Trauma
Accidents can happen… Read more about common surgical procedures we perform where trauma has occurred.
Unfortunately, people do fall over. Luckily, significant injuries are uncommon but some people do sustain fractures or soft tissue injuries.
Fractures can be treated with casting or orthotics with regular checks to make sure the fracture heals in a satisfactory position. However, some fractures require operative fixation using plates/screws or titanium nails/rods.
The decision is based on the age of the patients, the type of fracture and the position of the fracture.
Common fracture patterns
Distal radius (wrist)
- Managed with below elbow cast in adults, above elbow in children for 6 weeks
- If there is significant displacement or the fracture involves the joint then fixation with a distal radial plate and screws may be required. The advantage of this is that immobilsation is generally for only 2 weeks post-op with a removable splint after for protection
Elbow fractures
- These can vary from simple fractures like radial head or neck fractures that are easily treated in a sling to complex fractures involving the elbow joint or the distal humerus.
- The elbow needs early motion so unless the fracture pattern is amenable to a short period of time in a splint, surgery may be recommended.
Ankle fractures
- Involve the fibula, the medial malleolus (part of the tibia) or both after a twisting ankle injury. Severity can vary with simple fibula patterns followed by more complex fracture-dislocations.
If non-operative, fibula fractures are managed with a cast or splint for 6 weeks.
If the fracture is displaced then plate and screws are used. Immobilisation is for 2 weeks followed by a CAM walker for protection. Non weightbearing period is generally 6 weeks.
Clavicle fractures
- Clavicle fractures can be treated with a sling, even ones that are displaced.
- However, fractures that are complex or where the patient needs early mobility may be suitable for treatment with operative fixation.
Fracture of the neck of femur
- Generally occur in the older population with osteoporotic bone after a fall
- This is a significant injury that can affect an elderly patient medically, socially and functionally in the long term. Patients often need a period of rehabilitation and social circumstances may be changed because of the fracture.
Surgery is generally recommended for neck of femur fractures. They can be treated with a hip screw and plate / titanium rod or hip replacement depending on the fracture location.
Femoral and tibial fractures
- these are weightbearing bones in the body and the majority will require fixation with a plate or titanium rod and screws
- these are significant injuries with weightbearing often delayed 6 weeks and the fractures are usually accompanied by soft tissue damage.
- the fractures need monitoring for bony union
- full recovery generally takes around 12-18 months
Patella fractures
- If the patient can straight leg raise and the fracture is not displaced, this can be treated in a knee splint for 4-6 weeks.
- Displaced fractures need operative fixation as the exetensor mechanism is important for mobility.
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