Orthopaedic Trauma Surgery

Specialised Surgical Care for Acute Bone Fractures, Joint Injuries, and Musculoskeletal Trauma

Orthopaedic trauma involves injuries to the musculoskeletal system, including bones, joints, ligaments, tendons, and muscles, often resulting from accidents, fallsor sports injuries. Some trauma injuries, such as broken bones, may be immediately obvious and require urgent care in a hospital emergency department. Others, while not life-threatening, still demand specialised orthopaedic care to prevent long-term complications.

Patients experiencing orthopaedic trauma may need surgical intervention to stabilise fractures, repair tendons or ligaments, or restore joint function. The expertise of a trauma surgeon like Dr Antony Liddell is essential in these situations, providing timely and effective treatment to optimise recovery and restore function.

TYPES OF TRAUMATIC ORTHOPAEDIC INJURIES

Orthopaedic trauma encompasses a wide variety of injuries, each requiring careful evaluation and a specific treatment plan. Dr Liddell treats both common and complex lower limb orthopaedic injuries, including:

Hip Fractures: These can involve the femoral neck, intertrochanteric region, or subtrochanteric region of the hip. Hip fractures can severely limit mobility and typically require surgical intervention to stabilise the bone.
Hip Dislocations: This occurs when the femoral head (the ball of the hip joint) is forced out of the acetabulum (the hip socket). Dislocations are often the result of high-impact trauma and may require urgent reduction and stabilisation.
Acetabular Fractures: These are fractures of the socket portion of the hip joint and are often associated with hip dislocations. They may need surgical repair to restore joint function and prevent complications such as arthritis.
Anterior Cruciate Ligament (ACL) Tears: A tear or rupture of the ACL can significantly affect knee stability and often requires surgical reconstruction, particularly in active individuals.
Meniscal Tears: Tears in the meniscus, the cartilage discs in the knee, are commonly seen in trauma and sports injuries. Treatment can involve surgical repair or removal of the damaged portion (meniscectomy).
Patellar Dislocation and Fractures: Injuries to the kneecap can result from trauma or sudden twisting motions, requiring reduction or surgical repair depending on the severity.
Tibial Plateau Fractures: These are fractures that involve the top surface of the tibia (shinbone) at the knee joint and may necessitate surgical fixation to ensure proper alignment and function.
Bone Non-union or Malunion: In some cases, fractures fail to heal properly (non-union) or heal in a misaligned position (malunion). These cases often require revision surgery to correct the problem and promote proper healing.
Bone Infections (Osteomyelitis): Traumatic injuries can lead to bone infections, which may need surgical debridement and long-term antibiotic treatment to prevent further complications and ensure successful recovery.

DIAGNOSIS AND ASSESSMENT FOR ORTHOPAEDIC TRAUMA

The diagnosis and assessment of orthopaedic trauma often begin in the emergency department (ED), where timely and accurate evaluation is crucial. When a patient presents with a traumatic injury, whether from a car accident, fall, sports injury, or other trauma,the ED team takes immediate steps to assess the severity of the injury and stabilise the patient.

Emergency Department Process for Orthopaedic Trauma

Upon arrival at the emergency department (ED), patients with orthopaedic trauma are typically triaged based on the severity of their injuries. For obvious trauma, such as fractures, dislocations, or joint injuries, the initial focus is on stabilising the injury and managing pain. The emergency physician conducts a quick physical assessment to evaluate the extent of the injury, ensure circulation to the affected limb, and rule out any life-threatening conditions. In some cases, splints or stabilisation devices are used to prevent further injury until a full diagnosis can be made.

Imaging Tests

Imaging tests are crucial for accurately diagnosing the type and severity of the injury. X-rays are commonly used to detect fractures, dislocations, and bone misalignments, offering a quick and efficient method for initial assessment. For more complex injuries, a CT scan may be necessary to provide a detailed cross-sectional view of the bones, especially in cases of joint injuries or subtle fractures. If soft tissue damage is suspected, such as ligament tears or tendon injuries, an MRI may be performed to offer detailed images of the muscles, ligaments, and cartilage. Throughout this process, early pain management is essential, and patients may receive oral or intravenous (IV) pain relief to ensure comfort while diagnostic procedures are completed.

Orthopaedic Consultation

Once the initial assessment and imaging are completed, the emergency department team may consult an orthopaedic specialist or registrar, especially for complex fractures, dislocations, or significant musculoskeletal injuries. The specialist will carefully review your imaging, conduct a thorough physical examination, and consider your medical history to develop a personalised treatment plan.

Depending on the injury, treatment could involve immediate surgery or conservative management such as casting or bracing. If surgery is needed, it may be performed urgently or scheduled at a later date. Patients wishing to be treated privately can choose Dr Liddell as their surgeon, allowing them to receive timely, personalised care in a private hospital setting. Dr Liddell will guide patients through the surgical process, recovery, and follow-up care to ensure optimal healing and rehabilitation. For complex cases, additional diagnostic tools like 3D CT scans or MRI may be used to refine the surgical approach.

TREATMENT OPTIONS FOR ORTHOPAEDIC TRAUMA

The treatment of orthopaedic trauma is highly personalised, depending on the type and severity of your injury, as well as your overall health and activity level. Dr Liddell utilises both surgical and non-surgical approaches to help you achieve the best possible recovery.

Non-Surgical Treatments

Some fractures and minor injuries can heal without surgery. Depending on your condition, treatment may include:

Casting or bracing to immobilise the injury and support natural healing.
Physiotherapy to restore strength, flexibility, and function.

These approaches are typically recommended for stable fractures or soft tissue injuries that do not require immediate surgical intervention.

Surgical Treatments

For more severe or complex injuries, surgery may be necessary to properly realign bones, repair ligaments or tendons, and stabilise the affected area.

Common surgical procedures include:

Open Reduction and Internal Fixation (ORIF): A procedure to realign fractured bones and secure them with plates, screws, or rods.
Hemiarthroplasty: Used for certain hip fractures, this involves replacing the femoral head with a prosthetic implant while preserving the hip socket.
Total Hip Replacement (THR): Recommended in cases of severe hip fractures or joint damage, a full hip replacement may be needed to restore movement and function.
ACL Reconstruction: A surgical procedure to replace a torn anterior cruciate ligament with a tendon graft, helping to restore knee stability.
Meniscus Repair or Meniscectomy: Depending on the severity of the meniscus tear, the damaged tissue may be repaired or removed to relieve symptoms and improve function.

Recovery & Rehabilitation

The recovery process varies based on the severity of your injury and the type of treatment received. Dr Liddell will develop a personalised rehabilitation plan to support your healing, improve mobility, and help you regain strength and confidence as you return to daily activities.

PUBLIC OR PRIVATE TRAUMA PATIENT

In Australia, if you experience an accident or injury that requires orthopaedic care, you have the option of being treated in either the public or private healthcare system. Your decision may depend on factors such as how urgent your treatment is, your personal preferences, and your financial situation.

PUBLIC PATIENT

Access to Public Hospitals: Public hospitals provide comprehensive orthopaedic trauma care, often at no or minimal cost through Medicare. While urgent cases are prioritised, elective procedures may involve longer wait times due to demand.
Cost: Public patients generally pay little to nothing for treatment, as it is covered by Medicare however, some services may still involve out-of-pocket expenses.
Wait Times: Acute trauma cases, such as severe fractures or dislocations, are treated promptly however, non-urgent treatments, like follow-up care for healed fractures, ligament reconstruction, or elective joint replacement surgeries, may face delays due to longer waitlists.

PRIVATE PATIENT

Choice of Surgeon & Hospital: As a private patient, you have the flexibility to choose your orthopaedic surgeon and the hospital where you receive treatment. This allows you to access specialised care and select a surgeon with experience in your specific condition.
Shorter Wait Times: Private healthcare typically means faster access to specialist consultations, diagnostic tests, and surgery, which may be beneficial if you need treatment sooner.
Facilities and Costs: Private hospitals typically offer greater comfort, including private rooms and more personalised care. While private treatment involves higher costs, private health insurance can help cover a significant portion of the expenses, reducing out-of-pocket costs.

MAKING YOUR DECISION

When deciding between public and private healthcare, consider the urgency of your treatment, the ability to choose your surgeon, and financial factors. Private healthcare may provide faster access to treatment and a more personalised experience, while public hospitals offer high-quality trauma care with minimal out-of-pocket costs. Dr Liddell provides expert care for both public and private patients, ensuring you receive the most appropriate treatment for your needs.