Rib Fractures

Shoulder Fractures

Elbow/ Forearm Fractures

Wrist Fractures

Pelvis Fractures

Hip/ Femur Fractures

Knee/ Tibial Fractures

Ankle/ Foot Fractures

 Most fractures that Orthopaedic surgeons treat can be managed with a period of immobilization in a cast and then gradual progression of range of motion and function with time.  Each fracture is different, some fractures such as radial head fractures often don’t require a cast while others such as tibial plafond fractures often require surgical treatment.  My philosophy of fracture treatment is based on three principles: The personality of the fracture, the overall health of the patient and my ability as a surgeon to treat you each of which I will address below.  Although I take care of many of the tougher fractures and fracture problems  that develop, I am fairly conservative with regard to surgical intervention and proceed with or recommend surgery only when there is a clear advantage to surgical repair. 

For me the most important part of treating my patients is that they feel comfortable and confident with me as their surgeon, I think the face to face meeting and discussions are a very important part of the whole equation. I will rarely make a recommendation just looking at an x-ray because I need to include other factors, listed above, in my decision making process. My pledge to my patients is to be as objective, honest and forthright as possible about your care and if I don’t know the answer then I will be comfortable telling you “I don’t know”.

The personality of the fracture refers to the amount of energy that the involved area has absorbed as a whole. Just as car accidents run the spectrum from minor to severe, so does each type of fracture that I treat.  If the bone is badly splintered on x-ray and the patients skin is blistered from a fall from a height, this is a much more difficult problem to treat than a low energy twisting injury causing a non-displaced spiral fracture.  In general, the more severe the injury, the less likely that it will heal without some kind of intervention and in my experience it is far better to handle fracture problems proactively.

The overall health and occupation of my patients is certainly a consideration.  The treatment of a proximal humerus fracture in the dominant arm of a 40 year old worker and one in the non dominant arm of a sedentary 85 year old woman are often very different. The goal of the worker is complete recovery at the earliest possible time frame and a very long time horizon, while the goal of treatment in the 85 year old may be centered on pain relief.  I discuss these considerations with all my patients before rendering an opinion.

Finally, my abilities as a surgeon play a role in my recommendations. There are some fractures that I feel I can obtain better functional outcome with surgery and there are some that I may refer to another specialist for a second opinion. If I don’t recommend surgical treatment, I will be honest with you about that opinion.  I don’t want my patients to think I recommend surgery for everyone.