Trauma Surgery

Trauma can be defined as physical injuries caused by accidents and impacts. Trauma patients can be the victims of injuries ranging from a simple fall at home to complex injuries following road accidents. Trauma surgery is the stream which involves in surgical treatments for physical injuries, especially emergency situations such as accident cases. A team approach involving Doctors from various specialties and para medical staffs is necessary in addressing and resuscitating these patients.

Trauma patients usually present with multiple injuries which may involve the brain, face, chest, abdomen, pelvis, bone, blood vessels, nerves and soft tissues. Immediate primary care and resuscitation is the key in saving these patients which is possible only in tertiary centers with round the clock emergency care.

Once the patient is stabilized, the fractures and other injuries are addressed. The common orthopaedic procedures performed are

  • Nailing
  • Compression Plating
  • Locking plate fixation
  • Minimally invasive fixation (Small incision)
  • External fixation
  • Illizarov fixation (Ring fixation)

Nailing:

It is a procedure where the fractures of the long bones in the body are fixed with a long nail and screws. The fractures of the arms, thighs and legs are usually fixed with a nail. As it is load sharing, patients can start walking with support on the very next day of surgery.

Compression Plating:

The smaller bones in the body like the forearm and hand are usually fixed with compression plates and screws. They help to align the fractures perfectly are allowed early mobilization of the affected part.

Locking plate fixation:

It is a recent advancement in Orthopaedic implant design to address fractures of the weak bones. These plates provide an extra rigid fixation and hence prevent implant failure in elderly osteoporotic patients.

Minimally invasive fixation (MIPPO technique):

Another advancement in surgical techniques are the minimally invasive surgeries which are more cosmetic in nature because of the use of smaller incisions and less tissue damage. They help in early wound healing and faster recovery.

External fixation:

Fractures with wounds are prone for infection. In such instances where a routine plate or nail fixation cannot be done, external fixators are used to temporarily fix these fractures till the soft tissues heal. They are not permanent but a temporary mode of fracture treatment.

Illizarov fixation:

This is another method of external fixation in infected or grossly comminuted fractures where routine surgeries cannot be performed. They are also indicated in deformity correction or limb lengthening procedures.

First Aid Care:

The immediate care of a trauma victim plays a vital role in saving them. Following an accident, emergency services must be informed immediately. The basic supports that can be given are

If you have been injured in the accident, first check yourself for any injuries. Try to assess how well you can move your limbs, and if you experience symptoms such as dizziness etc. You need to be fit enough to help the others.

If other people are injured, first assess the extent of his/ her injuries. For e.g. blood from the head, neck, arms legs, abdomen back etc. Treat the quietest person first, they are usually more seriously injured or cannot breathe. People who can talk or scream, on the other hand, can breathe therefore can be treated a little later. Ask for the patient’s name, if he responds, it means he is able to understand the situation and has most likely not suffered a severe head injury.