Dr. Kellam, a noted orthopaedic trauma surgeon and currently one of the senior staff at Carolinas Medical Center, masterfully summarized the emergence and evolution of orthopaedic traumatology over the last 40 years--a process he was instrumental in shaping. In his native Canada during his training and early in his career, orthopaedic surgeons “ran the traumas,” a role typically performed by general surgeons in the U.S. His talk highlighted the parallel development of technologies for managing complex fractures, together with our increasingly sophisticated understanding of the biology of the multiply-injured patient. He drew a distinction between fracture surgeons--who limit themselves to managing broken bones in isolation--and true orthopaedic trauma surgeons, whose interest and expertise extends to the full spectrum of critical care medicine as well as fracture management. He was careful to emphasize that both approaches have merit, and he concluded by urging each surgeon in the audience to find his own preferred role in an integrated network of fracture and trauma care.