Heather Vallier

Last updated
Heather Audrey Vallier
Known for Early appropriate care
Orthopaedic trauma resuscitation guidelines
First female OTA president
Scientific career
FieldsOrthopaedic surgery
Institutions MetroHealth
Cleveland Clinic

Heather A. Vallier is an American orthopaedic surgeon at Cleveland Clinic and was the 36th president of the Orthopaedic Trauma Association and the first ever female president. She is known for developing early appropriate care, the resuscitation criteria now used globally to determine when polytraumatized patients are optimized for orthopaedic trauma surgical intervention.

Contents

Education

She completed undergraduate studies at Northwestern University in 1989. She later graduated from Stanford University School of Medicine. [1]

Vallier subsequently completed an orthopaedic surgery residency at the University of Wisconsin. She later followed by a fellowship in orthopaedic traumatology at Harborview Medical Center in Seattle, Washington. [2]

Career

Vallier worked at MetroHealth Medical Center in Cleveland as the Clyde L. Nash, MD Jr. Professor of Orthopaedic Education, prior to being recruited to the Cleveland Clinic in 2024. [3] [4]

Research

Early Appropriate Care

Vallier developed the concept of Early Appropriate Care, which re-defined Orthopaedic trauma resuscitation guidelines globally by determining when delayed definitive fixation for pelvis, femur, acetabulum, and spine fractures was indicated, and when polytraumatized patients were physiologically optimized for surgery. [5]

Other research

In a highly cited article published in The Journal of Bone and Joint Surgery (JBJS), Vallier demonstrated the time operative intervention for talar neck fractures does not impact the subsequent development of osteonecrosis. Instead, her findings showed the degree of displacement is what impacts osteonecrosis rates, impacting the management of talar neck fractures. [6] [7]

She has acted as the Steering Committee member of the Multicenter Extremity Trauma Research Consortium (METRC) since 2010 at MetroHealth, a network of 22 core level I civilian trauma centers and 4 core military treatment centers. This collaboration resulted in the PREVENT CLOT trial, demonstrating thromboprophylaxis with aspirin was noninferior to low-molecular-weight heparin for patients with extremity fractures, published in TheNew England Journal of Medicine in 2023. [8] She was an investigator in the "Study to prospectively evaluate reamed intramedullary nails in tibial shaft fractures" (SPRINT) trial, which demonstrated reamed intramedullary tibial nails are superior to unreamed nails for closed fractures, but no different for open fractures. [9]

Vallier's research has been funded by the US Department of Defense and NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases). [10] Vallier has a H-index of 42. [11]

Honors and awards

Vallier was elected as the president of the Orthopaedic Trauma Association in 2021, the largest organization dedicated to orthopaedic trauma globally, recognizing her contributions to the field of orthopaedic trauma. [12] [13]

Related Research Articles

<span class="mw-page-title-main">Compartment syndrome</span> Condition in which increased pressure results in insufficient blood supply

Compartment syndrome is a condition in which increased pressure within one of the body's anatomical compartments results in insufficient blood supply to tissue within that space. There are two main types: acute and chronic. Compartments of the leg or arm are most commonly involved.

<span class="mw-page-title-main">Orthopedic surgery</span> Branch of surgery concerned with the musculoskeletal system

Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders.

<span class="mw-page-title-main">Clavicle fracture</span> Medical condition

A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. Complications can include a collection of air in the pleural space surrounding the lung (pneumothorax), injury to the nerves or blood vessels in the area, and an unpleasant appearance.

<span class="mw-page-title-main">Hip fracture</span> Broken bone in hip joint region

A hip fracture is a break that occurs in the upper part of the femur, at the femoral neck or (rarely) the femoral head. Symptoms may include pain around the hip, particularly with movement, and shortening of the leg. Usually the person cannot walk.

<span class="mw-page-title-main">Malleolus</span> Ankle bone protrusion

A malleolus is the bony prominence on each side of the human ankle.

<span class="mw-page-title-main">Trimalleolar fracture</span> Medical condition

A trimalleolar fracture is a fracture of the ankle that involves the lateral malleolus, the medial malleolus, and the distal posterior aspect of the tibia, which can be termed the posterior malleolus. The trauma is sometimes accompanied by ligament damage and dislocation.

An open fracture, also called a compound fracture, is a type of bone fracture that has an open wound in the skin near the fractured bone. The skin wound is usually caused by the bone breaking through the surface of the skin. An open fracture can be life threatening or limb-threatening due to the risk of a deep infection and/or bleeding. Open fractures are often caused by high energy trauma such as road traffic accidents and are associated with a high degree of damage to the bone and nearby soft tissue. Other potential complications include nerve damage or impaired bone healing, including malunion or nonunion. The severity of open fractures can vary. For diagnosing and classifying open fractures, Gustilo-Anderson open fracture classification is the most commonly used method. This classification system can also be used to guide treatment, and to predict clinical outcomes. Advanced trauma life support is the first line of action in dealing with open fractures and to rule out other life-threatening condition in cases of trauma. The person is also administered antibiotics for at least 24 hours to reduce the risk of an infection.

<span class="mw-page-title-main">Taylor Spatial Frame</span>

The Taylor Spatial Frame (TSF) is an external fixator used by podiatric and orthopaedic surgeons to treat complex fractures and bone deformities. The medical device shares a number of components and features of the Ilizarov apparatus. The Taylor Spatial Frame is a hexapod device based on a Stewart platform, and was invented by orthopaedic surgeon Charles Taylor. The device consists of two or more aluminum or carbon fibre rings connected by six struts. Each strut can be independently lengthened or shortened to achieve the desired result, e.g. compression at the fracture site, lengthening, etc. Connected to a bone by tensioned wires or half pins, the attached bone can be manipulated in three dimensions and 9 degrees of freedom. Angular, translational, rotational, and length deformities can all be corrected simultaneously with the TSF.

<span class="mw-page-title-main">Unicompartmental knee arthroplasty</span>

Unicompartmental knee arthroplasty (UKA) is a surgical procedure used to relieve arthritis in one of the knee compartments in which the damaged parts of the knee are replaced. UKA surgery may reduce post-operative pain and have a shorter recovery period than a total knee replacement procedure, particularly in people over 75 years of age. Moreover, UKAs may require a smaller incision, less tissue damage, and faster recovery times.

<span class="mw-page-title-main">Spontaneous osteonecrosis of the knee</span> Medical condition

Spontaneous osteonecrosis of the knee is the result of vascular arterial insufficiency to the medial femoral condyle of the knee resulting in necrosis and destruction of bone. It is often unilateral and can be associated with a meniscal tear.

<span class="mw-page-title-main">Intramedullary rod</span> Metal rod inserted to treat fractures

An intramedullary rod, also known as an intramedullary nail or inter-locking nail or Küntscher nail, is a metal rod forced into the medullary cavity of a bone. IM nails have long been used to treat fractures of long bones of the body. Gerhard Küntscher is credited with the first use of this device in 1939, during World War II, for soldiers with fractures of the femur. Prior to that, treatment of such fractures was limited to traction or plaster, both of which required long periods of inactivity. IM nails resulted in earlier return to activity for the soldiers, sometimes even within a span of a few weeks, since they share the load with the bone, rather than entirely supporting the bone.

<span class="mw-page-title-main">Internal fixation</span> Orthopedic operation to fix bone

Internal fixation is an operation in orthopedics that involves the surgical implementation of implants for the purpose of repairing a bone, a concept that dates to the mid-nineteenth century and was made applicable for routine treatment in the mid-twentieth century. An internal fixator may be made of stainless steel, titanium alloy, or cobalt-chrome alloy. or plastics.

<span class="mw-page-title-main">Bimalleolar fracture</span> Medical condition

A bimalleolar fracture is a fracture of the ankle that involves the lateral malleolus and the medial malleolus. Studies have shown that bimalleolar fractures are more common in women, people over 60 years of age, and patients with existing comorbidities.

<span class="mw-page-title-main">Femoral fracture</span> Broken femur, at shaft or distally

A femoral fracture is a bone fracture that involves the femur. They are typically sustained in high-impact trauma, such as car crashes, due to the large amount of force needed to break the bone. Fractures of the diaphysis, or middle of the femur, are managed differently from those at the head, neck, and trochanter; those are conventionally called hip fractures. Thus, mentions of femoral fracture in medicine usually refer implicitly to femoral fractures at the shaft or distally.

Early appropriate care (EAC) is a system in orthopaedic trauma surgery aiming to identify serious major trauma patients and treat the most time-critical injuries without adding to their physiological burden.

<span class="mw-page-title-main">Tibia shaft fracture</span> Medical condition

Tibia shaft fracture is a fracture of the proximal (upper) third of the tibia. Due to the location of the tibia, it is frequently injured. Thus it is the most commonly fractured long bone in the body.

<span class="mw-page-title-main">Phemister graft</span>

A Phemister graft is a type of bone graft which uses bone tissue harvested from the patient to treat slow-healing, or delayed union bone fractures. Thus, it is a form of autotransplantation. Typically, the tissue used in the graft is cancellous bone harvested from the patient's Iliac crest and laid in strips across the fracture site. The use of the patient's living bone stimulates osteogenesis, the growth of bones.

Bone malrotation refers to the situation that results when a bone heals out of rotational alignment from another bone, or part of bone. It often occurs as the result of a surgical complication after a fracture where intramedullary nailing (IMN) occurs, especially in the femur and tibial bones, but can also occur genetically at birth. The severity of this complication is often neglected due to its complexity to detect and treat, yet if left untreated, bone malrotation can significantly impact regular bodily functioning, and even lead to severe arthritis. Detection throughout history has become more advanced and accurate, ranging from clinical assessment to ultrasounds to CT scans. Treatment can include an osteotomy, a major surgical procedure where bones are cut and realigned correctly, or compensatory methods, where individuals learn to externally or internally rotate their limb to compensate for the rotation. Further research is currently being examined in this area to reduce occurrences of malrotation, including detailed computer navigation to improve visual accuracy during surgery.

Charles Harry Epps, Jr. is an American orthopaedic surgeon who served as Dean of the Howard University College of Medicine.

<span class="mw-page-title-main">Congenital pseudarthrosis of the tibia</span>

Congenital pseudarthrosis of the tibia (CPT) is a rare paediatric disease presenting with a bowing deformity of the tibia at birth or within the first decade of life. It is most commonly associated with Neurofibromatosis type 1 (NF-1). For children with CPT, pathological fracture of the tibia eventually occurs, resulting in persistent nonunion of the fracture site. If left untreated, leg deformities, joint stiffness, leg-length discrepancy and pain will persist. Diagnosis is done clinically and through X-ray imaging, with numerous classifications based on the severity of bowing and presence of fracture or intraosseous lesion.

References

  1. ↑ "MASSACHUSETTS GENERAL HOSPITAL DEPARTMENT OF ORTHOPAEDIC SURGERY. Grand Rounds. Heather A. Vallier, MD: "Optimizing Musculoskeletal Recovery"" (PDF). Massachusetts General Hospital. October 27, 2022.
  2. ↑ "Heather Vallier". orthocorps.jbjs.org. Retrieved 2024-09-21.
  3. ↑ "61st Annual Murray S. Danforth Oration welcomes guest lecture from Dr. Heather Vallier | Department of Orthopaedics | Medical School | Brown University". orthopaedics.med.brown.edu. Retrieved 2024-09-20.
  4. ↑ "Heather Vallier, MD". Cleveland Clinic. Retrieved 2024-09-20.
  5. ↑ Vallier, Heather A.; Wang, Xiaofeng; Moore, Timothy A.; Wilber, John H.; Como, John J. (October 2013). "Timing of orthopaedic surgery in multiple trauma patients: development of a protocol for early appropriate care". Journal of Orthopaedic Trauma. 27 (10): 543–551. doi:10.1097/BOT.0b013e31829efda1. ISSN   1531-2291. PMID   23760182.
  6. ↑ Vallier, Heather A.; Nork, Sean E.; Barei, David P.; Benirschke, Stephen K.; Sangeorzan, Bruce J. (2004). "Talar neck fractures: results and outcomes". The Journal of Bone and Joint Surgery. American Volume. 86 (8): 1616–1624. doi:10.2106/00004623-200408000-00003. ISSN   0021-9355. PMID   15292407.
  7. ↑ Vallier, Heather A.; Reichard, Stephen G.; Boyd, Alysse J.; Moore, Timothy A. (2014-02-05). "A New Look at the Hawkins Classification for Talar Neck Fractures: Which Features of Injury and Treatment Are Predictive of Osteonecrosis?". JBJS. 96 (3): 192–197. doi:10.2106/JBJS.L.01680. ISSN   0021-9355. PMID   24500580.
  8. ↑ Major Extremity Trauma Research Consortium (METRC) (2023-01-19). "Aspirin or Low-Molecular-Weight Heparin for Thromboprophylaxis after a Fracture". New England Journal of Medicine. 388 (3): 203–213. doi:10.1056/NEJMoa2205973. ISSN   0028-4793. PMID   36652352.
  9. ↑ Bhandari, Mohit; Guyatt, Gordon; Walter, Stephen D.; Tornetta, Paul; Schemitsch, Emil H.; Swiontkowski, Marc; Sanders, David (2008-12-01). "Randomized Trial of Reamed and Unreamed Intramedullary Nailing of Tibial Shaft Fractures". The Journal of Bone and Joint Surgery. American Volume. 90 (12): 2567–2578. doi:10.2106/JBJS.G.01694. ISSN   0021-9355. PMC   2663330 . PMID   19047701.
  10. ↑ "Heather Vallier" (PDF). University of Wisconsin.
  11. ↑ "Heather Vallier". scholar.google.com. Retrieved 2024-09-21.
  12. ↑ "Heather Vallier, MD Elected President of the Orthopaedic Trauma Association (OTA)". Orthopaedic Trauma Association (OTA). Retrieved 2024-09-20.
  13. ↑ "Heather Vallier, MD, OTA President Invites You To Attend OTA 2021". Orthopaedic Trauma Association (OTA). Retrieved 2024-09-21.
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