Orthopedic Services
General Orthopedic Topics
Arthroscopy has revolutionized the treatment of joint injuries.
In the past, treatment of orthopedic injuries involved extensive surgery, including large incisions, a hospital stay, and a prolonged recovery period.
But today, with the help of an arthroscope, today's orthopedic surgeon can easily examine, diagnose, and treat problems in the joint that previously may have been difficult to identify.
The arthroscope is a small fiber-optic viewing instrument made up of a tiny lens, light source and video camera.
The surgical instruments used in arthroscopic surgery are very small (only 3 or 4 mm in diameter), but appear much larger when viewed through an arthroscope. Shown at right -- both as it appears on the operating table and when viewed arthroscopically -- is a probe, used for examination of internal structures (in this case the underside of a patella, or kneecap).
The surgeon inserts the arthroscope into the joint through a tiny incision (about 1/4 of an inch) called a portal. Two or three incisions may be made for portals. Other portals are used for the insertion of surgical instruments, such as the probe shown above. Typical incision sites and sizes for knee arthroscopy are shown at left. These incisions result in very small scars which in many cases are unnoticeable.
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Hit by a speeding forklift, a warehouseman suffers crushing injures to his legs and feet...A construction worker falls from a scaffold breaking both wrists and one elbow... A machinist is struck by the pieces of a shattered grinding wheel resulting in multiple fractures and penetrating wounds to his right arm and both legs...
All are faced with serious, limb-threatening, life altering injuries.
Managing the traumatically injured patient, especially those with multiple orthopedic injuries, often presents unique medical challenges. These patients often require immediate treatment at unpredictable hours such as nights, weekends and holidays. Treatment must often be initiated without the benefit of detailed history and physical examination, a pre-existing doctor-patient relationship, or insurance authorizations.
These patients typically need thoughtful, timely intervention to minimize complications, speed recovery, and return the patient to maximum functional capability. In patients with open fractures, emergent irrigation and debridement of the traumatic wounds is necessary. Most displaced unstable fractures require surgical stabilization. This often involves the use of implants such as plates and screws, intra-medullary nails, and external fixators.
When is a Trauma Specialist Needed?
Injuries requiring the intervention of a trauma specialist are generally acute in nature, although trauma specialists are often called upon to evaluate the chronic effects of past trauma. Patients with the following acute and chronic conditions may benefit from referral to a trauma and fracture care specialist:
Fractures of upper or lower extremities
Complex periarticular injuries
Pelvic and acetabular fractures
Complex femoral fractures
Multiple injuries
Injuries requiring internal or external fixation
Injuries caused by falls, impacts or penetrating objects
Injuries requiring post-traumatic bone reconstruction
Nonunions and malunions
Infections and osteomyelitis
