What are Complex Fractures?

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Complex fractures are rare variety of fractures. They are usually caused by high speed injuries like fall from height or high velocity road traffic accidents. They are very difficult to manage and require special expertise.

What are problems associated with complex fractures?

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• There are multiple bone pieces in a single fracture.
• Often multiple bones are involved at a time.
• In many cases, the fractures also extend into the nearby joint.
• In some instances, there is a wound near fracture site from which bone pieces may come out with severe bleeding.
• Often, adjacent muscles,ligaments, blood vessels or nerves may be damaged.
• There is often severe injury to the overlying skin with multiple blisters and abrasions.

What are the problems during recovery of these fractures?

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• There may be chances of delayed healing or non-healing of the fracture which may often require repeat surgeries.
• Often, infection may occur within the wound in open fractures, which may hamper healing.
• These fractures often extends to joints and due to multiple pieces, early movements may not be possible. This often leads to stiffness in the joint requiring prolonged physiotherapy.
• Associated injuries like ligaments, nerves or blood vessel also require particular surgeries and may cause temporary or permanent disability.
• Skin damage during the injury may cause wound problems after surgery.
• At long term, there are chances of arthritis of the affected joints. Arthritis is more common if the joint is not restored properly during the surgery.

Why do you need to consult a specialist in complex trauma?

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As mentioned, complex fractures are associated with multiple problems and if not properly managed, they will require multiple surgeries. Even after these surgeries, you may not get 100% result in incompetent or inexperienced hands.

In hands of a specialist complex trauma surgeon, the chances of full recovery with minimum numbers of surgeries are maximum. A specialist surgeon assesses your case as a whole along with meticulous attention to each and every injury. All problems are sorted out with the best available management for your case.

That is where we offer our expertise with a team having a vast 30 years of combined experience of more than 20000 surgeries.

Our fundamental points in management of complex surgeries include

• Round-the-clock availability of services with trained staff for emergency primary management of the injury
• Prompt consultation by the specialist for assessment of all injuries for the decision of definitive management
• Use of all available and necessary investigation for perfect management of the injuries (like 3D CT scan/ MRI/ Angiogram/ Doppler)
• Transparent counseling and discussion with relatives at prioritized basis regarding the available treatment options with advantages and disadvantages of each of them to help chose the best available option
• The course of the treatment, approximate recovery time as well as all possible complication that have or may occur are also discussed openly and transparently.
• The best implants are used including imported implants whenever feasible to give the long lasting results.
• Restoration of the joint is given utmost important for prevention of development of arthritis at later stage.
• Whenever possible, minimally invasive approaches are preferred so that scar is minimum.
• We prefer earliest mobilization of the adjacent joints depending upon the fracture type for earlier and full functional recovery and minimum dependence on physiotherapy.
• Constant improvement in surgical skills as well as treatment modalities with implementation of newer techniques at earliest.



With all these principals, we have been able to provide excellent results to all our patients and will hope to continue the same.




Why do you need to consult a specialist in complex trauma?

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The recovery time most commonly depend upon the site and type of the fracture along with initial severity of the injury. Apart from that, the skill of the surgeon and surgical technique also affects the recovery time.

Usually, you will be able to walk with support and do your daily needs like washroom within the first week in majority of the cases. The decision to put weight on the leg or lift weight will depend upon the site and type of fracture and usually ranges from 4 weeks to 12 weeks.




Why do you need to consult a specialist in complex trauma?

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Often the things are not in our hands and you may meet with certain problems. You may need particular repeat surgeries depending upon the problem.




No	Problem	Solution
1	Infection	1. Frequent dressing for a longer period of time  2. Debridement of the infected wound  3. Removal of metallic implants in some cases
2	Delayed Union	1. Removal of certain screws from the bone  2. Injection of bone marrow at the fracture site  3. Taking extra bone from the body and application at fracture site (Bone grafting) with or without application of extra implant  4. Removal of failed implants and application of new implants
3	Stiffness	1. Prolonged physiotherapy sessions with expert physiotherapist   2. Procedure of manipulation of the joint under anaesthesia   3. Rarely, surgical excision of fibrous adhesions may be necessary
4	Injuries of Associated   Structures	1. Emergency repair of blood vessels   2. Reconstruction of ligamentous injuries   3. Repair or tendon transfer surgeries for nerve injuries
5	Wound Problems	1. Prolonged dressings for wound healing   2. Plastic surgeries in certain cases
6	Arthritis	1. Joint replacement surgery in major joints  2. Excision of bone or fusion of the joint may be required in certain cases