Not all orthopaedic surgeons are trained equally to care for patients with serious injuries. While orthopaedic surgery residency training and board certification ensure a general level of knowledge about the evaluation and treatment of skeletal trauma, they do not provide the orthopaedic generalist, or a subspecialist in another field, with all the tools required for care of the seriously injured. Fellowship training in orthopaedic traumatology has emerged as one of the major ways to obtain the skills to care for these complex musculoskeletal injuries. The necessary skills can also be obtained through a combination of residency training, self-study and medical educational programs, collaboration with others experts in the field, and frequent, direct care of seriously injured patients. All of the orthopaedic surgeons in the UCSF/SFGH Orthopaedic Trauma Center possess this expertise, and 75% have completed Orthopaedic Trauma fellowships.
The additional training provided in an orthopaedic trauma fellowship provides these physicians with extensive experience 
in the medical and surgical management of a vast diversity of cases and creates orthopaedic traumatologists that are very proficient in a wide variety of skeletal surgeries. Injuries treated by the orthopaedic trauma surgeon range from simple ankle fractures to multiple trauma patients with involvement of the spine, pelvis and lower extremity long bones. The service at SFGH performs approximately two thousand operative procedures a year, 70% of which are trauma related. Over 90% of the patients are adults.