Upper Limb Trauma

Recovering from injury

A broken bone can cause a lot of immediate pain and, with upper limb trauma, it can mean a loss of mobility to your arm. Sometimes these injuries can be treated without an operation. To begin with, Rhys spends time reviewing each fracture to complete the necessary investigations and achieve the best long-term outcomes. Trauma patients are always prioritised to also ensure the best outcome. 

“Being able to help people recover from injury is a rewarding part of my work. It’s about contributing to someone’s journey that gets them back to their normal way of life,” says Dr Rhys Clark. 

When is surgery needed?

Broken bones (fractures) of your arm can result from minimal trauma, such as a simple trip or fall, or from major trauma, such as a motor vehicle accident. If the arm is the only part of the body affected, then a plaster or a sling may be used for initial treatment. Fractures of the wrist, elbow, and shoulder are relatively common and a good majority of them don’t need to be treated surgically. Some of these injuries can be managed by your general practitioner, while some of the more complex injuries need to be managed by an orthopaedic surgeon.

Shoulder and collarbone fractures

These injuries are usually seen in patients over 50, after a simple fall on an outstretched hand. In younger patients, shoulder fractures usually occur following significant trauma, such as a motorbike accident or a fall from a great height.

If the collar bone is fractured, there is usually a noticeable bump just under the skin at the site of the injury. If it is a simple fracture, it can be treated in a sling; however, if the fracture is more complex, then it may require an operation to reposition the bones into a more normal or anatomical position.

Upper arm fractures

When the fracture is located at the top of the humerus, you will most likely experience severe pain with a lot of bruising. With these fractures, a CT scan is taken to look at the fracture pattern in detail. If the bones are in a relatively good position, then the mainstay of treatment is in a sling. If the fracture is in many parts or severely displaced, then an operation may be required to improve the position of the bones or even replace the shoulder joint. 

“The shoulder is prone to getting very stiff and, where possible, we like to start the shoulder moving to avoid this. Once your fracture is stable enough, we’ll get you to work with a physiotherapist to help get your range of movement back.” 

Lower arm fractures

The bottom part of the arm bone is often broken from a fall from standing height. Unfortunately, this is more common in older patients. If the joint has been severely displaced, an operation is often required to put the joint back into the correct position. This ensures the best long-term outcome for your arm.  

In a severe injury, the elbow can be dislocated and fractured at the same time. Often, after a major injury to the elbow, patients are left with some elbow stiffness and may lose some range of movement. This can still happen despite having the best treatment available. 

Injuries around the elbow

The elbow is a complex joint that is actually made up from three different joints. It is very common to have small fractures of the radial head following a fall. These injuries often cause swelling in the joint and make it painful to bend or straighten your elbow. If the fracture is relatively undisplayed then it can be left alone and, once the swelling settles down, you will regain the movement of your elbow.

Wrist injuries

One of the most common fractures is a broken wrist or distal radius. In younger patients, this is usually the result of a fall with significant force such as off a skateboard. In patients affected by osteoporosis, wrist injuries can occur from a very minor fall. Often the fracture occurs just before the wrist joint so it doesn’t involve the joint surfaces.  

“If everything is well aligned, the fractures can be treated in a plaster or splint until the bones heal. But, if the fracture occurs through the joint surfaces or the joint is majorly displaced, surgery may be needed. In these cases, a small operation will place bones into a more normal position.”