Orthopedic Trauma and Fracture Care
Traumatic fractures often require immediate medical attention and, likely, surgery to prevent chronic conditions from developing or for the injury to cause further damage. Orthopedic trauma and fracture care are among the medical specialties that focus on emergency care.
All of our orthopedic surgeons cover the emergency room and take trauma cases at Island Health Hospital in Anacortes, WA. They are versed in caring for acute and trauma cases and fracture care.
What is an Orthopedic Trauma Injury?
Orthopedic trauma includes severe injuries to the bones, joints, muscles, ligaments, tendons, or nerves that usually result from sudden accidents or violent impacts. Fractures and other traumatic types of injuries usually occur during incidents like car accidents, falls, sports injuries, and industrial accidents that easily result in one or more fractures that require immediate orthopedic care.
Key parts of orthopedic trauma and fracture include:
- Diagnosis: Using X-rays, CT scans, or MRIs to identify the type and extent of the fracture.
- Reduction: The process of realigning the broken bone, which can be done externally (“closed reduction”) or surgically (“open reduction”).
- Internal or External Fixation: Internal fixation involves the use of screws, plates, and rods inserted surgically to hold the bone pieces together. External fixation uses pins or screws that are placed into the broken bone above and below the fracture site, which are then connected to a metal bar outside the skin.
- Rehabilitation: After the bone is set, recovery involves restoring the range of motion, strength, and function of the injured area.
Signs of Traumatic Fractures
Fractures as a result of a traumatic event include a wide range of injuries, that present a variety of symptoms. If suffering from any of the following signs, it’s imperative to seek emergency medical attention:
- The affected area is deformed
- The affected area is red and swollen
- Bruising and tenderness around the affected area
- Pain that progressively gets worse
- Severe pain when moving the affected joint
- Severe pain when standing or walking
- Bone protruding through the skin
- Numbness or tingling near the fracture site
- Inability to bear weight
- Loss of function in the affected area
Common Care and Surgery Treatments for Trauma and Traumatic Injury
Emergency treatments depend on the injury and severity of the damage, but common care options in an emergency setting include:
Urgent surgery to realign fractured bones and stabilize them using internal hardware, especially in cases of compound fractures with bone protrusion.
Applying an external frame to stabilize fractures when rapid intervention is required.
Removal of contaminated tissue from open fractures to reduce the risk of infection.
Relieving increased pressure in a muscle compartment to prevent permanent damage.
Inserting a metal rod down the center of a bone to stabilize fractures, especially useful for emergency care of unstable long bone fractures.
For cases of severe dislocations or joint injuries that could threaten limb viability.
An emergency surgical incision into a joint, particularly for septic arthritis or traumatic hemarthrosis (bleeding into a joint space).
Healing and Recovery FAQ
Recovery from a ligament injury varies based on severity (strain, partial tear, complete tear). It can take several weeks to months and involves phases of rest, restoring movement, surgery if needed, and gradually resuming daily activities.
Nerve cells can take weeks, months, or even years to regenerate fully, depending on the severity of the damage. In some cases, nerve injuries may not heal completely. Although nerve tears are rare in fractures, they can occur if the skin is also torn and can be repaired surgically.
The timeline for fracture healing depends on several factors:
- Your overall health
- Pre-existing conditions and injuries
- Type of fracture
- Which bone is fractured
- Cause of fracture
Fractures requiring surgery or immobilization can often be mobilized again after a few weeks. However, severe fractures may take a year or more to heal completely.
Eating foods that promote bone health is essential for fracture care and recovery. Protein serves as the body’s building block, including the skeletal system. Calcium strengthens bone tissue, while Vitamin D helps your body utilize calcium and other minerals for healthy bones. Additionally, Vitamin C is a crucial component of collagen, which binds minerals to bones.
A properly healing fracture shows improved movement and decreased pain over time. Regular follow-up check-ups with your doctor are essential to monitor your recovery accurately.
To expedite fracture healing:
- Ensure the immobilization of the fractured area to avoid disrupting the healing process.
- Stop smoking to promote healthy blood flow.
- Maintain a healthy diet rich in calcium, protein and vitamin D to support bone growth.
The duration for avoiding weight-bearing on a broken bone depends on the fracture’s severity. Consult your doctor monitoring your condition. They can advise when and how much weight you can safely bear. Physical therapy is typically prescribed for gradual weight-bearing exercises so that you can move safely as you heal.
Casts FAQ
Healing a fracture with a cast or boot typically takes several weeks. Your healthcare provider, who closely monitors your condition, will provide the best estimate for how long you need to wear a cast or boot.
Never attempt to remove your cast or boot yourself, as it can lead to injury. Only trained professionals should use cast saws to ensure your safety.
If your cast gets wet, dry it as soon as possible using a hair dryer on a cool setting. If it doesn’t dry within 24 hours, contact your doctor for further instructions.
Experiencing Signs and Symptoms FAQ
Dizziness or shortness of breath can occur after periods of inactivity, such as hospital recovery. However, these symptoms can also indicate blood clots in the lungs. Please visit the emergency room immediately to determine the cause and receive appropriate treatment.
Swelling in your leg after a fracture can occur for two reasons: the fracture itself and surgical treatment, if applicable. When soft tissues are injured in a fracture, the fluid channels are also affected, leading to swelling. This can take a considerable time to reduce, especially in the feet and ankles, due to gravity, and in some cases, it may never fully disappear. If you are concerned about the swelling, consult your doctor to explore ways to improve fluid drainage.
Injury can cause bleeding between tissues, resulting in a bruise. It can take months for your body to reabsorb the blood, and gravity may cause the discoloration to spread down your leg.
Tingling and unusual sensations are common after a fracture or injury due to inflammation, swelling, and wound incisions affecting the area. If these sensations worsen, contact your surgeon or visit the emergency room as soon as possible, as there may be excessive swelling or overly tight bandages.
If you experience a sudden increase in pain, it is essential to visit the emergency room for immediate care. The medical staff can then contact your healthcare provider for further guidance.
The main symptoms of a bone infection include:
- Bone pain
- Fever, chills, and sweating
- General discomfort or malaise
- Localized pain, swelling, redness, and warmth
- Pus in an open wound
Signs of a wound infection warrant a visit to the doctor. Look for:
- Fever and chills
- Nausea and vomiting
- Green, yellow, or brown pus
- Foul smell from the wound
- Worsening pain
- Bleeding
Small amounts of drainage are normal during wound healing. However, you must contact your doctor if there is excessive fluid leakage or soaked bandages when changing them.
Return to Activities of Daily Living (ADLs) FAQ
Your doctor can prescribe physical and occupational therapy to regain full function of your fractured area. Physical therapy enhances strength, balance, and range of motion, helping you stand, sit, and walk comfortably after a fracture. Occupational therapy focuses on improving your independence in daily activities, assisting with fine hand movements, and recommending accommodations to achieve optimal independence.
Physical therapy typically starts once the fractured area is immobilized. It helps relieve pain and swelling while preventing muscle wasting from immobilization.
Recovery can be uncertain, but your healthcare provider is the best person to assess your gait, considering your condition and treatment.
Remember to follow your doctor’s advice before bearing weight or walking on a healing leg fracture. If you suspect you’ve overexerted yourself, visit your healthcare provider for an evaluation.
Injury-related stress or pain can disrupt your sleep. Here are some tips to help you rest better:
- Use an ice pack (within 2-3 days post-surgery) or a hot pack for pain relief.
- Establish a bedtime routine, avoiding the stimulating lights of digital screens.
- Avoid napping during the day.
- If you can’t fall asleep within 20 minutes, get up and return to bed only when you’re ready to sleep.
Your return to work depends on your injury level and job type. Physically demanding jobs may require more healing and rehabilitation, while desk jobs might allow an earlier return. Discuss your work duties with your doctor to determine a suitable timeline.
Consult your doctor on when you can drive safely post-injury. Pain medication can affect reaction time, and a cast may limit movement. Pushing pedals and steering can cause pain, impacting your ability to drive safely.
Stay active with modified exercises to keep your healing fracture safe. Once you can move the fractured area, expect some weakness due to immobilization. Gradually regain strength and endurance with low-impact exercises.
The timing depends on your overall health and injury state. Don’t hesitate to ask your doctor for specific guidance.
Post-Recovery FAQ
A stress fracture can reoccur or worsen if activity is resumed too soon. Please discuss with your doctor to determine the appropriate time to resume specific activities.
Fractures often result from falls or accidents. To prevent fractures, consider the following safety measures:
- Engage in exercises that enhance balance, coordination, and strength.
- Use protective equipment when participating in contact sports.
- Wear supportive and comfortable shoes.
- Maintain a balanced diet for bone tissue regeneration.
- Consult your doctor for medications for bone loss reduction.
- Get a bone mineral density test from your doctor.
- Inside your home, ensure proper lighting, keep spaces clutter-free, and use non-slip mats in the bathroom and kitchen.
- Outside your home, use a mobility aid if recommended by your doctor.
If you suspect your bone hasn’t healed correctly, consult with us. Our experts and diagnostic services are here to provide you with comprehensive care.