A trauma patient is someone who has suffered a serious and life-threatening physical injury who could develop further complications, such as shock or respiratory failure. Orthopaedics is the branch of medical science concerned with disorders or deformities of the spine and joints.
Trauma and orthopaedic surgeons diagnose and treat a wide range of conditions of the musculoskeletal system. This includes bones and joints and their associated structures that enable movement – ligaments, tendons, muscles and nerves. Trauma and orthopaedic surgery is often abbreviated to T&O surgery.
Nature of the work
There are two aspects to the work:
- trauma – injuries to the musculoskeletal system, such as broken, fractured or dislocated bones and soft tissue injuries
- congenital and degenerative conditions of the musculoskeletal system, as well as infections and tumours
Trauma can range from low energy fractures (often in elderly patients) to multiple injuries such as those caused by a road traffic accident. Bone and joint infection can also require emergency admission and treatment.
T&O surgeons work with patients of all ages from babies to elderly people.
- joint arthroscopy – a thin telescope with a light (arthroscope) is inserted into joints via a small incision to investigate joint problems. This is most commonly the knee but other joints can also be investigated in this way. The arthroscope can be used to look for signs of arthritis and show possible damage to cartilage or ligaments. Minimally invasive surgery can be performed to repair damaged tissue by removing floating cartilage, torn ligaments or tissue around the joint that has become inflame
- bone fracture repair – surgery to repair a broken bone using metal screws, pins, rods or plates to hold the bone in place. Many different techniques are used depending on the location, severity and type of fracture to ensure that the bones are stable, heal correctly and maintain function. A bone graft may be used where the bone has been shattered
- arthroplasty – the replacement of whole joints following damage due to osteoarthritis or rheumatoid arthritis. Knee and hip replacements are the most common operations
- joint resurfacing – metal implants are used to re-surface the bone, for example for the hip joint. The head of the femur is re-surfaced with a metal dome and the hip socket is re-surfaced with various materials, meaning the bone is not cut or removed. Newer techniques such as partial knee resurfacing are being used for patients in the early stages of osteoarthritis
- general repairs on damaged muscles or tendons – these could be acute injuries due to trauma, or chronic injury due to progressive deterioration of the tissue
- corrective surgery – eg patella (knee-cap) realignment. These procedures correct problems of anatomical alignment which limit function and could cause long-term problems if left untreated. This surgery is often carried out on babies and children for congenital deformities