Complex fracture patients are cared for by several types of specialists who provide unique expertise for these injuries. Our team approach ensures that you receive the best possible treatment through the use of cutting edge diagnostic tools combined with advanced soft tissue and bone reconstruction techniques. Imaging like 3D CT scans and digital tomography provide the best possible view of the fracture when planning for treatment. 3D imaging is being used at Penn to create custom 3D printed implants for patients with challenging reconstructions. Penn surgeons also use advanced reconstruction techniques beyond standard plates, screws and rods for highly complex patients.
Complex Fracture Care at Penn includes:
- Advanced 3D imaging for superior visualization
- 3D printed, custom fracture solutions
- Coordinated plan for soft tissue and bone reconstruction
- Ring fixation which is less invasive and has less risk for infection long term
- Dynamic fixation for fractures that require more flexibility for optimal recovery
- Implants impregnated with antibiotics for patients at high risk of infection
- Optimized bone growth by using biologics and the Masquelet technique which promote healing
Complex fractures are complicated and require a lengthy healing process from surgery to rehabilitation since more than just bones are impacted. It's important for treatment plans to be carefully designed since no two fractures are the same.
After debridement, which is the removal of dead tissue and cleaning of healthy tissue, stabilization may be accomplished through several ways: external, internal or ring fixation with extensive antibiotic coverage. Unlike other centers, Penn most often uses what is called external ring fixation which requires no implants or metal – eliminating the risk of implant infection.
Once the soft tissue and bone are stabilized, surgeons will evaluate the injury with additional studies and imaging and determine the best treatment plan including techniques and expertise from all specialties in the center including orthopaedic trauma, microvascular surgery, plastic surgery, and other specialties.
A treatment strategy may include a range of options including:
- Fracture fixation: A fracture fixation is a surgical procedure that stabilizes the affected limb, preparing for transfer or reconstruction.
- Debridement: Removal of dead tissue which is necessary for proper wound healing.
- Soft tissue coverage: Soft tissue coverage comes mostly from the patient’s own tissue. Surgeons use local tissue and grafts – usually taking a much smaller amount of skin or tissue than previously required to cover injuries.
- Revascularization: In cases of severe trauma, blood flow to affected tissues can be compromised resulting in necrosis--death of body tissue. Early treatment is critical. Using microvascular techniques, the Penn team is able to restore blood flow to the affected area and avoid amputation or more severe debridement (removal of damaged tissue).
- Fracture reconstruction: Surgery to fix a broken bone typically using metal screws, rods, or plates to hold the bone in place as it heals. In addition to traditional screws, Penn also uses state-of-the-art dynamic screws and plates for fractures in locations that require more flexibility for optimal healing. Penn also utilizes 3D printed implants for custom reconstruction.