People sustaining trauma have distinct recovery and non-recovery clinical trajectories, a difference that is incompletely explained by subject characteristics or the magnitude of injury. Recent data suggest that the non-recovery of trauma is the consequence of underlying changes within the genetic landscape of the immune system. This prospective study seeks to address the following hypothesis: There is a correlation between epigenetic changes of the immune stem cell within the bone marrow and the clinical phenotype and trajectory of persons sustaining trauma. We will study subjects who have sustained orthopaedic trauma consisting of long bone or pelvic fractures requiring operative intervention for stabilization and repair. We will analyze the bone marrow aspirate obtained at the time of fracture fixation with longitudinal clinical aspects of the subjects clinical trajectory to address the aforementioned hypothesis