Orthopaedic trauma & fracture care

A fracture is a break in a bone. Fractures vary considerably in their severity and the treatment required.

They may be:

An accurate assessment of the fracture pattern and the surrounding soft tissues is important when deciding on the most appropriate treatment.

Orthopaedic trauma can involve almost any part of the upper or lower limb.

Common injuries include:

Assessment begins with understanding how the injury occurred, followed by a careful clinical examination.

X-rays are used for most suspected fractures.

More complex fractures, particularly those extending into a joint, may require a CT scan to understand the fracture pattern and assist with surgical planning.

An MRI scan may occasionally be required when there is concern about associated ligament, cartilage or other soft-tissue injuries.

Not every fracture requires surgery.

Stable fractures with acceptable alignment can often be treated successfully without an operation.

Treatment may include:

Regular follow-up is important to ensure that the fracture maintains an acceptable position while healing.

Surgery may be recommended when a fracture is displaced, unstable, involves a joint or cannot be maintained in an acceptable position without fixation.

Surgery may also be necessary for open fractures or injuries associated with significant damage to the surrounding soft tissues.

The aim is to restore the anatomy of the injured bone or joint and provide sufficient stability for healing and rehabilitation.

Depending on the fracture, fixation may include:

The appropriate method depends on the location and pattern of the fracture, bone quality, soft-tissue condition and individual patient requirements.

Fractures extending into a joint require particular attention.

Damage or displacement of the joint surface may affect movement, stability and long-term joint function.

Where surgery is required, the aim is to restore the joint surface as accurately as possible while providing stable fixation, allowing rehabilitation to begin when appropriate.

An open fracture occurs when a wound communicates with the fractured bone.

These injuries require urgent assessment because of the increased risk of infection and damage to the surrounding soft tissues.

Treatment usually involves antibiotics, careful surgical cleaning of the wound and stabilisation of the fracture. More severe injuries may require additional procedures to manage the damaged skin and soft tissues.

Children's bones are still growing and fractures need to be assessed differently from those in adults.

Many paediatric fractures have excellent healing potential and can be treated without surgery.

However, fractures involving the growth plate, significant displacement or joint surface require careful assessment to minimise the risk of future deformity or growth disturbance.

Treatment is selected according to the child's age, fracture pattern and remaining growth.

Recovery depends on the type and severity of the injury.

Bone healing commonly takes several weeks, but complete recovery of strength, movement and function may take considerably longer.

Rehabilitation may include:

Follow-up X-rays may be used to monitor healing before activity is increased.

Urgent medical assessment is recommended following an injury if there is:

Some orthopaedic injuries are time-sensitive and should be assessed promptly.

Every fracture and traumatic injury is different.

Treatment depends on the fracture pattern, degree of displacement, joint involvement, soft-tissue injury, age, bone quality and functional requirements of the patient.

Where possible, injuries are treated without surgery. When surgery is necessary, the aim is to achieve stable fixation while respecting the surrounding soft tissues and preserving the patient's natural anatomy.

The ultimate goal is to achieve safe fracture healing, restore movement and function, and allow the patient to return to normal daily activities, work and sport.