Urgent vs planned trauma care

Some injuries need emergency department care first: open fractures, severe deformity, numbness, pale foot or hand, or uncontrolled pain. Once stabilised, definitive orthopaedic planning continues at consultation.

  • Go to emergency care immediately for open wounds with bone, circulation loss, or severe deformity
  • Book consultant review for stable fractures needing surgical vs cast treatment decisions
  • Bring ambulance reports, X-rays, and CT scans on disk or link

Shoulder, hip, knee & ankle trauma

Each joint has different risks after injury. Shoulder fractures may threaten the rotator cuff; hip fractures affect walking immediately; knee fractures often involve the cartilage surface; ankle fractures depend on skin swelling and syndesmosis stability.

Surgeries & procedures — fractures & trauma

Trauma care is organised by region — shoulder, hip, knee, and ankle — so your injury is matched to the right fixation plan. Elbow, wrist, and forearm fractures are treated within the same consultant service. When a joint cannot be repaired, partial hip or shoulder replacement may be part of recovery.

Shoulder trauma

  • Proximal humerus fracture — locking plate or hemiarthroplasty in older patients
  • Displaced greater tuberosity fractures with rotator cuff involvement
  • Clavicle fracture fixation (plate) when shortening or skin risk
  • Scapula fracture management — non-operative or operative when unstable
  • Shoulder dislocation after trauma — reduction and instability assessment
  • Fracture-dislocation patterns requiring combined bone and soft-tissue planning

Hip trauma

  • Femoral neck fracture — cannulated screws in younger bone; partial hip replacement when appropriate
  • Intertrochanteric (hip) fracture — cephalomedullary nail or sliding hip screw
  • Subtrochanteric femur fracture — intramedullary nail fixation
  • Acetabular (socket) fracture — assessed for operative vs referral pathways
  • Pelvic ring injuries — stabilisation planning with trauma team when needed

Knee trauma

  • Tibial plateau fracture — articular surface restoration with plates
  • Distal femur fracture — lateral/medial plating or retrograde nail
  • Patella fracture — tension-band wiring or partial excision of small fragments
  • Knee dislocation — urgent reduction, vascular assessment, staged ligament surgery
  • Multiligament knee injury with fracture — coordinated bone and ACL/PCL/MCL/LCL care
  • Periprosthetic fracture discussion after prior knee surgery

Ankle trauma

  • Lateral malleolus and bimalleolar ankle fracture fixation
  • Medial malleolus fracture — screws or plate
  • Posterior malleolus fragments when they affect joint stability
  • Pilon fracture (distal tibia) — staged or acute plating depending on soft tissue
  • Syndesmosis injury repair with ankle fracture surgery
  • Calcaneus and midfoot fractures — selected operative fixation

Elbow, wrist & forearm trauma

  • Radial head, olecranon, and distal humerus fractures
  • Elbow dislocation and Monteggia injury patterns
  • Distal radius (wrist) fracture — volar locking plate or cast when stable
  • Forearm both-bone fractures — plates in adults; flexible nails in children when suitable
  • External fixation for severe open injuries

Regional injury overview

Shoulder

  • Proximal humerus and clavicle fractures
  • Shoulder dislocation after falls or sport
  • Scapula fractures when unstable

Hip

  • Femoral neck and intertrochanteric hip fractures
  • Partial hip replacement for selected neck fractures
  • Pelvic and acetabular injuries — complex case planning

Knee

  • Tibial plateau and distal femur fractures
  • Patella fractures and knee dislocations
  • Combined fracture + ligament (ACL/PCL) injuries

Ankle

  • Malleolar and bimalleolar ankle fractures
  • Pilon (distal tibia) fractures
  • Syndesmosis tears with ankle instability

Surgical principles

When surgery is required, fixation aims to restore length, rotation, and joint surface where possible — using plates, screws, nails, or external fixation as the injury demands.

Combined bone and ligament injuries may need staged surgery; ligament reconstruction is coordinated with sports-knee expertise when the knee is involved.

Rehabilitation after fracture

Weight-bearing status, brace use, and physiotherapy timing are written down clearly. Return to work or sport follows bone healing and strength milestones — not arbitrary calendar guesses.

Other specialist areas

Common questions

When is a fracture an emergency?

Open fractures, severe deformity, loss of pulse or sensation, or uncontrolled pain require emergency care before outpatient booking.

Can a fracture be treated without surgery?

Yes — many stable fractures heal well in a cast or brace with follow-up X-rays. Surgery is recommended when alignment, joint surface, or stability cannot be maintained non-operatively.

What does weight-bearing mean after a leg fracture?

Your surgeon specifies none, partial, or full weight-bearing — often with crutches or a frame. Loading too early can displace fixation; loading too late can weaken bone and muscle.

Who treats ligaments if my knee fracture also tore ACL?

Bone fixation is prioritised for alignment; ligament surgery may be immediate or delayed depending on swelling, skin, and associated injuries — planned as one coherent pathway.

What elbow injuries are treated surgically?

Radial head fractures, olecranon fractures, distal humerus fractures, and unstable elbow dislocations are common. Treatment may use plates, screws, tension-band wiring, or radial head replacement depending on the pattern.

Do you treat hip fractures in elderly patients?

Yes. Femoral neck and intertrochanteric hip fractures are common trauma presentations. Treatment may be screws, a nail, or partial hip replacement depending on bone quality, displacement, and activity level.

When does an ankle fracture need surgery?

Unstable alignment, multiple malleolus fractures, syndesmosis injury, or pilon patterns often need operative fixation. Stable isolated fractures may be treated in a cast with close follow-up.