Orthopaedic trauma can occur to anybody at any time (Orthopaedic Associates 2018).
According to data from the Australian Institute of Health and Welfare, it’s the most common type of injury resulting in hospitalisation .
Among the 538,000 (approximately) injury-related hospitalisations that occurred between 2021 and 2022 (AIHW 2023a):
Bone fractures accounted for 206,602
Dislocations accounted for 11,339
Soft-tissue injuries accounted for 52,476 .
(AIHW 2023b)
This article will provide a broad overview of orthopaedic trauma and why it occurs.
What is Orthopaedic Trauma?
The term orthopaedic trauma refers to injuries to organs or tissues in the musculoskeletal system , which includes:
Bones
Joints
Muscles
Tendons
Ligaments
Cartilage
Any related tissues and vessels.
(COSSM 2020)
Types of Orthopaedic Trauma
Orthopaedic trauma can range in severity from a minor muscle strain to a potentially life-threatening injury (Better Health Channel 2022).
Categories of injury that fall under the umbrella of orthopaedic trauma include:
Dislocations
Fractures
Breaks
Sports hernia
Impingement
Overuse injuries
Sprains.
(Beaumont 2018)
There are numerous types of specific orthopaedic injuries, but among the most common are:
Sprained ankle or foot
Anterior cruciate ligament (ACL) injury
Meniscus tear
Plantar fasciitis
Dislocated shoulder
Rotator cuff tear
Tennis elbow
Carpal tunnel syndrome
Wrist fracture
Stress fracture.
(COSSM 2019)
Dislocated shoulders are common orthopaedic injuries.
Causes of Orthopaedic Trauma
Orthopaedic trauma may be caused by:
Acute trauma - a sudden injury, for example:
Motor vehicle accidents
Sport injuries
Falls
Physical violence
Natural disasters
Chronic trauma - the application of repetitive motion or force, causing an injury to occur over time
Degenerative change - wear and tear that occurs with age.
(Lloyd & Lewis 2020; Cooper 2020)
Risk Factors For Orthopaedic Trauma
Osteoporosis
Age , as bones naturally lose density as part of the ageing process, making them more prone to breakage
Older women are particularly at risk - half of all women over 50 will experience a bone fracture, compared to one-third of men over 50
Being an Aboriginal and Torres Strait Islander person
Living in a very remote area
Living in a lower socioeconomic area
Being overweight or obese , which puts increased pressure on the musculoskeletal system
Playing sport
Smoking
Alcohol consumption , which can affect bone structure and mass
Heavy use of corticosteroids
Certain chronic conditions , including rheumatoid arthritis, diabetes, coeliac disease , Crohn’s disease and ulcerative colitis
Previous bone fracture
Occupations that involve repetitive movements, increasing the risk of strains
Improper manual handling techniques .
(Lewiecki 2024; Hendrie 2021; AIHW 2023a; Beaumont 2018; American Bone Health 2020; Lloyd & Lewis 2020; Brennan-Olsen et al. 2017)
Symptoms of Orthopaedic Trauma
Depending on the type of injury, these may include:
Pain (may be sharp, dull, aching, cramping, stabbing or burning)
Redness
Warmth
Bruising
Swelling
Tenderness
Numbness
Stiffness
Reduced range of motion
Difficulty bearing weight on the affected area
Bleeding
Deformity (e.g. a limb looking out of place)
Numbness or tingling
Weakness in the affected area
Muscle spasms
Fatigue.
(Lloyd & Lewis 2020; COSSM 2020; Throckmorton 2021)
Diagnosing Orthopaedic Trauma
Depending on the injury, diagnostic methods may include:
Arthrography
Bone scans
Computed tomography (CT Scan)
Doppler ultrasound
Dual-energy X-ray absorptiometry (DEXA)
Electromyography (EMG)
Intrathecal contrast-enhanced CT scan
Joint aspiration and analysis
Laboratory studies of blood, urine or synovial fluids
Magnetic resonance imaging (MRI)
Muscle tests
Nerve conduction study (NCS)
Palpation
Physical examination
Quantitative computed tomography
Range of motion tests
Venography
X-ray.
(Apollo Hospitals 2020)
Treating Orthopaedic Trauma
Treatment might require the use of an external fixation device.
Treatment varies and may be surgical or non-surgical depending on the specific type of injury sustained and its severity (Mount Sinai 2020).
Generally, the common goals of treating orthopaedic trauma are:
Correcting any physical problems
Alleviating symptoms
Improving the patient’s quality of life
Preventing further problems from occurring in the future.
(Lloyd & Lewis 2020)
Specific treatments might include:
An external fixation device (e.g. metal screws, pins, rods or plates)
Arthroplasty (replacement of a whole joint)
Corrective surgery (e.g. realignment)
Cast immobilisation
Functional cast or brace
Traction
Physical therapy
Analgesic medicines
RICE (rest, ice, compression and elevation)
Rest.
(NHS 2023; Throckmorton 2021; COSSM 2019)
Some injuries, such as stress fractures, might heal on their own (COSSM 2019).
Complications of Orthopaedic Trauma
In some cases, orthopaedic trauma might lead to complications or chronic issues such as:
Nonunion fracture (a fracture that doesn’t heal)
Delayed union fracture (a fracture that takes longer to heal than normal)
Malunion fracture (a fracture that doesn’t heal in the correct alignment)
Joint deformity
Infection.
(Mount Sinai 2020; Henry Ford Health System 2016)
Potential signs of complication include:
Chronic pain
Wound drainage
Fever
Swelling
Limping.
(Henry Ford Health System 2016)
Complications should be referred to an orthopaedic specialist for treatment (Henry Ford Health System 2016).
Preventing Orthopaedic Trauma
The risk of experiencing orthopaedic trauma can be reduced through measures such as:
Always wearing a seatbelt
Always wearing a helmet when riding a bike, skateboarding, rollerblading, etc.
Wearing appropriate safety gear when playing sport
Stretching and warming up before exercising or playing sport
Using proper manual handling techniques
Maintaining a healthy lifestyle
Avoiding smoking
Wearing comfortable, low-heeled shoes to reduce the risk of tripping or slipping
Using night lights to prevent tripping in the dark
Removing clutter
Keeping bones healthy and strong through weight-bearing exercise (e.g. walking) and increasing balance through exercises that build muscle
Ensuring adequate intake of calcium and vitamin D.
(Cooper 2020; Cleveland Clinic 2022; Lloyd & Lewis 2020)