Overview
 Prof. KS Leung Professor Leung Kwok-sui is the founding professor and leading the development in the past 30 years with international renowned achievements. Together with Dr. Ning Tang (Consultant) and Dr. CY Tso (Associate Consultant), our vision is to serve all trauma patients with the highest standards of care and advancement of osteosynthesis and trauma care through education and research. Despite the trauma referral center of New Territories East Cluster serving more than 1.3 million residents and covering the largest catchment area, we provide timely emergency service to all major trauma patients with our 24 hour operation theater. With the aging population, the main service load now resides in the holistic care for geriatric fragility fractures, which we strive to preserve function, hasten rehabilitation and continue the care in the community through comprehensive fall prevention programs.
To advance in trauma care, extensive collaboration with different institutes has been established with researches from basic science to clinical studies. Our research results has been presented in numerous international conferences, meetings and also published in high impact international journals and books. Working with various departments within the Chinese University of Hong Kong and outside professional organizations including the Orthopaedic Learning Center, HKOA, HKCOS, AADO etc. we emphasis education for the medical students, post-graduate students, surgeons, allied health professionals and fellows both locally and internationally (Fig.1).
 Fig.1
We serve not only patients in the hospital but also extend our services into the community (Fig.2a) and also actively participate in many humanitarian missions: HA 2008 Sichuan earthquake relieves team, Sichuan earthquake Red Cross after quake missions and Operations concern missions in China (Fig.2b Fu-Ping County Hospital).
 Fig.2a  Fig.2b
Development milestones
To best serve our patients, new concepts and new technologies has been adopted and developed
over the years and among all the important ones include minimal invasive surgery (MIS), damage
control surgery (DCO) etc. We also try to standardize our management of patients through clinical
pathways and protocols setting. Other important developments include:
| 1. |
Current concepts of fracture fixation: Gamma nail development (Fig.3) |
 Fig.3
| 2. |
Computer assisted orthopaedic surgery (CAOS) in trauma |
a. |
Pre-operative: Planning is the first step to successful surgery and software including Mimics,
Osirix, Orthoview could be used for viewing and surgical planning (Fig.4). 3D printing (Fig.5)
provide additional templating, surgical simulation and as intra-op guidance possibilities. |
b. |
Intra-operative: 3D mobile C-arm with intra-op navigation systems provides accurate three
dimensional information of pathoanatomy of fractures and real time interactive tool/implant
position in relationship to the anatomy. Together with image fusion technique (Fig.6), robot
assistive surgery (Fig.7) and 3D printing jig, precise fracture reduction and fixation with
minimal invasiveness has been attained with excellent functional outcome achieved (Fig.8). |
c. |
Post-operative: Comprehensive database has been established for research has been
established. |
CAOS Milestones:
• |
2000 2-D fluoroscopic Navigation |
• |
2003 3-D fluoroscopic Navigation |
• |
2005 Robot assisted surgery (Fig.7a, Fig.8) |
• |
2006 Pelvic-acetabular fracture safety margin (Fig.4) |
• |
2006 3-D fluoroscopic /CT/MRI fusion navigation (Fig.6) |
• |
2007 3D navigation/arthroscopy guided fracture fixation |
• |
2008 2nd Robot development (Fig.7b) |
• |
2011 10 year review- navigation for Pelvic-acetabular fracture |
• |
2013 3D printing and patient specific implant (Fig.5) |
Fig.4 
Fig.5  Fig.6  Fig.7a (Prototype I)  Fig.7b (Prototype II)  Fig.8
| 3. |
Arthroscopic assisted surgery in articular fractures management representing another major
MIS technique: |
a. |
Subtalar arthroscopy and percutaneous close reduction internal fixation for os calcis fracture
(2010) (Fig.9) |
 Fig.9
| b. |
Tibial plateau fracture fixation with knee arthroscopy and 3D navigation (2007) (Fig.10) |
 Fig.10
| 4. |
Biophysical modalities in fracture treatment: |
| a. |
Low intensity pulsed ultrasound (2000) (Fig.11) |
| b. |
Vibration platform (2005) (Fig.12) |
 Fig.11  Fig.12
| 5. |
Biomaterial: Injectable bioabsorbable bone substitute (2003) (Fig.13) |
 Fig.13
Current developments
Digital Orthopaedics is under developing since it will provide a scientific way of analyzing all factors
related to the management of trauma patients and with the best guide for the treatment of trauma
in an individual. We have also started on the collaboration with geriatricians in the development of
orthogeriatrics and establishing the fragility fracture registry. Hopefully these will lead to successful
prevention program that eventually decreases the incidence of occurrence for fragility fractures.
Ongoing Clinical Research Projects
• |
Percutaneous Fixation of Displaced Calcaneal Fractures with Subtalar Arthroscopy and Fluoroscopy Guidance (Fig.14) |
• |
Analyzing the Syndesmosis and its Biomechanics in Ankle Fractures: A Cadaver Study (Fig.15) |
• |
Vibration Therapy as an Intervention for Postural Training and Fall Prevention after Distal Radius Fracture in Elderly Patients: A Prospective Randomized Controlled Trial (Fig.16) |
Fig.14 Subtalar arthroscopy 
Fig.15 X-ray showing syndesmosis  Fig.16 Vibration therapy at community centers
Clinical Trauma Team Members
• |
Dr. TANG Ning |
• |
Dr. TSO Chi-yin |
• |
Dr. NG Wai-kit Raymond |
• |
Dr. WONG Man-yeung Ronald |
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