Dr. Robert O'Toole explains how the University of Maryland's Problem Fracture Program can help patients with fractures that don't heal properly. 

Surgeons at the RA Cowley Shock Trauma Center and University of Maryland Medical Center are international leaders in the care of orthopedic trauma.

Renowned for treating the most complex fractures, our board-certified team of specialists routinely sees patients with previous fractures that continue to have problems.

For patients, who need specialized care for a problem fracture, they offer:

  • Outpatient evaluation and care
  • Second opinions
  • Corrective surgery

Caring for the Complex Fracture

Orthopedic trauma injuries require specialized care. Unfortunately, post-surgical infection, improper bone healing, soft tissue problems, arthritis and poor wound healing are common after fracture, even with excellent initial care.

Our problem fracture team, which includes surgeons, infectious disease specialists and physical and occupational therapists, is dedicated to the treatment of these complex issues.

Our physicians are highly experienced in caring for post-surgical issues that can develop months or years down the road from the time of the original injury.

Conditions evaluated within the University of Maryland Problem Fracture Program include:

  • Fractures that did not heal (non-unions)
  • Fractures that healed in poor position (mal-unions)
  • Fractures that healed with the limb short (limb length discrepancy)
  • Post-surgical infections and bone infections (osteomyelitis)
  • Arthritis after a fracture — a common occurrence when fractures involve a joint

About Our Problem Fracture Team

Our orthopedic trauma surgeons of the Outpatient Orthopaedic Trauma Program are global leaders in the research and development of cutting-edge treatment strategies and techniques to restore function and mobility after a traumatic injury.

Our team of orthopedic trauma experts includes:

  • Orthopedic trauma surgeons with expertise in complex issues after fractures
  • Complex joint replacement surgeons, who subspecialize in trauma-related issues
  • Upper extremity orthopedic trauma surgeons, who will care for nerve and tendon injuries in addition to fractures
  • Infectious disease physicians specializing in infections related to fractures
  • Plastics and soft tissue reconstruction surgeons
  • Physical and occupational therapists dedicated to rehabilitation after complex injuries


Appointments are available within one week, and sooner for urgent cases. Call 410-448-6400 to schedule. No referral is needed. You may also request an appointment online

Outpatient Locations

Shock Trauma Outpatient Pavilion at UMMC
23 Penn Street, Room TGR 100
Baltimore, MD 21201

University of Maryland Orthopaedics at Camden Yards
351 West Camden Street, Suite 501
Baltimore, MD 21201

Referrals and Physician Services

In addition to providing direct patient care, our orthopedic trauma surgeons offer second opinions and senior-level consultation to external physicians for complex cases. Referring to the Problem Fracture Program

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