Upper Limb Trauma
I provide a full upper limb trauma service. This involves the management of fractures from the collar bone to the finger-tip.
Generally most common fractures of the upper limb may be managed without surgery.
Surgery for some fractures may be performed to provide earlier functional return but carries risks.
Collar Bone fractures
These are common injuries and the majority may be managed non-operatively with a sling for comfort. They may take some time to fully unite and surgical fixation does provide the benefit of earlier functional return
Fractures around the shoulder are complex and are often associated with a reduction in function of the shoulder regardless of how they are treated. There are numerous patterns of fracture and I commonly request a CT scan to help define things further. The decision on management is based on the appearance of the fracture.
The majority may be managed without surgery but surical fixation may provide benefits in specific cases. I also perform shoulder replacements for trauma to allow an earlier return of function in certain patients.
Fractures to the bone of the upper arm which don'y involve either the shoulder or elbow joint are commonly managed in a humeral brace. This is a functional brace which stabilises the fracture to allow function of the arm. It has good outcomes.
I may offer plate fixation of these fractures in certain circumstances
Similar to shoulder fractures, any fracture that involves the elbow joint may well cause significant long term stiffness. I routinely arrange CT scans of these fractures to assess whether they would benefit from surgical fixation or indeed elbow replacement
Fractures of the forearm
The forearm is actually a joint that allows the hand to turn over. Hence forearm fractures need to be managed aggressively to preserve this movement.
Wrist fractures are very common. The majority may be managed non-surgically as long as the position is acceptable. Some remain in an unacceptable position and some are difficult to stabilise without surgery.
Surgery on these fractures does allow an earlier return of function but carries additional risks.