4 Common Orthopaedic Trauma Injuries and How We Treat Them

by Robert Golden, MD, Chief of Orthopaedic Trauma
August 27, 2019

Some of the most unexpected injuries in medicine are due to orthopaedic trauma, which involves problems related to bones, joints, and soft tissues (muscles, tendons, and ligaments). The most common orthopaedic trauma injuries are the result of falls and car crashes, but we also see many injuries due to:

  • Bicycle accidents
  • Gunshot wounds
  • Motorized scooter accidents

We see a lot of younger people in their late teens to mid-20s with orthopaedic trauma injuries, as well as people over 50. Younger people tend to engage in more high-energy activities that involve the risk of accidents, such as riding motorized scooters and bicycles. Older people are more likely to have balance disorders and weaker bones, which can lead to falls and bone fractures.

Related Reading: Electric Scooter Safety: Avoid These Common Injuries While on the Road

Our orthopaedic trauma team at MedStar Washington Hospital Center cares for these patients with the latest treatment options, helping them get back to their everyday lives. Read on to learn about the most common orthopaedic trauma injuries we see, how we treat them, and what people should do if they experience an orthopaedic trauma injury and are waiting for emergency medical professionals to arrive.

LISTEN: Dr. Golden discusses common trauma injuries and how they’re treated in the Medical Intel podcast.

How We Treat Common Orthopaedic Trauma Injuries

Lower Extremity Fractures

We see a large number of lower extremity injuries from individuals getting struck by cars, such as a tibial plateau fracture, which occurs when you break the bone on the top part of your tibia, right below your knee. This often happens because a car’s bumper strikes someone from the side at about knee level. Other common lower extremity injuries, such as a femur fracture and pelvic fracture, occur the most in the spring and summer, when people are out riding their motorcycles, bicycles, and motorized scooters.

Treatment for lower extremity fractures typically involves a surgeon realigning a patient’s affected bone and joints to their natural positions and holding them in place with plates and screws in a way that allows for them to heal properly.

While bones typically take about three months to heal, the hardware we insert during surgery sometimes is strong enough to support patients’ weight, allowing them to walk right after surgery. But speak to your doctor to see what to expect from your surgery, as some fractures, such as those close to joints, need to be fixed with hardware that is not designed to support the patient’s weight, resulting in people waiting weeks to months to put weight on their legs. Once patients are able to bear weight again, physical therapists can help them with strength and flexibility exercises to minimize stiffness and regain muscle loss. Social workers also can help patients plan for disability insurance or any time off work while they recover.

Wrist Injuries

We often see individuals with wrist injuries after they try to catch themselves when they slip and fall. This is especially common during the winter months, when snow and ice are on the ground. One of the most common wrist injuries we see is a fractured distal radius (broken wrist).

Treatment for a distal radius fracture typically involves patients either wearing a cast for around six weeks to allow the wrist to heal or undergoing surgery to better align the wrist and stabilize it  in order for it to heal properly.

Bones That Don’t Heal Properly

Some people are referred to us by their primary care doctors or other orthopaedic specialists because they’re having complications from previous fractures, such as a bone healing crookedly or not healing at all (nonunion).

To treat a nonunion, we first try to identify whether the patient’s bones aren’t receiving enough blood supply or the patient is lacking vitamins and minerals, such as vitamin D, which are necessary for proper bone healing. If neither is the case, we typically can get the bone to begin healing by retrieving bone from another part of the body and inserting it into the fracture site of the bone that isn’t healing properly.  We may need to also stabilize the bone differently from what was tried initially.

For bones that heal crookedly, we may need to cut the bone to realign it to the proper position.  We then stabilize it to hold it in that position. Depending on the situation, this can be performed all on the inside of the body or by using a system on the outside of the body that connects with a computer program.

Bone Infections

Some patients are referred to us because of osteomyelitis, a complicated bone infection. Osteomyelitis often can occur after trauma and can affect any bone. Without the proper treatment, osteomyelitis can spread to the tissues near the bone, kill the bone, and prevent any fractures from healing.

We treat these bone infections with surgery in which we open up the bone, remove as much of the infection as possible, and prescribe the patient antibiotics to both kill any remaining traces of the infection and keep it away long-term.

Can You Prevent Orthopaedic Trauma Injuries?

Unfortunately, many orthopedic trauma injuries are due to random events, such as someone running a red light and hitting another person’s car. There isn’t much we can do to prevent these types of events.

But it’s possible for you to avoid some traumatic injuries by carefully selecting what activities you want to participate in and understanding your physical limits. If you’re riding a motorcycle or bicycle, for example, make sure you’re moving at a safe pace and are always aware of your surroundings. If you’re on a ski trip, don’t ski on the hardest trail without having the appropriate skill level.

Orthopaedic trauma injuries, such as a #brokenleg or #brokenwrist, often are the result of random events, such as a #carcrash. But sometimes they can be avoided by avoiding certain activities and knowing your physical limits. https://bit.ly/2ZE724B via @MedStarWHC

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What Should People Do in an Emergency?

If an individual experiences an orthopaedic trauma injury, such as a severely injured limb, call 911 right away to request an ambulance. While the ambulance is on the way, it’s important for the injured person to stay calm and keep the affected arm or leg still. This can not only reduce the pain but also help prevent further injury to the soft tissues surrounding the injured bones. If there’s newspaper or cardboard nearby, try rolling it up to form a makeshift splint.

If someone has an open fracture—when there’s an open wound or break in the skin near the broken bone, what used to be referred to as a compound fracture—or has any injury that causes excessive bleeding, applying pressure on the area helps reduce the bleeding while they wait for emergency medical professionals to arrive.

Related Reading: How Bystanders Can Stop Severe Bleeding After Traumatic Injury

Expert Care at MedStar Washington Hospital Center

Our experienced orthopaedic trauma team at MedStar Washington Hospital Center offers patients expert care, as we successfully treat thousands of patients with a variety of traumatic injuries every year.  We also use a team approach in which we reach out to other specialties when patients have injuries outside of orthopaedic trauma. For example, when we see a patient with both a broken bone and torn ligament, we work with the sports medicine team so that the trauma team treats the bone issues while the sports medicine team treats the torn ligament.

Two of our more well-known instances of treating patients were following the Congressional baseball shooting in 2017 and the Navy yard shooting in 2013. Our team treated victims of these shootings by using a team approach in which the departments of orthopedic trauma, general surgery, and vascular surgery all worked together, ensuring that the victims we cared for survived and could eventually return to their everyday lives.

Not all cases of orthopaedic trauma are so publicized, but the patients still receive the same high level of care from our team. One patient visited us for a checkup seven years after we treated him following a car crash in which he injured both of his legs and feet, which resulted in some open (compound) fractures, or when bone comes out through the skin. He also sustained several injuries to internal organs. The general surgery trauma team treated him by stabilizing all his internal organ injuries and performing several surgeries that helped minimize his risk of infection. Then we stabilized his bones with plates, screws, and rods; and the plastic surgery team provided flap coverage to cover his injuries to allow them to heal properly.

While orthopaedic trauma injuries often are frustrating, painful, and unexpected, our team is dedicated to caring for you with treatments that get you back to your everyday life as soon as possible.

If you’ve recently experienced an orthopaedic trauma injury, our expert team is ready to help. Call 202-877-3627 or click below to request an appointment with an orthopaedic surgeon.

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Category: Healthy Living, Medical Intel     Tags: orthopaedic injuriesorthopaedic trauma