Dr. Trumble is a professor in the Department of Orthopaedics and Sports Medicine and Chief of the UW Hand & Microvascular Surgery Service.
Dr. Trumble received his Medical Degree at Yale University School of Medicine in 1979. He has been at the University of Washington since 1989, when he was recruited to develop a Hand and Microvascular Surgery Program at the UW.
Dr. Trumble was recently ranked as a "Top Doctor" in the
category of "Hand Surgery" on Seattle Magazine, September 2007. He also featured in the Seattle Post-Intelligencer for reattaching a hand as part of a 'daring' rescue. The Seattle P-I ran the story on February 6: 'Man's hand reattached after daring rescue at sea: A clean cut, ice and pure luck save the day; shipmates and a gutsy copter crew save him'.
What do you most enjoy about your work?
Like many physicians in teaching hospitals, I enjoy practicing at the University of Washington because we have the opportunity to help patients from diverse backgrounds who present with a wide range of problems that challenge our diagnostic and surgical skills. The chance to help patients heal from injuries and overcome the pain of arthritis is wonderful and inspiring. I also enjoy the opportunity to teach young people who want to go into the field of medicine at a variety of different levels including fellows, residents, medical students, and students in physician assistant programs.
What is your treatment philosophy?
I always try to work with my patient to determine the therapy or surgery that will relieve pain and provide the best functional recovery in a way that is compatible with their lifestyle. Meeting this challenge often requires very innovative approaches to surgery and therapy.
What are your interests outside of medicine?
I enjoy coaching and rooting for children's soccer, basketball, and gymnastics. The sports I enjoy the most are skiing, windsurfing, and soccer.
What is the focus of your teaching efforts?
In 1990, I founded the University of Washington Hand Fellowship Program to provide advanced training in hand surgery for surgeons who had completed training in orthopaedic surgery or plastic surgery. The program has grown to include three fellows in a fellowship accredited by the ACGME.
To focus on the educational needs of these students and residents, I put together a textbook, Principles of Hand Surgery and Therapy, which provides a precise, well-illustrated curriculum for their education. I often combine education and research to help residents and medical students gain special insights about hand problems. This provides an opportunity to develop new treatment techniques and provide a better understanding about injuries and illnesses effecting patients with problems that orthopaedic, plastic, and hand surgery share in common through our research programs. Students and residents take part in these research programs as a way to gain in depth experience in specific problems in surgery as well as learning the principles of medical research. Our research efforts range from the theoretical aspects of nerve regeneration to the practical aspects of treating fractures of the wrist.
What do your most recent research efforts focus on?
My current research efforts focus on: (a) nerve regeneration and nerve healing, (b) fractures of the wrist, including the radius and scaphoid as well as (c) clinical studies on carpal tunnel syndrome and flexor tendon injuries.
(a) Nerve regeneration: With the support from the American Society for Surgery of the Hand and the Orthopaedic Research and Education Foundation, we have developed resident research projects to evaluate the ability of nerves to regenerate using nearby uninjured nerves and special growth factors. In addition, we have worked with a variety of new products to help reduce nerve scarring that affects many common nerve problems such as carpal tunnel syndrome.
(b) With support from the Orthopaedic Research and Education Foundation and the American Society for Surgery of the Hand we have developed laboratory studies to determine more effective means of treating distal radius fractures, which are the most common fracture in all age groups. We have evaluated how to diagnose displaced fractures that extend to the joint and the methods to provide the most stable fixation. Our studies have demonstrated that even a 1.0-millimeter difference makes a substantial impact on fracture healing.
Additional studies also funded by the American Society for Surgery of the Hand have also helped us improve our techniques for treating scaphoid fractures, which are the second most common fracture involving the wrist. Internal fixation using specially designed screws helps to minimize the period of immobilization in cast from many months to only a few weeks.
(c) Major grant support for clinical outcome studies by the Orthopaedic Research and Education Foundation and the Boeing Foundation have allowed us to complete our clinical studies involving carpal tunnel syndrome and flexor tendon injuries. These studies were specially designed to compare different types of surgery or therapy in order to improve and shorten the patient’s recovery. As a result of these studies we have proven that endoscopic carpal tunnel surgery allows for faster recovery of function and earlier return to work than techniques involving larger skin incisions without the assistance of fiberoptic devices. Flexor tendon injuries involve a substantial loss of hand motion because the tendons that move the digits become scarred and will not glide. Innovations in therapy that allow for early hand exercises result in better patient motion and less need for revision surgery to release scar tissue.
What is the focus of your clinical efforts?
My clinical efforts have been focused to establish a hand surgery service that provides comprehensive coverage for all University of Washington affiliated hospitals.
In 1989, I joined the University of Washington as the only full time physician practicing hand surgery. Since that time, we have been able to develop a program that combines orthopaedic and plastic surgery into a comprehensive program that involves the University of Washington Medical Center, Harborview Medical Center, Seattle Childrens Hospital, the V.A. Hospital Medical Center, Overlake Hospital, and Northwest Hospital with five dedicated hand surgeons. We offer the only 24-hour emergency service for devastating hand injuries that require hand or digit replantation in the Northwest.
The Hand Surgery Service at the University of Washington offers comprehensive care ranging from congenital hand problems at Childrens Hospital, major injuries at Harborview Medical Center and complex cases involving arthritis or sports injuries at the University of Washington Medical Center. To provide access for patients who live on the eastside of Lake Washington, we have now opened an Eastside Subspecialty Center two blocks north of Overlake Hospital.
Selected bibliography of Dr. Trumble's publications:
- Trumble TE, Gilbert M, Murray LW, Smith J, Rafijah G, McCallister WV: "Displaced Scaphoid Fractures Treated with Open Reduction and Internal Fixation with a Cannulated Screw," Journal of Bone and Joint Surgery, Vol. 82-A, No. 5, p. 633-41, May 2000. [Read abstract] [Read full text]
- Trumble, TE. Principles of Hand Surgery and Therapy. Hartcourt International. 2000. [View publisher information]
- Trumble, TE, Diao, E., Abrams RA, and Gilbert-Anderson MM: "Prospective Randomized Trial of Endoscopic vs. Open Carpal Tunnel Release with Single Portal Technique," Journal of Bone and Joint Surgery, in press.