Peter A. Cole, MD

11/20/2025

"The largest GAP between standard of care and standard of practice exists in the surgical stabilization of rib fractures—SSRF.” I have quoted my friend Fred Pierracci many times while teaching on the subject since I heard him say this during his Presidential Chest Wall Injury Society Address several years ago. It is estimated that perhaps only 10% of indicated rib fractures are treated with surgical stabilization, and the morbidity and mortality of this missed opportunity is high.

ACS Press Release: https://www.facs.org/quality-programs/trauma/quality/best-practices-guidelines/

Just over a year ago, I was asked to be a part of a task force to write the 1rst ever guidelines on Chest Wall Injury for the American College of Surgeons. With tremendous respect for the project Co-Chairs, Mike McKee and Ron Gross, I could not say no despite the proposed aggressive schedule to HAMMER through the project inside of a year with biweekly meetings, “Are you kidding me!”

https://www.facs.org/quality-programs/trauma/quality/best-practices-guidelines/ ………and here we are!

There are few published documents that influence care—CHANGE CARE—like ACS Best Practice Guidelines. It was a high honor to be one of two orthopedic surgeons from North America selected for this activity and it was a career highlight. I am thankful to our Chairman and all members for such a growth opportunity. The endorsement of this document from not only ACS but the Orthopaedic Trauma Association and Chest Wall Injury Society brings it even closer to home. Congratulations!

11/11/2025

Lateral Implosion Injuries………….are THE BOMB!! 💣💥

After treating myriads of patients with Scapula Fractures, I began seeing associated injuries and started thinking about all this pathology in a different way. It was like taking off one blinder after another, opening my scapula mind to a shoulder girdle mind, and then to the world of ribs, and then subsequently to an extent that my entire patient practice has evolved into a fascinating Ortho-Thoracic career.

Thanks to my wonderful co-authors, we responded with a multidisciplinary themed article which underscores the recognition of traditional orthopaedic diagnoses for general & thoracic surgeons, which promotes better communication between trauma-focused specialties.

“Lateral implosion injury: a multidisciplinary management approach”

https://ccts.amegroups.org/article/view/104671/html

11/06/2025

11/03/2025

Hats off to Dr. Andy Choo, founder of ULTRA, the Upper Limb Trauma Association within the Orthopaedic Trauma Association. This was the 3rd Annual meeting—awesome!

*A few highlights for me: Many competent scapula surgeons in the house – Keynote address by Dr. Christian Ge**er a smashing success – SC Joint dislocation surgery is finding a mainstream!

10/28/2025

Dear Colleagues,

I hope you’ll join the Orthopaedic Trauma Association Webinar tomorrow, Wednesday the 29th at 8:00 p.m. CT, on a topic that’s become a true passion of mine—one that began with my love for scapula fractures. You see, rib fractures go together so often in the Forequarter Lateral Implosion Injury. My guests are the absolute best educators in the field of rib fracture management—starting with my colleague “Weatherby,” known simply by his last name, along with Tom White and Evert Eriksson, the Founder & Chairman and the current President of the Chest Wall Injury Society. One hour—have a blast!

REGISTER HERE: https://zoom.us/meeting/register/vJAkdu-qpj0jZdNiEDs3kOhK8r4b_hRwFA

10/22/2025

It was awesome to mix it up with Drs. Niloofar Dehghan, Ken Egol, and Mike McKee on a shoulder trauma dinner bash at Chico Malo with some serious shoulder trauma fans. Also, a special thanks to “The Company Formerly known as Exactech” for a great evening…we cannot wait to hear the new name—coming soon! 🔜

10/14/2025

One of the most vexing challenges in the realm of Scapula Fracture Surgery and Total Shoulder Replacements is the dreaded acromion fracture associated with a Reverse Total Shoulder Arthroplasty. It is an extremely painful condition which occurs in about 5% of patients who undergo a shoulder replacement which means there are about over 7,000/year in America alone. I joined a team of 5 fracture & arthroplasty surgeons and 3 engineers to develop a solution for this problem which is being introduced at the Annual Meeting of the Orthopaedic Trauma Association this week in Phoenix, AZ. I will have the opportunity to expand upon a surgical solution which will help solve this problem.

REGISTER HERE: https://web.cvent.com/event/9a1b529a-1da5-4f60-9418-22e983541603/summary?RefId=Summary%2FWebsite%2FPDF

Displayed are X-Ray images of methods I have employed to fix the problem to now, and an illustration of the new plate used for fractures of the Acromion Spine.

10/08/2025

10/06/2025

09/25/2025

It was a Marathon Week hosting our 6th Minnesota Scapula Course and 5 International Scapula Scholars at Regions Hospital. The course was a knockout and featured two rising stars in the field, Drs. Douglas Haase (U of MO) and Humza Shaikh (OSU), in addition to scapula thoughtleader-stalwarts Andrew Choo (UT Houston) and Jonah Davies (UC Irvine), and my incomparable partner David Weatherby (U of MN—Regions NorthStar). What most impressed me is that the standards of treatment and understanding are deeper and rising, both on the part of faculty and participants. I could have chosen 5 of the 16 attendees to join faculty in the future and that represents opportunities for scaling in other states. Multitudes of injured patients are now clearly receiving treatments that did not exist in most places even 5 years ago! Finally, our teams shined—Research Team (The Scapula Institute), sponsor Stryker, and et al.—aces across the board. Thank you!

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09/15/2025

Ortho Trauma Surgeons Weigh In

Solid steady effort to get this project done – proud of this TEAM!
https://www.sciencedirect.com/science/article/abs/pii/S0020138325004401

An experienced Orthopedic Trauma Surgeon with a 15-year practice has treated around 7,500 patients and has implanted well over 15,000 plates or nails. If only 5% required hardware removal, that would be 750 hardware removals—a plausible statistic in North America. This matter is important.

In a prior retrospective investigation, we examined the incidence and motivations behind patients requesting the return of their hardware, as well as the increased respect shown toward their surgeon and hospital when this request was granted (Mavrommatis S, LaRoque MC, Yang G, Brahme IS, Cole PA. Does the Option to Keep Explanted Orthopaedic Trauma Implants Influence Patient Satisfaction and Perception of Care? Results of a Survey Study. J Orthop Trauma. 2023;37(7):e288–e293).

Additionally, we published on the ethical considerations of this issue (The Ethics of Explanted Orthopaedic Hardware Return to Requesting Patients. J Orthop Trauma. 2022;36(8):371-374). I have been impressed with the emotion many patients have around wanting their hardware back, and toward that end, we are currently enrolling patients in a prospective trial to learn more about patients’ rationale for wanting (or not wanting) their explants, and whether culture, age, or gender reveals trends around the matter. I have had many patients make things out of their hardware such as jewelry, lamp stands, and picture frames— it is heartwarming to receive gifts from patients made of hardware that I placed many years earlier. There are many things to consider including cost and safety, legal implications, precedent and implants in other specialties, but I believe they can all be addressed with reasonable guidelines.

09/12/2025

It was a thrill to bring my friends together from around the globe for a Super Panel to discuss my favorite recent topic: Top 5 Challenges in Scapula-Clavicle Trauma. We lit up San Diego and a room full of 50 surgeon & engineer challengers to roil in the controversies!

TGIF! It’s time to KICK OFF our annual course!