Trauma Treatment

Trauma treatment deals with the immediate effects of an accident or injury – including treating pain and swelling – but may also treat longer-term impacts, such as repairing soft tissue damage or supporting fractures to heal fully. Treatment aims to relieve pain and maintain the fullest possible range of movement once the injury has healed. Prompt diagnosis and treatment by an expert is critical in ensuring timely treatment and return to early function.

Common trauma injuries include sprains, strains and ruptures of muscles, tendons and ligaments. Fractures can range from stress fractures – which are cracks in the bone caused by overuse – through to open fractures, where the bone pierces the skin resulting in a high risk of infection.

Philosophy for trauma treatment

1 Diagnose the full extent of injury
Assessment and imaging (e.g MRI, x ray)

2 Treatment Plan
Splint or surgery (e.g. plate and screws)

3 Optimise healing and return to function
Ensure good nutritional status
Individualised rehabilitation programme

4 Prevent future fractures
Assess for osteoporosis where relevant

Among the trauma injuries treated commonly by Mr Queally are:

These might include:

• Ankle sprains which are common in sportspeople This is when damage to the ligaments occurs, stretching them beyond their normal range of motion.
• Ankle fracture, which is a break in one of the bones of the ankle (tibia, fibula and talus). This type of injury can also affect the ligaments.
• Torn or strained tendons or muscles, as a result of over-stretching them. This can be due to sudden trauma or microscopic tears that develop over time.

Treatment will depend on the type and severity of the ankle trauma. For some injuries such as mild sprains the RICE method (rest, ice, compression, elevation) may be sufficient. However, more serious trauma may require treatment such as:

• Immobilisation in a splint or cast – this is the normal treatment for stable fractures, which are where the bones have not been pushed out of place. The splint is generally kept in place until the fracture has healed.
• Surgery to repair the fracture – if the ankle is unstable or the bones have been displaced you may need surgery to repair the fracture. The bones will be held in place using implants such as a metal plates and screws or a rod in the bone.
• Physiotherapy – this may be used to improve the range of motion and build strength after a severe sprain.

This is the most common location for a hip fracture. It occurs at the top of the thigh bone at the femoral head, which is the ball part of the ball and socket joint. Just below the femoral head is the femoral neck, which can become fractured at various points. This type of fracture is common in older people, particularly women.

Treatment for a femoral neck fracture may include:

• Painkilling medication and anti-inflammatories.
• Medication to increase bone density and help reduce the risk of further fractures.
• Internal fixation surgery using metal screws and pins to hold the bones together while the fracture heals.
• Partial hip replacement which removes the head and neck of the femur and replaces it with a metal prosthesis.
• Total hip replacement which replaces the upper femur and socket with a prosthesis.

These are breaks in the bones of the leg. They are normally due to some kind of accident or injury, including road traffic accidents, falls and sports injuries.

Treatment will depend on the type and location of the break. It may include:

• Setting the leg – if you have a displaced fracture the bones may need to be manipulated back into position before a splint is applied.
• Immobilisation – a splint or cast is used to hold the broken bone in position while it heals.
• Physiotherapy – this is important to rehabilitate and restore strength and mobility to the injured leg.
• Internal fixation using plates, rods and screws may be necessary to hold the bones in position while healing takes place in complex or multiple fractures.

These are injuries that affect the kneecap (patella). Common patella trauma includes:

• Kneecap fracture – this is normally due to a heavy fall and it can cause the kneecap to fracture in one or more places.
• Patellar tendon tear – if the tendon above or below the kneecap is torn it will prevent the knee from straightening
• Patellar tendinitis – also called jumper’s knee, this is an injury to the patellar tendon.

Treatments may include:

• Kneecap fracture may be treated using an immobiliser brace to hold it in place while you heal or you may need surgery to hold the pieces of bone in place with wires, pins or screws.
• Physiotherapy – this can help to restore movement and strength after surgery.
• A brace to keep the knee straight is used to treat simple tendon tears.
• Surgery may be needed to repair a large patellar tendon tear.

Common injuries include sprains which stretch or tear the ligaments, muscle strains or ruptures due to overstretching muscles. Other common injuries include:

• Bursitis – a swelling behind the elbow which is normally de to overuse.
• Tennis elbow – this is a form of tendinopathy, due to making repetitive movements. It is common in sports people as well as certain trades such as carpentry or plumbing.
• Fractures – these can occur in the upper arm or forearm at the elbow joint.

Treatments may include:

• Mild sprains may be treated using the RICE method alongside anti-inflammatories and painkillers.
• Fractures and more severe soft tissue damage may need to be immobilised with a brace, splint or cast.
• Physiotherapy may help to rehabilitate the affected area once it has healed and prevent stiffness.

Hand and wrist injuries are common, particularly among sportspeople. Typically we see:

• Wrist sprains which often occur when you put your hand out to break your fall. This results in falling onto the palm, bending your wrist backwards which can stretch or tear the ligaments.
• Hand fractures particularly to the fingers or metacarpals – this is a common injury in sportspeople.
• Wrist fractures – this may be due to falling onto an outstretched wrist or the wrist being bent backwards due to sudden pressure, for example during a car accident.

The treatments for hand and wrist injuries are often similar to those for elbow injuries described above.

Many different types of people may require treatment for trauma, including:

• Older people who have had a trip or fall.
• Sportsmen and women who have sustained an injury.
• People at work, such as construction workers or anyone who works at a height.
• Anyone involved in a serious accident or injury, such as a road traffic accident.
• Victims of crime.

Diagnosis, treatment and recovery times will vary depending on the type and extent of the injury and the type of treatment you receive. Generally, the more invasive the treatment, the longer the recovery times.