Trauma and Fracture Care

Dr. Robert Orfaly with a patient
Dr. Robert Orfaly is an orthopaedic surgeon who focuses on the hands, shoulders and elbows.

OHSU is one of only two Level 1 Trauma Centers in Oregon. Trauma teams are here 24 hours a day, seven days a week; because the first hour after injury is critical, bone and joint trauma specialists are always here for you.

Treatment options

We offer a full range of care for patients with severe fractures of the arm, leg, pelvis or spine. We also treat patients with multiple fractures. Treatment includes emergency care and post-emergency follow-up. Our bone and joint specialists can also help treat and correct deformities resulting from a trauma or previous injury.


Some fractures need to be treated with surgery that allows the orthopaedist to see the broken bone. This allows your doctor to realign the bones correctly. Once the bone is back in place, it can be held there with small plates and screws or by placing a rod inside the bone to stabilize it. These treatments allow you to use the injured arm or leg and help the broken bone heal correctly.

When a joint is dislocated, the ligaments and muscles around it are often injured. If you have a dislocated joint, it must be put back in place before it can work properly. If the bone or surrounding ligaments have been damaged, the joint might be unstable.  Surgery can put the joint back in place and help repair the bones and ligaments. We have orthopaedists who specialize in repairing specific joints. Our specialists can perform surgery to bring back stability to the joint and help it work well again.

Bones in the spine can break in an injury or after they weaken with age. A spinal compression fracture occurs when spinal bones (vertebrae) become weak, collapse and break.

Such fractures are common in people with osteoporosis, affecting about one-quarter of women after menopause and about half of women over 80. Older men are also at risk. Compression fractures occur in the softer bone at the front of the spine.

A nonunion is broken bone that has not healed correctly. Although treating nonunions is complex, the OHSU fracture team has expertise in surgery, bone biology and infectious disease to address the causes of nonunion. 

Nonunion has three major causes:

  1. Too much motion at the fracture site. If the bone was not stabilized enough when the fracture was first treated, the ends of the broken bones might not come together (unite) as they should.
  2. Conditions that keep new bone from forming. If you have diabetes, smoke or have a disease that affects your blood vessels, your body may not make new bone well. When your body does not make new bone to join the broken ends of the fracture, it does not heal.
  3. Infection at the fracture site. This is the most challenging cause of nonunion. Bacteria keep new bone from forming and break down the bone that is already there. Treatment includes surgery to remove the infected bone, stabilization of the bone and antibiotics for the infection.


Own the Bone Star Performer

We have been recognized by the American Orthopaedic Association as an Own the Bone "Star Performer" for 2023-2024. This designation is only given to institutions that perform the highest level of fragility fracture and bone health care.

Schedule an appointment


OHSU Orthopaedics Clinic, South Waterfront
3303 S. Bond Avenue
Portland, OR 97239

OHSU Orthopaedics Clinic, Beaverton 
15700 SW Greystone Court
Beaverton, OR 97006

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Physician advice and referrals

To refer a patient or seek advice from an OHSU provider please visit our Physician Advice and Referrals page or call us at 800-245-6478 or 503-494-4567.