devoted to degenerative surgery and orthopaedic health care, whereas public practice is more devoted to trauma care post-traumatic related complications. Currently, we can assume that in France nearly 1,000 surgeons are dedicated orthopaedic trauma surgeons. In France, since the early 1980’s there is no more general surgeons who are involved with orthopaedic trauma, and similarly none of the orthopaedic trauma surgeons is undertaking either abdominal or thoracic trauma surgery, as well as neurosurgical trauma. Nonetheless, a lot of trauma surgeons are involved with spinal trauma in their practice. It is of note that only 100 orthopaedic and Trauma surgeons are trained in the academic French program annually. This fact

generates some discrepancy between the number of retiring orthopaedic surgeons and the need for incoming ones. Due to this existing gap , there is an open recruitment of surgeons from the French speaking world in order to cover the existing demand. As the training program in French speaking countries is very similar to the French one due to colonial history, national committees give allowance for a practice license in the orthopaedic and trauma discipline, which is issued by the French National Medical Council. The members of the national committees are nominated by the French Society of orthopaedic Surgery (SOFCOT) and GETRAUM, as well as other sub-specialties of Orthopaedics. Overall, the management of Orthopaedic Trauma in France is well organized with Level I trauma centers in all University Hospitals, where acute cases, as well as post-traumatic sequelae are being managed. In addition, all main cities which are capitals of a district have their own Orthopaedic and Trauma department where all cases which do not involve polytrauma can be treated. Finally, all emergency departments located in any public hospital have their own orthopaedic department where such cases as hip, wrist and ankle fractures can be managed. Moreover, due to a national administrative settlement, all hospitals are linked together and if a difficult trauma case goes to a level III trauma center, it will be transferred with the SAMU (Medical Emergency Transport) service to the Level I Trauma center. To help surgeons working in all level II and III traumas centers, to upgrade their competencies in Trauma management, GETRAUM organizes post-graduate sessions, with workshops and Controversial Cases Discussions (CCD), at a district area level, with a national Faculty involved. As the number of members of our society is growing up very quickly, it seems that our objectives are on the right direction to fulfil the goal of quality treatment of trauma patients in any part of the country. In the health care system, management of emergencies are on top of the duty of all physicians, in particular those who are working in the public hospitals. This political attitude is very positive for Orthopaedic and Trauma surgeons, as more than 50% of their activity is dedicated to trauma management. Meanwhile, there is still a lot of work to be done, as there is not any registry available for trauma management in our country. This will be one of the major goals in the next few years for GETRAUM. In conclusion, this Injury issue devoted to GETRAUM may give worldwide colleagues a glance on how we treat our patients in France. I hope this volume will be of educational value to all of us. Reference [1] Les effectifs et l’activité des professionnels de santé. ONDPS. Ed La Documentation Française. 2004. www.ladocumentationfrancaise.fr/rapportspublics/064000455/index.shtml.

Th. Bégué, GETRAUM President Department of Orthopaedic and Trauma Surgery, Antoine Beclere Hospital, University Paris-Sud, 157 rue de la Porte de Trivaux, 92140 Clamart, France last page reference