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Correction

When Michael Bellino was growing up and contemplating his plans for the future, his father, an orthopedic surgeon, gave him some pointed career advice.

"'Don't go into medicine, don't go into orthopedic surgery - and whatever you do, don't do trauma,'" Bellino recalls his father telling him. "'The hours are long, and you'll be on call all the time.'"

While Bellino originally planned to become a veterinarian - he majored in zoology at the University of Massachusetts - he ultimately ignored his father's advice, and dozens of Northern California patients who have suffered hip and pelvis fractures are the better for it.

Last August, Bellino was hired as chief of Stanford's orthopedic trauma service, fresh off a one-year fellowship in hip and pelvis reconstruction at Good Samaritan Hospital in Los Angeles. Hip and pelvis repairs are complex, high-risk operations that many orthopedic surgeons do but few do very well, Bellino said.

"With some procedures, it doesn't matter that much if you don't get it exactly right," he said. "With this operation, it's got to be perfect."

Most of Bellino's patients belong to one of two categories: victims of trauma (car accidents or falls from high places), or elderly patients who've sustained injuries from falls. Successfully operating on the pelvis and the attached hip joint is tricky for several reasons, Bellino explained. "The structure of the pelvis is difficult to work with because it has an unusual shape and is located deep in the body," he said. Furthermore, "there are at least 10 different ways (the pelvis) can fracture," compared with a simpler bone like the tibia. Finally, operating on the pelvis can be risky because there are several delicate structures nearby, including nerves, blood vessels, the bladder and reproductive organs.

If such an operation isn't perfectly done, Bellino explained, there is increased stress on the articular cartilage, which can lead to post-traumatic arthritis. For the patient, this can cause considerable pain and loss of function, including not being able to walk.

A significant number of Bellino's cases, in fact, are re-dos for patients whose surgery was unsuccessfully done elsewhere. And given that Bellino is one of just a handful of physicians in California with specialized training in repairing hip and pelvis fractures, an increasing number of patients with these conditions are being referred to Stanford.

Things were much different before Bellino came; patients with hip and pelvis fractures often were sent to other academic medical centers, like UCSF, UC-Davis and Santa Clara Valley Medical Center.

"Because of his being here, we're getting a lot of patients we didn't get before - at least three to four a month," said David Spain, Stanford Hospital's chief of trauma/surgical care. "He's been a huge plus for Stanford and particularly the trauma program. A lot of guys in the community can take care of broken arms and legs, but pelvis fractures are much more challenging. You need someone who's highly trained to take care of them." And, Spain added, "He's a good guy to work with."

Bellino, who grew up in northern New Jersey and received his MD at New York Medical College, said he enjoys what he does because "it's always challenging." And, he added, it's rewarding to see patients restored to normal or near-normal functioning after debilitating injuries. "I'll see patients where one of the bones is completely separated from the pelvis. When you can help someone like that walk normally again, it's a great thing to see."