Complex fractures make up the minority of all broken bones sustained in the United Kingdom each year but can be associated with considerable pain and complications following injury and are a large burden on healthcare resources.
The treatment of these injuries is often complicated and usually involves multiple healthcare professionals and specialists.
These specialists include emergency doctors, surgeons, specialist nurses, people who take X-rays and scans (radiographers), people who advise on exercise and movement (physiotherapists) and people who help patients to regain their independence (occupational therapists).
Open fractures (when there is an open wound at the site of a broken bone)
Midfoot, hindfoot and severe ankle fractures (known as pilon fractures or intra-articular distal tibial fractures, when the fracture extends into the ankle joint)
Complex fractures exhibit certain characteristics which may include:
- Soft tissue damage
- Severe cartilage injury to joint
- Bone loss due to severe trauma
- Presence of multiple fractures in a single bone
- Comminuted bone fragments (broken into many pieces)
- Associated joint dislocation
These types of injury require timely specialist care aimed at preserving life and limb whilst achieving an optimum functional outcome and continued quality of life for the injured patient.
To promote the best outcome for patients who sustain such severe injuries trauma networks and hospitals require the appropriate pathways and infrastructure in place to minimise complications and enable optimum recovery.
To promote the provision of quality, evidence based care in the UK national guidelines, BOA Standards for Trauma and Orthopaedics (BOASTs), have been developed as a standard against which to measure best practice.
The care that we provide for patients at James Cook is measured against these standards as we strive to achieve excellence in clinical care provision.
We are able to provide a combined service for orthopaedic and plastic surgery in which consultants from both specialties work simultaneously to treat open fractures as part of regular, combined orthopaedic and plastic surgery operating lists.
Patients are also able to be provided with follow up in a dedicated limb reconstruction clinic where monitoring of their progress and rehabilitation can continue to be monitored by the specialist team.
Specialist paediatric orthopaedic trauma surgeons are also available to provide expert care for children who have sustained these types of complex injuries.
Additional patient and public information relating to complex fracture management can be found online at the National Institute for Health and Care Excellence.