General

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When a bone's cortex is disrupted, it's termed fractured. Words like broken, cracked or buckled are also employed to signify the same condition - a fractured bone. The fracture is typically characterized by its site (e.g., bone) and orientation (horizontal, oblique, transverse). Fractures occur through diverse means. While many stem from trauma, some result from pathological issues or repetitive strain. Trauma ranges from severe incidents like car crashes to minor mishaps like slips and falls.

• Open or Compound Fracture – The skin overlying the fracture is also broken.
• Comminuted Fracture – The bone is broken into multiple pieces.
• Avulsion Fracture – A muscle or ligament pulls the bone away, fracturing it.
• Fracture Dislocation – When a fractured bone is associated with a dislocation of a joint.
• Pathological Fracture – A fracture through bone weakened by an underlying condition – e.g. cancer, osteoporosis.
• Stress Fracture – A fracture due to overuse; repetitive stresses and strains.

Fracture healing involves the formation of a calcified blood clot that binds the fractured bone segments. Proper recovery necessitates maintaining correct bone alignment and providing protection during the healing process. Treatment ranges from simple plaster casts to surgical realignment for displaced fractures. Failure to heal leads to non-unions, while incorrect healing results in mal-unions, both potentially requiring corrective surgery, such as limb reconstruction.

Limb reconstruction surgery, a subset of trauma and orthopedic surgery, focuses on rectifying deformities in upper and lower limbs, addressing limb defects, and employing techniques for limb equalization. Its primary goal is to optimize the function of limbs affected by deformities.

A range of modern surgical techniques are used to perform limb reconstruction surgery, including:

1. Conventional plate fixation
2. Locking plate fixation
3. Intramedullary Nailing
4. Circular fine wire external fixators
5. Bone Transport and limb lengthening
6. Angular and/or rotational correction
7. Joint Arthrodesis or reconstruction

The techniques used are customised for each individual case and often involve a combination of above techniques.

Common deformities :

1. Non-unions: Fractures that have failed to heal.
2. Mal-unions: Fractures that have healed in the wrong position.
3. Post-traumatic arthritis: Arthritis of a joint following a fracture or trauma.
4. Bone loss: Fractures that have lost bone at the time of accident or subsequent surgery.
5. Bone infection (Osteomyelitis): infected bone commonly associated near a site of previous injury or surgery.