Orthopaedic Trauma

Orthopaedic Trauma

Orthopaedic trauma is a broad term describing all kinds of injuries affecting the bones, joints, muscles, tendons, and ligaments in any part of the body that are caused by trauma. The term is wide-ranging and may refer to minor fractures or severely broken bones with a direct threat to the patient’s life.

ASTER RV ORTHOPEDIC DEPARTMENT focuses on treating fractured bones and musculoskeletal injuries and making sure the injured part of the body regains its original strength and maximum function it used to have prior to the injury.

Services catered by our center-

• Plaster cast application for simple injuries
• Internal fixation with plates and screws
• Intramedullary fixation with nails for long bones fractures
• Intra articular fracture management
• Hand injuries
• Complex pelvic acetabular fixation
• External fixation
• ilizarov fixation
• Foot and ankle injuries
• Multidisciplinary approach for poly traumas
• Damage control orthopedics
• Reduction of joint dislocations
• Rehabilitation programme following fracture management for restoring pre-injury status

Musculoskeletal trauma involves injury to one or more of the following structures:

Bone: A unit of the skeleton composed of the hardest variety of connective tissue. Bones give shape and support to the body. In addition to surrounding and protecting vital organs, they serve as points of attachment for the muscles of the limbs, making movement possible.

Joint: The area where two or more bones articulate with one another. Joints are usually classified in terms of the amount of motion permitted at the articulation. Most joints of the extremities are synovial joints, which allow the greatest amount of motion.

Ligament: A bundle of connective tissue forming part of the fibrous capsule surrounding a joint and attached to it. Every joint of the extremities is reinforced by two or more ligaments, whose purpose is to stabilize the joint by confining its movements to specific planes and preventing movement beyond physiologic limits.

Tendon: The fibrous structure connecting a voluntary muscle to bone, cartilage, or ligaments. Tendons enable muscles to effect motion in the joint or body area to which they are attached.

Orthopedic injuries to these structures include the following:

Fracture: A disruption of bone tissue. Fractures may be caused by: (1) an application of force exceeding the strength of the bone, (2) repetitive stress, or (3) an invasive process that undermines the bone's integrity.

Dislocation: Complete disruption of a joint, such that the articular surfaces of the bones that comprise the joint are no longer in contact with one another.

Subluxation: Partial disruption of a joint, in which some degree of contact between the articular surfaces remains.

Fracture-dislocation or fracture-subluxation: Disruption of a joint combined with fracture of at least one of the bones involved in the articulation.

Strain: A tearing injury to muscle fibers resulting from excessive tension or overuse.

Sprain: A tearing injury to one or more ligaments of a joint, which occurs when the joint is forced beyond the limits of its normal planes of motion.

The many different types of orthopedic trauma are classified based on the affected body part.

• Upper extremity injury, which includes a broken arm or wrist, collarbone, or ribs
• Lower extremity injury, which includes a broken ankle, hip, pelvis,thigh bone and leg bones
• Soft tissue injury, which affects the muscles, tendon, and ligaments

Based on severity it is classified into

• Simple trauma-Minor fractures which can be treated with simple measures
• Polytrauma-major fractures of multiple bones
• open fractures-where there is breakage in skin and bones protruding out
• Life threatening complex poly traumas
• Pathological fracture

The most common causes of traumatic injuries are:

• Falls
• Twisting the ankle
• Road traffic Accidents
• Repetitive stress
• Blows to specific parts of the body

Some people also have a greater propensity for fractures after a fall or accident. For example, a person suffering from osteoporosis, a condition wherein the person’s bones are weak and fragile with some bone conditions (Pathological fractures), can easily break a bone even with a minor fall or slip.

Some people may also suffer from conditions that affect their eyesight or their balance, causing them to fall more frequently and raising their risk of injury.

Additionally, bones do not always break the same way. The break can occur in a straight line, diagonally, or in a spiral manner. Bones can also break into several pieces and, in open fractures, they may stick out of the skin.

Key Symptoms and when to obtain Orthopedic Consultation

Trauma to the bones and soft tissues that fall under orthopedic care may be accompanied by several possible symptoms, depending on which part of the body is affected. The most common symptoms of a broken limb or body part include:

• Pain
• Swelling
• Tenderness
• Bleeding , but only if the break in the bone damages the skin
• Major bruising
• Inability to move the affected part without experiencing pain
• Bone sticking out at an abnormal angle(DEFORMITY)
• Bone sticking out of the skin
• A pins and needles sensation if some nerves are injured
• Inability to lift or rotate the injured part
• Inability to put any weight (for leg injuries)
• Severe pain when breathing in (for broken ribs)
• Shallow breathing
• A grinding, cracking, or snapping noise is heard at the time of the fall or accident

Management of Musculoskeletal injuries

• Initial management
• Regardless of the severity of the injury, during the ride to the hospital, it is important to keep the injured body part stable by using temporary splinting of limb
• Applying an ice pack to the injured area will help reduce the pain and inflammation
• If there is a bone sticking out at an odd angle, no attempt should be made to re-align it. If there is an open wound, it should be covered with a clean cloth and pressure must be applied to minimize the bleeding

Orthopedic trauma is treated depending on its severity. Simple features can be treated conservatively(non-operative) with plaster or simple surgeries-plates and screw fixation/fixation with intramedullary nails

Open injuries: Open injuries involve wounds with Contamination with bad skin conditions which requires management of wound and also bone. These have high chances of infection. These requires External Fixation and skin reconstruction

PolyTrauma- These are life threatening Injuries so requires multidisciplinary approach and requires ICU care and addressing injuries in order at the same time stabilizing hemodynamics of the patient (Damage Control Orthopedics).