Trauma Treatments

Effective Treatments Towards Recovery

Trauma Treatments

Dr Chua is an Orthopaedic Surgeon whose practice focuses on the surgical and non-surgical treatment of the trauma cases, including reductions, internal fixations, external fixations, Arthroplasty and Arthrodesis and more.

What you need to know:

Reduction is the method of repositioning displaced bone fragments into their normal alignment. It can be done non-surgically (closed reduction) or requires surgery (open reduction), depending on the type and extent of the fracture.

Candidates for Surgery
Patients with fracture in the acetabulum, forearm and ankle are usually great candidates for surgery.

Surgical Procedure
The surgeon will first create and incision along the front, side or back of the fracture, and then attach metal plates and screws to the outer surface of the bone. This is done to hold the fragments together while they heal. Occasionally, a combination of reductions with other approaches are used to treat the patient.

broken bones of the forearm are held in position by plates and screws while they heal

Internal Fixation

This procedure refers to the fixation of plates, screws and other metals within the affected bone to keep the bone in position.

Candidates for Surgery
Fractures of the acetabulum, leg and elbow can be treated with internal fixation, in some cases together with open reduction.

Surgical Options
Intramedullary nailing involves inserting a metal rod into the bone marrow, and letting it pass across the fracture site to keep it in position. When applied together with open reduction, the broken bone fragments are first repositioned to their normal alignment, then held together with special screws and metal plates that are attached to the outer surface of the bone. Bone grafts – often from the pelvis – are also used in this option.

External Fixation

In certain cases where the skin, bone and surrounding tissue may be too severely damage for internal fixations, and large incisions, screws or plates may injure the skin further, causing a risk of infection, these fractures are often treated with an external fixator.

Candidates for Surgery
Fractures in the forearm, elbow and leg are suited to be treated with external fixators, especially in patients whose fracture site and condition is not optimal for large incisions and internal fixations.

Surgical Procedure
For external fixation, metal pins or screws are placed into the bone above and below the fracture site from outside of the skin. These pins and screws are then attached to a bar outside the skin. This entire device acts as a stabilising frame that holds the bones in proper position, allowing them to heal progressively. In certain cases, it may be removed and eventually treated with internal fixators once the condition improves.

Arthroplasty and Arthrodesis

Arthroplasty, or bone replacement, is considered when the impacted bones are too severely damaged to be fixed properly.

Arthroplasty Procedure
Firstly, the broken bits of bones are carefully removed from the fracture site, and then the fractured bone(s) are replaced by a metal or plastic implant in place of the injured bone. Though replacements may require revisions after many years due to looseness and other factors.

Candidates for Arthrodesis
Young patients are typically good candidates for arthrodesis procedures. This procedure involves applying plates and screws to the affected bones to allow the bones to grow together or eventually fuse together as one ‘healthy’ bone.

Revision Surgery

Revision surgery needs to be done when the original replacement parts grow loose due to age or when there is other complications involved.

Replacement Procedure
In this case, the original implant needs to be first removed from the bone, and replaced with a new implant. Usually, the new implant will have a longer stem to ensure effectiveness and provide extra stability. In certain cases, allograft bone may be used to supplement weak or any missing bones

Skeletal Traction

Skeletal traction is a pulley system of weights and counterweights that holds the broken pieces of bone together, keeping the leg straight and can often help to relieve pain.

Candidates for Surgery
Patients with fracture after total hip replacement and acetabular fractures can benefit from this surgical option, it keeps the bones relatively aligned and can provide some pain relief as well. Fractures of the leg such as femural shaft fracture and distal femur fractures can also be treated with skeletal traction.