Trauma

Common Trauma Injuries

• Fractures of the long bones. Breaks to the femur (thigh bone), tibia (shin bone), humerus (upper arm bone), or radius and ulna (forearm) are among the most common injuries requiring surgical repair. When the bone fragments are displaced or unstable, surgery is necessary to realign them and hold them in position while they heal.

• Collarbone (clavicle) fractures. The collarbone is one of the most commonly broken bones, often as a result of a fall onto the shoulder or a direct impact. Many heal well without surgery, but significantly displaced or shortened fractures, particularly in active patients, are better treated surgically to restore the correct alignment and allow early return to function.

• Ankle fractures. A broken ankle, particularly when it involves the joint surface or multiple fracture points, can be unstable and difficult to manage in a cast alone. Surgery realigns the bones and holds them securely, protecting the ankle joint and reducing the risk of long-term stiffness or arthritis.

• Wrist fractures. A fracture of the radius at the wrist, often the result of putting a hand out to break a fall, is one of the most common fractures seen across all age groups. When the fracture is unstable or the joint surface is disrupted, surgery gives a more reliable result than casting alone.

• Hip fractures. A fractured hip is a serious injury, particularly in older patients. Early surgical treatment is strongly preferred, as prolonged immobility while waiting for a fracture to heal carries significant risks to overall health.

• Shoulder fractures and dislocations. A break to the top of the humerus (the upper arm bone at the shoulder) can range from a simple crack to a complex multi-part fracture. Surgical repair or replacement may be necessary depending on the number and position of the fragments. Acute shoulder dislocations also require careful management to protect the surrounding structures and reduce the risk of recurrence.

• Patella (kneecap) fractures. A direct blow to the kneecap or a sudden, forceful straightening of the knee can cause the kneecap to fracture. When the fragments are separated, surgery is needed to bring them back together and hold them while the bone heals.

Common Trauma Procedures

Open Reduction and Internal Fixation (ORIF)

The most common surgical approach to fracture management. The fracture is exposed through a carefully placed incision, the bone fragments are repositioned into their correct alignment, and then held in place with metal hardware fixed directly to the bone. This approach is used for fractures of the ankle, wrist, collarbone, kneecap, and other bones where precise realignment is needed.

Intramedullary Nailing

For fractures of the long bones, a metal rod is inserted through the centre of the bone (the medullary canal) and locked in place with screws at either end. This technique provides strong, reliable repairs along the entire length of the bone and allows patients to bear weight earlier than other methods.

Collarbone Fracture Fixation

When a collarbone fracture is significantly displaced or shortened, surgical fixation using a plate and screws restores the correct length and alignment of the bone. This reduces the risk of the shoulder dropping into a permanently altered position and allows a much faster return to activity than waiting for the fracture to heal in a sling.

Hip Fracture Repair

Hip fractures are typically treated either with screws to hold the bone together while it heals, or with a partial or total hip replacement, depending on where the fracture is and the age and health of the patient. Early surgery is strongly preferred to minimise the risks associated with prolonged immobility.

Acute Shoulder Dislocation Management

A dislocated shoulder is relocated as promptly as possible, usually under sedation or anaesthetic to allow the muscles to relax fully. After relocation, the extent of any associated damage to the ligaments, labrum, or bone is assessed. In younger patients or those with recurrent instability, early surgical stabilisation is often recommended to prevent the dislocation from becoming a recurring problem.

What to Expect Prior to Surgery

1. A pre-operative assessment. Dr. Barrett will review the patient's symptoms through examination to confirm the diagnosis and plan the surgery. General health is also assessed to make sure the patient is fit for the operation and anaesthetic.

2. A medication review. Patients may be asked to stop certain medicines (such as blood thinners or anti-inflammatory drugs) in the days before surgery.

3. Consent and preparation. Dr. Barrett explains the procedure, the fixation method being used, and what to expect during recovery, so that the patient and their family can make an informed decision and prepare accordingly.

What to Expect During Surgery

Trauma surgery is performed under either a general anaesthetic (the patient is fully asleep) or a regional anaesthetic (the affected limb is numbed). The approach depends on the type and location of the fracture. Most procedures take between 1 and 2.5 hours.

1. The fracture is accessed through an incision placed to give the best view of the bone fragments.

2. The fragments are carefully repositioned into the correct alignment under direct vision or with the assistance of live X-ray guidance.

3. The hardware, plates, screws, nails, or a combination, is applied to hold the bone securely in the correct position.

4. The incision is closed and dressed. A splint, brace, or sling may be fitted depending on the location of the fracture.

What to Expect During Recovery

Recovery from fracture surgery varies considerably depending on which bone was broken, the complexity of the fracture, and the method used. The following is a general guide:

Days 1 – 7

Swelling, bruising, and pain are normal after fracture surgery and are managed with medication. Some fractures allow early weight-bearing or movement, others require a period of strict rest and protection. Dr. Barrett will give specific guidance for each situation.‍

Weeks 2 – 6

Physiotherapy begins with gentle movement exercises aimed at reducing stiffness and beginning to restore function.

Weeks 6 – 12

Bone healing is well established for most fractures by this stage, and physiotherapy progresses to more active strengthening work. Most patients are returning to light daily activities.

Months 3 – 12

Full recovery, particularly for complex fractures involving joint surfaces, or injuries to the femur or tibia, can take between 6 and 12 months. Dr. Barrett will monitor healing at follow-up appointments and guide the patient's gradual return to full activity.