FRACTURES & TRAUMA

The clavicle (also known as the collarbone) is the bone that connects from the shoulder to the sternum or breastbone. Most clavicle fractures occur from a direct blow to the collarbone. This can happen in car accidents or from playing sports. This can also occur from a fall onto the shoulder.

Patients who suffer a clavicle fracture often have swelling and bruising over the fracture site. They can also have increased pain and feel a grinding sensation when trying to move their shoulder and arm.

Clavicle fractures can be seen on x-rays ordered by your doctor. Most clavicle fractures are treated without surgery. Non-surgical fractures are treated by having the patient wear a sling for comfort and support while the fracture heals. Some clavicle fractures that are displaced require surgery to fix the broken ends back together to allow the bone to heal in proper alignment using a metal plate and screws.

The elbow joint is made up of three bones: the humerus, which is the upper arm bone, and the ulna and radius, which are the forearm bones. The bones are held together by ligaments and surrounded by muscle tendons to allow proper movement of the elbow joint. In growing children, the elbow bones have growth plates which are areas of developing bone that eventually develop into solid bone as the child grows. Fractures to the elbow and the growth plates can be caused by a fall onto an outstretched hand or a direct blow to the elbow, such as in a car accident. Common fracture locations of the elbow include the radial head and olecranon in adults and the growth plates and supracondylar humerus in children.

Patients who suffer an elbow fracture often have swelling of the elbow and can sometimes have bruising over the fracture site. Patients will have pain when trying to move their arm. They can also feel clicking or popping sensation when moving their elbow. In some cases, a deformity of the elbow bones can be seen.

Elbow fractures can usually be seen on X-rays ordered by your doctor. In some cases, a CT scan may be used to determine the severity of the fracture. Elbow fractures can be treated non-surgically if the fracture is in good alignment, most commonly with a cast, brace, or sling. However, If the fracture is out of proper alignment, surgery may be required to fix the fracture using a metal plate and screws or pins.

The wrist joint is made up of the distal ends of the ulna and radius (the forearm bones) and eight small bones known as the carpal bones. Most fractures of the wrist are caused by a fall onto an outstretched hand, such as a fall from a bike. Wrist fractures are common in children and also common in patients over the age of 60 who suffer from weak bones (osteoporosis). Common fracture locations of the wrist include the distal radius (most common wrist fracture in children) and the scaphoid bone (one of the carpal bones).

Patients who suffer a wrist fracture will have immediate pain and swelling of the wrist. They will also have pain with wrist movement and stiffness due to the swelling.

Wrist fractures can usually be seen on X-rays ordered by your doctor. In the case of a scaphoid fracture, a CT scan may be used to determine the severity of the fracture. Most wrist fractures are treated non-surgically with a cast for a period of 3-5 weeks followed by a removable wrist brace for another 3-5 weeks. However, some wrist fractures require surgical fixation if the fracture is displaced or fails to heal properly.

The hip joint is a ball-and-socket joint like the shoulder and contains the head of the femur. The femur, which is the longest bone in the body, connects the hip to the knee. Fractures of the hip and femur are usually the result of high-energy forces from events such as motor vehicle accidents or falling from a height. However, patients who suffer from conditions such as osteoporosis or bone tumors are at increased risk of hip and femoral neck fractures.

Patients who suffer a hip or femur fracture will usually have sudden severe pain along with swelling and bruising. Patients will report pain with walking or may not be able to walk or get up from the ground after a fall due to the pain. A visible deformity is sometimes seen.

Hip and femur fractures are usually diagnosed with evaluation and x-rays by your doctor. In some cases, further imaging such as a CT scan or MRI may be needed to identify the location and severity of a hip or femur fracture. Treatment of hip and femur fractures depends on the severity of the fracture and the health and lifestyle of the patient. Nondisplaced fractures can sometimes be treated with modified weightbearing devices such as a walker and bracing for support with periodic x-rays to assess healing. However, displaced or unstable fractures require surgical fixation with rods, plates, and/or screws to realign the bone ends.

The tibia and fibula are the long bones that connect the knee to the ankle. These bones can be fractured in a number of ways including direct trauma from playing sports such as football or a fall from a height. Some proximal fibula fractures can be the result of a high ankle sprain. Proximal tibia plateau fractures can be observed in patients who suffer contact and twisting injuries of their knee.

Patients who suffer a tibia or fibula fracture will usually have sudden severe pain along with swelling and bruising. Patients will report pain with walking or may not be able to walk or get up from the ground after a fall due to the pain. A visible deformity is sometimes seen in a tibia of fibula shaft fracture.

Tibia and fibula fractures are usually diagnosed with evaluation and x-rays by your doctor. In some cases, further imaging such as a CT scan or MRI may be needed to identify the location and severity of the fracture. Treatment of tibia and fibula fractures depends on the severity of the fracture and the age, health, and lifestyle of the patient. Nondisplaced fractures can sometimes be treated with a cast or brace and modified weightbearing with crutches or a wheelchair with periodic x-rays to assess healing. However, displaced or unstable fractures require surgical fixation with rods, plates, and/or screws to realign the bone ends.

The ankle joint is made up of the lower ends of the tibia and fibula and the talus bone on which they sit. An ankle fracture is a break in one or more of these bones that make up the ankle joint. Sometimes, ligaments may also be damaged. Ankle fractures are most often caused by motor vehicle accidents, rolling or twisting of the ankle, and tripping or falling. People participating in sports such as basketball, football, soccer, and skiing are at a high risk of developing ankle fractures.

Common symptoms of an ankle fracture include pain and swelling around the ankle, bruising, tenderness to touch, inability to walk on the leg, and deformity if the ankle is dislocated.

Following an ankle injury, it is important to have the ankle evaluated by your doctor for proper diagnosis and treatment. Diagnosis is made based on the history of injury and physical examination of the ankle. In addition, the surgeon may order X-rays of the ankle to determine the extent of the injury.

Treatment varies with the type and severity of the injury. The common method of treatment of ankle fractures is adequate rest, ice application, leg elevation, and medications to reduce swelling and pain. A short leg cast or a brace may be applied over the fractured ankle to provide support. Some ankle fractures are treated with a splint which is placed on the ankle for few days until the swelling subsides. Once the swelling decreases, a cast may be placed on the ankle to hold the broken bone in a specific place. Surgery may be needed to realign the bones before placing the splint. During surgery, your doctor may place metal screws, plates, or rods to hold the broken bone in place until the healing happens. In some cases, crutches may be used to prevent bearing weight on the ankle.