Orthopaedic Surgery and Sports Medicine services for traumatic injury
We treat a variety of traumatic injuries ranging on a spectrum from low to high energy trauma. Below is a list of commonly encountered fractures, though we also have experience treating a wide variety of other traumatic injuries. Please contact us to learn more about our services.
Clavicle Fractures
Clavicle (collarbone) fractures are one of the most common injuries after direct contact on the shoulder. The fracture may occur anywhere along the clavicle. Depending on the fracture type, location, and degree of displacement, nonoperative treatment with a sling or operative treatment with surgical fixation may be recommended.
Elbow Fractures
Elbow fractures comprise a variety of injuries that involve a combination of the distal humerus, radius, and/or ulna. Occasionally these fractures can extend into the joint space or involve the surrounding ligaments or tendons. Proper diagnosis with X-Rays and occasionally CT scan is important in planning the appropriate treatment.
Forearm Fractures
Forearm fractures occur between the elbow and wrist joints and involve the radius and/or ulna. Fractures in adults typically require surgical fixation, though some smaller fractures and injuries in pediatric patients may not necessarily require surgery.
Pelvis Fractures
The pelvis is a complex bone involving a number of ligamentous and tendinous attachments along with the sacroiliac and hip joints. Workup of these injuries is often complex and can involve both X-ray and CT scan. Depending on the type of fracture, surgery may or may not be recommended.
Hip Fractures
Hip fractures are common injuries after a fall or direct impact to the hip. These fractures may involve the femoral head, neck, or intertrochanteric area. As the femur is integral for ambulation, these fractures almost always require prompt surgical fixation to allow immediate weight bearing and decrease the likelihood of associated complications of bedrest.
Knee Fractures
Knee fractures may occur in the distal femur, proximal tibia, and/or fibula. Occasionally these fractures can extend into the joint or be associated with other ligament and soft tissue damage. Accurate diagnosis is key to plan appropriate treatment, which may or may not involve surgery.
Ankle Fractures
Ankle fractures comprise a broad spectrum of injury ranging from simple fractures without displacement to complete fracture dislocations that can break through the skin. Due to the variability, treatment options are highly dependent on initial presentation and radiographic imaging. Occasionally ligament tearing is associated with these fractures, which may extend upwards toward the knee.
Patella Fixation
Complex patella fractures involving multiple bony pieces can be difficult to treat. Here are before and after X-ray images of a complex patella fracture involving the joint surface with tearing of the patellar tendon below the fracture. This was surgically fixed with a combination of a plate and screws along with a repair of the patellar tendon.
Femoral Neck Fixation
Impacted femoral neck fractures can sometimes be treated with screw fixation alone for faster surgery, recovery, and healing. Here are before after pictures of a valgus impacted femoral neck fracture that underwent percutaneous pinning. The posterosuperior lag screw was placed first with short threads, followed by the anterosuperior screw with slightly longer threads to improve purchase. The calcar neutralization screw was placed last with full threads to maximize purchase. Washers were added to disperse screw head force across the lateral wall due to extensive osteoporotic bone. Screw divergence was maximized for support of the head, and screws were placed as close to the neck cortex as possible to optimize fixation.
Hip Fracture Fixation
Hip fractures can occur in a variety of ways, with both simple and complex fracture types. Here we can see an intertrochanteric fracture with multiple fracture fragments, resulting in an unstable fracture type. Due to the complexity of this fracture, a long intramedullary nail was chosen for fixation to optimize stability for healing. Preoperative and postoperative X-rays show the surgical treatment in this case.