Service of  orthopedic and  traumatology surgery is responsible for the management of patients admitted to the ward, out patient, emergency andspecialty surgical activity.

1.a.Outpatient are performed in the annex building to the hospital with a total of 34 cosultation  weekley  (16 physicians), morning and afternoon .  2012 the  Service   visited more than  24.000 patients,of whom  about 8.000 were first consultations. It should be noted the interconnection with the primary centers, by regular meetings (including videoconferencing week)that allow   integrated care of  patients.

1.b. Emergencies of the especialty are attended by specialists in orthopedic and trauma surgery,  at the Emergency Unit of the hospital, 24 hours.  2013 around 1.500 patients received emergency medical care,  of which over 500 required admission for treatment. According to the study on safety of multiple trauma  patients , that includes 10 hospitals with the highest volume in all Catalunya, Hospital Universitari de Girona Dr.Josep Trueta is the hospital in Catalunya that recives more multiple trauma  patients , placing it as a  centre of category  2B, which allows the global support of such  patients.Here are combinated the fact that is the referral hospital in a region with a high accident rate and that is the only one.

1.c. the surgical activity  represents a significant part of the healthcare service line, distributing this activity in more tha  12 weekly surgeries at the Hospital Trueta,with works time morning and afternoon . The Service performed more than   1.600 operations a year , of which  75% correspond to planned surgery , and of these, nearly 20% are performed on outpatient basis. Outpatient  Major surgery  are performed on Clínica Girona (256 surgeries  2012),and surgery of short-stay at the  Clínica Salus of  Banyoles (286  on 2012), in order to reduce the maximum waiting time for operations , performing at Hospital Josep Trueta  major complex surgeries (prostheses, spinal surgery, spare parts, fractures, etc)

In order to get specialist care the  patient requires, the Service is divided into nine  super units, which allows us to provide comprehensive assistance and best quality to mour patients.

This units are,

• Articular replacement surgery (prosthesesof hip and knee )
• Pathology of the upper limb
• Arthroscopy unit
• Septic pathology and spares arthrplasty
• Child orthopedic surgery
• Foot diseases
• Pathologies of the spine
• Bone and joint disease rheumatoid
• Orthopedic onclogical diseases

Different population charactheristics and  evolution of the specialty have determined some specific areas within the  Service,where they develop technical  assistance and  integrated treatment of special complexity:

1. Osteoarthritis in young patient.  Increased life expectancy and demands of the population, make treatment techniques in young patients with osteoarthritis have evolved   considerably in recent years.   At the Service , the Unit of Arthroplasty is a  pioneer and leader in the use of  specific implants (arthroplasty) for patients with knee and hip osteoarthritis d (bone stems conservation, new  material for implants...) and alternatives surgical techniques (arthroscopies of knee and hip...). However the prostheses unit has begun implementing  a new   program for the  treatment and monitoring of  patientsundergoing knee replacement that attempts to improve the assitencial care in these pathologies.

2. Reviws/hip and knee parts. During the period  2007-2012 at the  Service were made more than  1200 knee replacement and around 1100 hip.Althoug it is a   technique with a very good results , hip and knee arthroplasties may present in time loosening and associated complications . The Service provides  a Unit of  Septic and Arthroplasties parts. 2012  were held around  70 interventions of knee and hip replacement. Together with Internal Medicine has started a working group and monitoring of patients with infectious  osteoarticular diseases,involving those responsibles for this diseases in all  hospitals of Girona. The Unitat of  septics is leader in the diagnosis and treatment infectious bone and joint diseases and performs almost   100% of treatment of such diseases in the health care area of the region of  Girona.

3. Pathologies of the spine . Spinal Unitat treated over 4.800 patients in 2012, of which  25% are first appointments. The number of operations is around of 100 planned and  30 urgent, with a very significant trauma patients .  Is the desire of the Service, following the guidelines of the management of the health region ,strengthening a reference unit of the spine pathology , which includes the treatment of diseases afecting the spine  (degenerative, deformity, tumor, trauma), with a resolution capacity of around  6.000 visits per year, and lead,  multidisciplinary, global diseases , promoting excellence and  development in this area. Three especialists doctors of the Unit perform monitoring and treatment specifically for these type of pathology. Currently ,spine unit, recieves especialists doctors from around the state, learning percutaneous surgical techniques , dynamic instrumentation , etc.

4. Infant orthopedic traumatology. One of the objectives in the  COT has been encouraging and revive  activity in the field of pediatric ortopedics and i traumatology. In this sense is intended to give care and continous attention to main diseases of the locomotor and  musculoeskeletal of child and  adolescent, including from clubfoot(CTEV) ,hip  dysplasia, and spinal deformities . The Unit is  formed by a doctor specialist and collaboration with  resident doctor of the specialty and pediatrics of the Hospital  aand primary care pediatrics, performing around 1500 outpatient visits per year. Also in daily  collaboration with the  various upperspecialists of the Traumatology service ,  the unit provides comprehensive care and treatment regarding musculoskeletal health of childen and adolescents.

5. Traumatology. Hospital Universitari de Girona Dr. Josep Trueta performed 600 surgeries  2012, in muskuloeskeleta trauma patients , and around  10.000 patients at the emergency unit of COT. A significant rate of  multiple patients are visited (various muskuloskeletal and visceral injuries), who come to the Hospital  as a referral center of Girona region.  Trauma unit paticipates in the training of doctors who make the super-traumatology specialty  ,and  organizes  coursesand  international conferences which bring together specialistes of  different countries.