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Ballarat Orthopaedics & Sports Medicine
Trauma Surgery Specialists
Ballarat Orthopaedics & Sports Medicine provide the vast majority of trauma surgery for Ballarat and the region. Much of the surgery is performed on an emergency basis at St John of God, or at Ballarat Health Services.
Some injuries are dealt with on a semi-elective basis – if adequate first aid is undertaken, it may be reasonable to have wrist and ankle fractures operated as day surgery, either at one of the above institutions, or Ballarat Day Procedure Centre.
We aim to use Rapid Recovery Surgery principles where possible.
We perform emergency surgery for both upper and lower limb injuries. Below are a collection of downloadable brochures for common injuries.
Wrist fractures are common occurrences. Traditionally, they were treated with plaster, after realigning the fracture. Six weeks in plaster cast is usually enough. This works reasonable well most of the time, and success can reasonable be predicted if there is no pain and a new x-ray at twelve days shows good alignment.
Some groups have bad outcomes. People with osteoporosis often have the fracture collapse. This can cause chronic pain.
Fractures into the joint if displaced are prone to post-traumatic osteoarthritis. Arthritis of the base of the thumb is worsened by a time in plaster.
Ankle fractures have obviously occurred for all times. Traditionally, treatment involved re-aligning the fracture, and then applying a plaster cast. Six weeks in a plaster cast is usually adequate.
This works reasonable well most of the time, and success could reasonably be predicted if there was no pain, and a new x-ray at twelve days shows good alignment. Generally, stiffness had resolved by three months, and full function returned.
Some groups have bad outcomes. People with osteoporosis often have the fracture collapse. This can cause chronic pain, fractures around the joint can lead to post-traumatic osteoarthritis. Not moving your ankle in plaster is prone to causing blood clots, which can be dangerous.
Bipolar Replacement for Neck of Femur Fractures
There are a variety of patterns to hip fractures, each has its own best way of treatment. The fracture you have is called a subcapital fracture of the femur.
Over the last 60 years, the standard of care for this has been Moore’s hemi-arthroplasty. Of recent years in Australia, we have searched for a better answer, with an increased chance of full recovery.
A variety of options exist. The bipolar hip replacement has the lowest chance of needing further surgery. It uses a normal total hip replacement stem, and a cup that bridges between the hip replacement head size, and the pelvic socket.
It has a lower dislocation risk than total hip replacement performed for fracture. We use an uncemented stem design – this reduces post-operative confusion, and slightly reduces the risk.
Supracondylar Femur Fracture
Supracondylar refers to the part of the femur just above the knee joint. In the 1960s treatment involved being treated in a traction bed for eight weeks, a fracture brace, then weight bearing might start again at 3 months from injury.
This often resulted in a loss of independence, and in some instances death, especially in the elderly. Early internal fixation devices didn’t get good fixation in the osteoporotic bone, and were prone to failure.
Osteoporosis is almost invariably part of the problem. Many patients also have vitamin D deficiency, delaying or preventing bone healing. The majority of patients are elderly, and sometimes their independence is threatened.
Our preferred solution allows: early relief of pain, no splinting, ability to get out of bed and early weight bearing. This gives us our best chance of return to full function and independence.