The trauma service at Mediclinic Airport Road Hospital offers management of simple and complex fractures of all age groups including children. The services deals with all fractures of the lower and upper limbs.
1)- Upper Limb fractures:
Upper limb fractures include:
Broken forearm, hand, fingers, wrists, shoulder, elbow and collarbone .
2)- Lower Limb fractures:
Lower limb fractures include:
Foot, ankle, knee, thigh, hip, and pelvis fractures:
Femoral and knee fractures:
The thighbone (femur) is the longest and strongest bone in the body. The long straight part of the femur is called the femoral shaft. Femur shaft fracture depends on the type of force that causes the break.
The bones pieces can either be lined up correctly (stable fracture) or have misalignment (displaced fracture). The skin around the fracture may be intact (closed fracture) or the bone may puncture the skin (open fracture).
Depending on the type of fracture, either external fixation with metal pins and screws will be used to stabilise the bone in its right position. In other cases, a special metal rod is inserted in the femur canal across the fracture to keep it in the correct position.
Kneecap fracture (also known as patella fracture) is common in vehicle injury with direct impact on the shaft. Some patella fractures can be treated by wearing a cast or splint until the bone heals but in complicated fractures surgery is needed. Transverse fracture is a two part fracture which is fixed in its place by using screws, pins or a wire "figure-of-eight" configuration tension band. This procedure is best for treating fractures that are located near the centre of the patella. In other type of fracture, if the kneecap is crushed into small pieces that can’t be fixed, it will be removed completely as a last resort.
Tibial and ankle fractures
Lower leg fractures with complicated or periarticular fractures of the tibia are treated surgically i.e. fixed with plates, screws or nails. Simple tibia fractures or fibula fractures can be treated with a plaster cast.
The lower leg consists of two bones; the thicker of the two is called the tibia and the thinner the fibula. A firm bandage is usually sufficient to treat a fibula fracture. A plaster cast or surgery is rarely needed. Tibia fractures are always treated with a plaster case or with an operation. A plaster cast is used for simple, uncomplicated shaft fractures. If the patient has suffered an open fracture, then plates, screws or nails are used to fix it. The same applies for particularly complicated breaks (several fragments, displaced fractures) and periarticular fractures (tibia head fracture).
Osteosynthesis is the treatment of bone fractures with metal parts.
Foot and toe fractures:
Toe and foot fractures are quite common, resulting from a direct blow to the foot - such as kicking something hard or dropping a heavy object on the toe. It can also be a result of overuse or repetitive stress – such as high impact sports like basketball and running. Foot and toe fractures are very painful but rarely require surgery. Buddy taping and change of activities can help relieve the pain and other nonsurgical treatments are considered for their treatment. However, in case of a complicated fracture such as if the bone is out of place and the toe is deformed, surgery is performed for correction.
Acetabular and hip fractures:
Hip joint is a ball and socket joint in which the ball is the head of the femur or thigh bone and the socket is a cup-shaped acetabulum.
The most common type of fracture is a hip fracture which is a break in the top quarter of the thighbone called the femur. In this fracture, the patient complains about the pain over the outer upper thigh or in the groin and suffers significant discomfort with flexing or rotating the hip. Hip fracture is the most frequently occuring minor trauma in the elderly or young people undertaking high energy sports. Long term medication can also increase the risk of hip fractures.
Depending on the area of the upper femur involved, hip fractures are classified as:
- Intracapsular fracture
- Intertrochanteric fracture
- Subtrochanteric fracture
An acetabular fracture is a break in the socket portion of the "ball-and-socket" hip joint. When the acetabulum is fractured, the femoral head may no longer fit firmly into the socket, and the cartilage surface of both bones may be damaged. In case of longer irregularity and instability of joint, the ongoing cartilage damage can lead to arthritis.
Depending on the pattern of the fracture, bone displacement, and overall health of the patient, treatment, timings and surgical or non-surgical techniques are decided.