Lower Limb Trauma
Trauma surgery is a large part of Dr Rhys Clark’s work. Every patient and every injury is slightly different; therefore, trauma surgery requires detailed and swift action to get the best outcome. When it comes to lower limb trauma, patients can be unable to walk and will experience severe pain.
“Trauma patients are always prioritised as quick action is needed to get the best outcome – this is especially true with lower limb trauma as we’re dealing with mobility,” says Dr Rhys Clark.
Lower limb injuries
Injuries of the lower limb can be either broken bones (fractures), or soft tissue injuries such as ligament ruptures or sprains, and can occur from minor sporting trauma all the way to major traffic accidents. Often after an injury of the lower limb, a patient may be put on crutches so they can move around. You may have your foot put in a plaster or boot and, if you have injured your knee, you may be placed in a splint.
The hip is an area of weakness and is one of the primary sites affected by osteoporosis. Simply catching your foot on the rug is enough to cause a fall and a hip fracture. Once you have a hip fracture you will not be able to walk on that leg and, due to the pain, people are often transported to hospital in an ambulance. Once in hospital, simple X-rays can diagnose the problem and sometimes further imaging is required.
Depending on the type of hip fracture, your hip may need to be replaced by either a full hip replacement or half hip replacement. Some fractures can be stabilised – those where the blood supply to the femoral head isn’t compromised.
“The aim of surgery is to get you up and mobile as quickly as possible. Rehab and weight-bearing outcomes will depend on how the fracture is fixed as we know that those who have the operation as soon as reasonably possible will track better outcomes.”
Following hip fracture surgery, a physiotherapist will see you every day while you’re in hospital. This treatment will help you get up onto your feet and regain strength and the ability to walk.
Fractured thigh bone
These occur due to high energy trauma. We often see them after major accidents; however, they can occur around a hip or knee replacement. If you have a displaced fractured thigh bone, you will not be able to walk or get around. If the injury is around a joint replacement, then often that joint replacement will become loose and need replacing when the fracture is fixed.
The knee is one of the largest joints in the body and relies on strong ligaments to hold it together and to keep it stable. Often an injury around the knee will mean an injury to one or more of these ligaments. It is possible to fracture the shin bone (tibia) and sometimes this fracture can extend into the joint. Injuries around the knee often cause large amounts of swelling and can be very painful. Sometimes patients are put in a splint to help stabilise the knee initially. As the knee joint is so complex, in addition to a Xray, you may require a CAT (CT) scan to look further at the bones or an MRI if we are concerned there is a tear in a ligament or one of the cartilages around the joint.
If you have torn a ligament in your knee, such as the anterior curate ligament (ACL), it very rarely requires urgent surgery. Once a diagnosis has been made, the first step is to allow the knee time to settle down prior to any intervention (if needed).
“Sometimes, an operation is required to improve the position of the fracture. And, as an Orthopaedic surgeon, I often work with a specialised physiotherapist to help you regain a range of movement and build the strength in the muscles around your knee. No matter what the treatment plan, every decision we make is done in an effort to give you the best outcome for lifelong mobility.”
Foot and ankle injuries
Foot and ankle injuries are wide and varied – from minor ankle sprains, all the way up to severe fractures and dislocations of the foot and ankles. It is often difficult to tell if an ankle injury is a sprain or a small fracture; therefore, a simple Xray will give adequate information on what is happening in your foot.
Once your injury has been assessed, it may be able to be treated in a CAM boot, followed by physiotherapy. Other times, an operation is necessary. A vast majority of ankle injuries can be treated without an operation and it’s always recommended that patients elevate the foot in the short-term to help with the immediate swelling.