Hematopoietic Stem Cell Dysfunction in the Elderly After Severe Injury

Severe Trauma Population Inclusion criteria will be: 1. All adults (age ≥18 to 54) 2. Blunt and/or penetrating trauma resulting in long bone or pelvic fractures requiring ORIF or closed reduction percutaneous pinning (CRPP). 3. Blunt and/or penetrating trauma patient with either: 1. hemorrhagic shock defined by: i. systolic BP (SBP) ≤ 90 mmHg or ii. mean arterial pressure≤ 65 mmHg or iii. base deficit (BD) ≥ 5 meq or iv. lactate ≥ 2 2. Or injury severity score (ISS) greater than or equal to 15. 4. All adults (age 55 and older) require: 1. Blunt and/or penetrating trauma resulting in log bone or pelvic fractures requiring ORIF or CRPP 2. Either hemorrhagic shock defined by: i. Systolic BP (SBP) ≤ 90 mmHg or ii. Mean arterial pressure ≤ 65 mmHg or iii. Base deficit (BD) ≥5 meq or iv. Lactate ≥ 2 3. Or Injury Severity Score (ISS) greater than or equal to 15. 5. Ability to obtain Informed Consent prior to OR repair of injury. Exclusion Criteria will be: 1. Patients not expected to survive greater than 48 hours. 2. Prisoners. 3. Pregnancy. 4. Patients receiving chronic corticosteroids or immunosuppression therapies. 5. Previous bone marrow transplantation. 6. Patients with End Stage Renal Disease. 7. Patients with any pre-existing hematological disease. Elective Hip Repair Population Inclusion criteria will be: 1. All adults (age ≥18) 2. Patient undergoing elective hip repair for non-infectious reasons. 3. Ability to obtain Informed Consent prior to operation. Exclusion Criteria will be: 1. Pregnancy. 2. Prisoners. 3. Patients receiving chronic corticosteroids or immunosuppression therapies. 4. History of receiving Chemotherapy or Radiation within the last 6 months 5. Previous bone marrow transplantation 7\. Patients with End Stage Renal Disease 8. Patients with any pre-existing hematological disease