Orthopedic Trauma Service

Injury Types and Descriptions

Spine

The spine is the long bony column in the back that protects the spinal cord. The spinal cord is a bundle of nerves through which information about movementand sensation travels between the brain and body.

Trauma to this area is usually the result of car crashes, sports accidents, falls and gunshot wounds. Treatment of the spine is important so that the spinal cord may be protected from serious damage.

After a trauma, it may not be clear to the team whether your spine has been injured — despite x-rays or other tests that show no injury to the bones. If you are unable to move your neck, have other serious injuries requiring immediate medical attention, have less-than-full consciousness or are under the influence of drugs or alcohol at the time of initial evaluation, the team will not rule out a spinal injury. If this is the case, the team will wait until you are awake, alert, and able to feel neck and back pain before making a decision about an injury diagnosis. Until a decision is made, you will wear a collar around your neck and may remain on bed rest.

Any injury to this area is usually managed by our colleagues on the Orthopaedic Spine Service. Further information may be obtained in the spinal cord injury information booklet. If interested, please ask your trauma coordinator for a copy.

Shoulder/Arm

Clavicular (collarbone) fracture usually is a result of a fall or direct force onto the arm or shoulder. It can occur in all age groups. The most common treatment is a sling and swathe. As the bone is healing, a large “bump” may develop as part of the healing process. This bump usually disappears, although a small bump may remain.

Scapular (shoulder blade) fracture is rare, although it is seen in trauma patients as a result of high-energy blunt trauma, such as motor vehicle crash, motorcycle crash or a fall. A sling is the usual treatment; however, this injury may require surgery. It is important to check with your doctor regarding moving your shoulder, as it may take six months to a year to get complete motion back in the shoulder. Because the injury is the result of a high-energy trauma, other fractures usually accompany this injury.

Shoulder (glenoid, humeral head or humeral neck) fracture usually is a result from a fall onto an outstretched arm or from direct trauma to the shoulder. This injury may require surgery.

Humerus (upper arm) fracture usually is the result of a direct blow on the upper arm, a fall onto the arm or a motor vehicle crash. Depending on your age, the treatment may be a cast, a sling or surgery.

Olecranon (elbow) fracture usually is the result of a direct blow or fall onto the point of the elbow. There are different types of “elbow” fractures, so ask your doctor about your type. The most common treatment for this fracture is surgery.

Radius and/or ulna (lower arm) fracture usually is the result of a fall onto your extended arm or a direct blow to your lower arm. It is possible to fracture one or both bones in your lower arm. The treatment depends on the severity of the fracture, which bone is fractured and where the fracture is. Treatments for this type of fracture include a cast or surgery.

Scaphoid (wrist) fracture is a fracture that is located on the thumb side of your wrist. It usually is the result of a fall onto an outstretched wrist or a motor vehicle crash. The treatment of this fracture may begin with a cast. If the bone isn’t healing, surgery may be necessary. This fracture typically takes some time to heal.

The Pelvis and Acetabulum

Complex combined pelvis and acetabular fractures

Pelvic fracture is usually the result of a major trauma like a motor vehicle crash, industrial accident, a fall from a tall height in young patients, or a fall from standing in elderly patients. There are three bones within the pelvis that can be fractured, with the treatment depending on the bone injured and the severity of its injury. In more severe pelvic fractures, there is a possibility of blood loss and other injuries. Common treatmentsfor a fractured pelvis range from limited weight bearing on your legs to surgical repair of the fracture. Much relief is felt within the first six months of injury.

Acetabular fracture is usually the result of a motor vehicle crash. In this type of injury, the socket connecting the pelvis to the femur (thighbone) is broken. The most common treatment for this type of fracture is surgery.

Hip and Leg

High energy fracture involving the weight bearing surface of the ankle joint (pilon fracture)

Hip fracture is more common in elderly persons who have fallen. It also can be caused by a direct blow or a motor vehicle or motorcycle crash. After the hip is fractured, it is common for your leg to turn outward and shorten. The usual treatment for a hip fracture is surgery with a stay in a rehabilitation hospital usually necessary as part of the recovery process.

Femur (thighbone) fracture usually is the result of a major force or trauma. It requires a considerable force to break a normal femur — the longest and strongest bone in the body. The usual treatment for this fracture is surgery. Traction is sometimes used to stabilize the fracture until surgery can be performed.

Patella (kneecap) fracture usually is the result of direct trauma to the knee. It can be caused by a fall, motor vehicle crash, motorcycle crash or automobile-pedestrian crash. This fracture may be treated with a knee immobilizer or by surgery depending on the severity.

Tibial and/or fibular (lower leg) fracture usually is the result of direct trauma to the lower leg. The causes of this type of fracture include falls from a height and motor vehicle collisions. The force of the trauma will directly influence the severity of the injury. Treatments range from a simple cast to surgery.

Ankle fracture can be caused by a variety of trauma types, such as a fall, a direct blow to the ankle, or a motor vehicle collision. The treatment of ankle fractures varies with the severity of the fracture. Ankle fractures are treated with splints, casts or surgery.

Calcaneus (heel) fracture usually is the result of a fall from a significant height when the patient lands directly on the feet. This type of injury usually causes great swelling and is often accompanied by fractures to the back. The treatment of these fractures varies from splints, to casts, to surgery. Surgery often is performed after the swelling has gone down.