Orthopedic trauma is a severe injury to part of the musculoskeletal system, such as bones, joints, or ligaments. In some cases, it presents a life-threatening medical emergency, while in others, it is in need of urgent attention but the patient is not in imminent danger. Treatment usually requires the services of an orthopedic surgeon and can require an orthopedic trauma specialist, someone who focuses on caring for patients in need of critical attention because of serious injuries.
Car accidents are a common cause of orthopedic trauma. People can also sustain trauma in slips, falls, and industrial accidents. Immediate risks for patients can include bleeding out if major arteries are involved or are close to the trauma site, going into shock from pain and blood loss, and injury to internal organs caused by fractured bones or crush injuries. When a patient presents at a hospital or on the scene of an accident with orthopedic trauma, a quick assessment is performed to determine the extent of the trauma and develop a treatment plan.
People with severe musculoskeletal injuries commonly have other injuries related to the trauma and these must be evaluated and treated at the same time. Treating a patient's broken femur while ignoring a head injury, for example, would put the patient in significant danger. Sometimes, the most obvious wound is not the most serious one. An examination, medical imaging studies, and monitoring of the patient are needed to identify all the injuries and triage them in order of importance to increase the chances of surviving through treatment.
Management of orthopedic trauma usually requires a surgery. In surgery, the site of the trauma will be probed to remove any foreign objects and irrigated to clean it. The bone will be set and may be fastened with rods, screws, and other devices if is heavily damaged. A cast may be applied to fix the bone in place or the patient may need to wear slings and other devices while the bone heals if a cast is not feasible. While the patient is under anesthesia, treatment for other injuries may be offered as well by members of a surgical team.
Recovery from orthopedic trauma can take weeks or months, in the case of severe fractures and large bones. The patient may need physical therapy to develop muscle strength and flexibility. Follow-up X-rays and exams are used to monitor the progress of healing and identify complications like infections, inflammation, or nonunion, where bones do not knit back together after being set.