ACTUAR Multi-Center Research Studies

2550 23rd Street, Building 9, 3rd Floor
San Francisco, CA, 94110

ACTUAR Current Projects:

Orthopaedic Multi-Center Open Tibia Study
ACTUAR is conducting a prospective multi-center study to examine the state of care and predictors of quality of life after open tibial shaft fractures in Latin America. Currently, 22 sites across Latin America have been on-boarded, and 18 of these sites are actively enrolling patients into the study. This project is novel in its size and design, and will not only answer an important question, as open tibia fractures represent a significant burden of disease, but the process of participating in the study will also introduce centers to develop collaborative research initiatives.

Orthopaedic Trauma Research Priorities in Latin America Delphi Study
Funding for research in orthopaedic trauma in an international setting is significantly lacking. This study aims to determine the clinical research priorities of orthopedic surgeons in order to facilitate, instigate, and encourage engagement in multi-center national and international clinical research in Latin America. The study uses a Delphi method design involving multiple short survey rounds to determine a consensus through a panel of orthopaedic trauma surgeon-experts.

Soft-Tissue Wound Coverage Management Study
The UCSF ethics-approved study survey will evaluate the soft-tissue coverage of open fracture wounds in Latin America, examining factors including surgical preferences, techniques, available resources, timing, and training. This study will be solicited from the Boards of National Orthopaedic Societies to distribute to their membership and through ACTUAR members.

The INternational ORthopaedic MUlticenter Study in Fracture Care (INORMUS) is a multi-centre, observational cohort study designed to inform the incidence of the global burden of orthopaedic injury. The target enrollment for this study is 40,000 patients. Currently, there are already 36,000 patients enrolled into the study, 1,000 of which are patients from Latin American enrolling sites. The objective is to enroll 4,000 patients from Latin American sites by 2022. All ACTUAR members with an interest in this study are invited to participate. Requirements for a site to participate in the study include: a commitment of 4-12 weeks to collect data on trauma cases; a dedicated study coordinator to help with the collection and enrollment of data; institutional ethics approval; and a contract with UCSF or McMaster University.

INORMUS Participating Sites:
Argentina – Hospital Sirio Libanes (Fernando Bidolegui)
Mexico - Hospital Civil (Jose Martinez)
Mexico - Puerta de Hierro (Luis Padilla/Jose Maria Martinez/Claudia Ramirez)
Venezuela – Hospital Universitario (Carlos Sanchez/Igor Escalante)

Bolivia – Clínica del Sur (Sergio Iriarte)
Brazil – Instituto de Ortopedia e Traumatologie (Kodi Kojima)
Brazil – Vila Velha ßHospital – (Nelson Elias)
Colombia - Centro Medico Imbanaco (Mauricio Zuluaga/ Federico Reina)
Colombia – Fracturas y Fracturas (Jose Eduardo Quintero)
Colombia – Federico Reyna
Ecuador – Hospital de la Policía Nacional Guayaquil (Gavino Merchan)
Honduras – Ruth Paz Foundation (Tomas Minueza/Monica Ortiz)
Mexico –Christus Muguerza (Manuel Ylizaliturry)
Panama - Hospital Santo Tomas (Mario Garuz)
Paraguay – Instituto Previsión Social (Julio Segovia)
Uruguay – Asociación Espanola Primera de Socorros (Antonio Barquet)

Participating Sites:

Argentina: Centro Médico Integral Fitz Roy
Principal Investigator: Santiago Svarzchtein, MD

Argentina: Clínica Zabala
Principal Investigator: Marcelo Rio, MD

Argentina: Hospital Interzonal General de Agudos
Principal Investigator: Rafael Amadei, MD

Argentina: Hospital Sirio Libanes
Principal Investigator: Fernando Bidolegui, MD

Colombia: Fracturas y Fracturas
Principal Investigator: Jose Eduardo Quintero, MD

Colombia: Fundación Cardioinfantil
Principal Investigator: Miguel Triana, MD

Colombia: IPS Universitaria
Principal Investigator: Claudia Medina, MD

Cuba: Hospital General Universitario Calixto Garcia
Principal Investigator: Horacio Tabares, MD

Mexico: Hospital Civil de Guadalajara
Principal Investigator: Jose de Jesus Martinez Ruiz, MD
Study Coordinator: Diego Estrada, MD

Mexico: Hospital Country 2000 Guadalajara
Principal Investigator: Rafael Jimenez, MD

Mexico: Hospital Universitario Dr. Jose Eleutario Gonzalez Monterrey
Principal Investigator: Mariana Salazar, MD
Study Coordinator: Erika Guerrero, MD

Mexico: Instituto Mexicano del Seguro Social 45
Principal Investigator: Mónica Martinez, MD

Mexico: Instituto Mexicano del Seguro Social 89
Principal Investigator: Edgar Mercado Salcedo, MD

Mexico: Instituto Mexicano del Seguro Social 45 UMAE VFN Mexico City
Principal Investigator: Ruben Torres, MD
Principal Investigator: Fryda Medina, MD
Study Coordinators: Edgar Reyes, MD, Perla Ordóñoz, MD

Mexico: Puerta de Hierro Norte Guadalajara
Principal Investigator: Jose María Jimenez, MD
Principal Investigator: Luis Padilla, MD
Principal Investigator: Ricardo Madrigal, MD
Study Coordinators: Claudia Ramirez, MD, Arelhi Gonzalez Cisneros, MD

Paraguay: Servicio de Ortopedia y Traumatología Hospital Central IPS
Principal Investigator: Julio Segovia, MD
Study Coordinator: Diego Almada, MD

Paraguay: Hospital del Trauma
Principal Investigator: Victor Rienzi, MD
Study Coordinator: Miguel Cardozo, MD

Venezuela: Hospital Universitario de Caracas
Principal Investigator: Carlos Sanchez, MD
Principal Investigator: Igor Escalante, MD

National Orthopaedic Societes:

Argentina: Asociación Argentina de Trauma Ortopédico (AATO)
Bolivia: Sociedad Boliviana de Ortopedia y Traumatología (SBOLOT)
Brazil: Sociedade Brasileira de Trauma Ortopédico (SBTO)
Brazil: Sociedade Brasileira de Ortopedia e Traumatologia (SBOT)
Chile: Sociedad Chilena de Ortopedia y Traumatología (SCHOT)
Colombia: Sociedad Colombiana de Cirugía Ortopédica y Traumatología (SCCOT)
Cuba: Sociedad Cubana de Ortopedia y Traumatología (SCOT)
Dominican Republic: Sociedad Dominicana de Ortopédia y Traumatología (SDOT)
Ecuador: Sociedad Ecuatoriana de Ortopédia y Traumatología (SEOT)
El Salvador: Asociación Salvadoreña de Ortopédia y Traumatología (ASOT)
Guatemala: Asociación Guatemalteca de Ortopédia y Traumatología (AGOT)
Honduras: Asociación de Cirugía Ortopédica y Traumatología de Honduras (ACOTH)
Mexico: Federación Mexicana de Colegios de Ortopedia y Traumatología (FEMECOT)
Nicaragua: Asociación Nicaraguense de Ortopedia y Traumatología (ANOT)
Panama: Sociedad Panameña de Ortopedia y Traumatología (SPOT)
Paraguay: Sociedad Paraguaya de Ortopedia y Traumatología (SPOT)
Peru: Sociedad Peruana de Ortopedia y Traumatología (SPOT)
Puerto Rico: Sociedad Puertorriqueña de Ortopedia y Traumatología
Uruguay: Sociedad de Ortopedia y Traumatología del Uruguay (SOTU)
Venezuela: Sociedad Venezolana de Cirugía Ortopédica y Traumatología (SVCOT)

About Us:

Asociación de Cirujanos Traumatólogos de las Americas (ACTUAR)
There is need for global North-South American relationships that allow South American colleagues to access resources available in North American centers. This includes expertise, organization, and infrastructure to address research questions relevant to the South American countries. To this end, the Asociación de Cirujanos Traumatólogos de las Americas (ACTUAR; was developed. ACTUAR, led by organizing faculty from UCSF/IGOT, is the product of a group of orthopaedic surgeons interested in an international collaborative initiative focused on building sustainable, research capacity across institutions throughout Latin America. Currently, there are over 150 members involved in ACTUAR, representing all 20 Spanish-speaking Latin American countries.

Our Team:

    Theodore Miclau, MD, Principal Investigator
    Dr. Theodore Miclau, MD, Professor and Vice Chairman of the Department of Orthopaedic Surgery at the University of California, San Francisco (UCSF), and Director of the Orthopaedic Trauma Institute at UCSF/Zuckerberg San Francisco General Hospital (ZSFG), fosters our international partnerships in Latin America. He is the current Chair of the Steering Committee for the International Orthopaedic Trauma Association and past president of the Orthopaedic Trauma Association, International Combined Orthopaedic Research Society, Orthopaedic Research Society. Ted is an orthopaedic surgeon who specialized in the treatment of injuries caused by trauma, such as complex fractures and bone loss. He is an internationally recognized expert on the cellular and molecular mechanisms of bone regeneration and repair, locally applies antibiotics, and minimally invasive fracture surgery.

    David Shearer, MD, MPH, Co-Principal Investigator
    Dr. David Shearer, MD, Assistant Professor and Orthopaedic Surgeon of the Department of Orthopaedic Surgery at the University of California, San Francisco. Dr. David Shearer completed his undergraduate degree in Mechanical Engineering at the Massachusetts Institute of Technology following by his medical degree at the University of Washington. With an interest in clinical research and global health, he obtained an MPH from the Harvard School of Public Health before beginning residency training in orthopaedic surgery at UCSF. He subsequently had fellowship training in orthopaedic trauma at Harborview Medical Center in Seattle and foot and ankle surgery with Dr. Michael Coughlin in Boise, Idaho. He joined the faculty at UCSF in 2015 with clinical interests in complex fracture care as well as acute and post-traumatic conditions of the foot and ankle. As co-director of the IGOT Global Research Initiative, his primary academic interest is building research capacity and conducting high-quality clinical studies in low and middle-income countries through IGOT’s partnerships.

    Saam Morshed, MD, PhD, MPH, Co-Principal Investigator
    Dr. Saam Morshed, MD, Associate Professor and Orthopaedic Surgeon of the Department of Orthopaedic Surgery at UCSF, received his Bachelor’s degree from Harvard University and completed both medical school and orthopaedic residency at the University of California, San Francisco. As an Orthopaedic Research and Education Foundation Clinical Research Training Fellow, he received a Master’s of Public Health and Ph.D. in Epidemiology from the University of California, Berkeley. Prior to returning to UCSF to join the faculty in the Department of Orthopaedic Surgery, he completed subspecialty clinical training in orthopaedic trauma at Harborview Medical Center in Seattle. Saam is an attending orthopaedic trauma surgeon and Director of the Clinical Research Center at the UCSF SFGH Orthopaedic Trauma Institute. His clinical practice is focused on skeletal trauma, surgery of the pelvis and acetabulum, and problem fractures including malunions and nonunions.

    Madeline Mackechnie, Administrative Director and Project Officer
    Madeline MacKechnie graduated summa cum laude with a Bachelor’s degree in International Development Studies and holds a Master’s degree in Global Development Studies from Queen’s University, Canada, where her work focused on equitable solutions to healthcare disparities, specifically in Latin America. At the UCSF Orthopaedic Trauma Institute, Madeline coordinates IGOT’s orthopaedic surgical education initiatives and clinical research symposiums in-house, as well as in low-and middle-income countries. She is committed to developing and advancing high-quality orthopaedic surgical skills programs, both existing and new. Alongside UCSF faculty, Madeline has helped develop ACTUAR, Asociación de Cirujanos Traumatólogos de las Americas, a collaborative initiative focused on building research capacity in Latin America. In addition, she coordinates COACT, Consortium of Orthopaedic Academic Traumatologists, an organization representing leading orthopaedic institutions across North America that promotes global health efforts and best practices in musculoskeletal trauma care.


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