Trauma & Fracture Surgery in Thane

1. Road Traffic Accidents

Road accidents involving cars, motorcycles, bicycles or pedestrians can cause high-energy injuries.

These may include fractures of the thigh bone, shin bone, pelvis, arms or other skeletal structures.

Severe accidents may also damage surrounding muscles, ligaments, nerves and blood vessels.

2. Falls and Slip Injuries

Falls are a common cause of fractures, especially among older adults.

A fall onto an outstretched hand may cause a wrist fracture, while a fall onto the hip may lead to a hip fracture.

Age-related changes in bone density can increase fracture risk.

3. Sports Injuries

Sports involving running, jumping, collisions or sudden changes in direction can cause fractures and joint injuries.

Common examples include ankle fractures, wrist fractures, shoulder injuries and fractures associated with contact sports.

4. Workplace and Industrial Accidents

Falls from heights, heavy equipment injuries and crushing accidents can result in complex fractures.

These injuries may involve multiple bones and significant soft-tissue damage.

5. Osteoporosis-Related Fractures

Osteoporosis reduces bone strength, increasing the likelihood of fractures following relatively minor trauma.

Common sites include the hip, wrist and spine.

Treatment may involve both management of the fracture and evaluation of underlying bone health.

6. Repetitive Stress Injuries

Repeated loading of a bone can cause small cracks known as stress fractures.

These injuries may affect athletes, runners or individuals who suddenly increase their physical activity.

Most stress fractures are treated non-surgically, although selected high-risk injuries may require surgery.

7. Direct Impact or Trauma

A direct blow from an object, collision or physical injury can cause a bone to fracture.

The resulting fracture may be simple or complex depending on the force and location of impact.

1. Closed Fracture

A closed fracture occurs when a bone breaks without an associated opening in the skin.

The fracture may be stable or displaced, and treatment depends on the degree of damage.

2. Open Fracture (Compound Fracture)

An open fracture occurs when a broken bone communicates with the outside environment through a wound.

These injuries carry an increased risk of infection and require urgent hospital assessment.

Treatment commonly involves antibiotics, wound cleaning, surgical debridement and fracture stabilisation.

3. Displaced Fracture

A displaced fracture occurs when broken bone fragments move out of their normal alignment.

Some displaced fractures can be repositioned without surgery, while others require surgical fixation.

4. Comminuted Fracture

A comminuted fracture occurs when a bone breaks into three or more fragments.

These injuries are often associated with significant trauma and may require advanced fixation techniques.

5. Intra-Articular Fracture

An intra-articular fracture extends into a joint surface.

Accurate assessment and restoration of joint alignment are important because untreated joint irregularities may contribute to stiffness and post-traumatic arthritis.

6. Stress Fracture

A stress fracture develops due to repetitive loading rather than a single major injury.

Treatment generally focuses on reducing stress on the affected bone and allowing appropriate healing.

7. Fragility Fracture

A fragility fracture occurs following low-energy trauma, often in individuals with osteoporosis.

These fractures commonly affect the hip, wrist, spine and upper arm.

8. Nonunion or Malunion Fracture

Nonunion occurs when a fracture fails to heal as expected.

Malunion occurs when the bone heals in an incorrect position.

Selected cases may require corrective surgery, bone grafting or revision fixation.

1. Hip Fractures

Hip fractures are particularly common among older adults following falls.

Patients may experience severe hip pain, difficulty standing or inability to bear weight.

Depending on the fracture type, treatment may involve:

• Internal fixation with screws
• Dynamic hip screw fixation
• Intramedullary nailing
• Partial or total hip replacement in selected cases

The treatment aims to stabilise the injury and help patients regain mobility.

2. Femur Fractures

A femur fracture affects the thigh bone, one of the strongest bones in the body.

These fractures often result from high-energy trauma in younger patients or low-energy falls in patients with weakened bones.

Many adult femoral shaft fractures require surgical fixation using an intramedullary nail or another appropriate implant.

3. Tibia and Fibula Fractures

The tibia and fibula are the two bones of the lower leg.

Fractures may occur following road accidents, falls, sports injuries or direct trauma.

Treatment options include casting, intramedullary nailing, plate fixation or external fixation.

4. Ankle Fractures

Ankle fractures may involve one or more bones forming the ankle joint.

Symptoms include pain, swelling, bruising and difficulty standing or walking.

Unstable or displaced fractures may require fixation with plates and screws to restore joint alignment.

5. Wrist and Distal Radius Fractures

Wrist fractures frequently occur when someone falls onto an outstretched hand.

Treatment may involve a splint, cast, fracture reduction or surgical fixation with a plate and screws.

6. Shoulder and Proximal Humerus Fractures

Fractures near the shoulder can occur following falls, sports injuries or accidents.

Some fractures can be treated with a sling and rehabilitation, while displaced or complex injuries may require surgery.

7. Forearm Fractures

Fractures of the radius or ulna may affect forearm rotation and arm function.

In adults, displaced fractures involving the shafts of both bones often require accurate reduction and internal fixation.

8. Pelvic and Acetabular Fractures

Pelvic fractures may result from severe trauma or fragility-related falls.

Certain injuries can involve significant internal bleeding, requiring emergency trauma care.

Complex pelvic and acetabular fractures may require specialist surgical management at an appropriately equipped centre.

9. Clavicle Fractures

Collarbone fractures commonly occur after falls onto the shoulder or direct impact.

Many heal without surgery, although selected displaced or unstable fractures may benefit from surgical fixation.

10. Multiple or Complex Fractures

Some patients sustain injuries involving several bones or joints.

These injuries require a coordinated approach involving fracture stabilisation, assessment of associated injuries and rehabilitation planning.

1. Clinical Examination

Dr. Girish Dhanawat evaluates the patient's symptoms, injury history, swelling, deformity and ability to move the affected part.

The examination may include assessment of circulation, nerve function and surrounding soft tissues.

2. X-Ray Examination

X-rays are commonly the first imaging investigation used to diagnose fractures.

They help identify:

• Location of the fracture
• Number of bone fragments
• Degree of displacement
• Bone alignment
• Involvement of nearby joints

3. CT Scan

A CT scan may be recommended for complex fractures, particularly those involving joint surfaces, the pelvis or multiple bone fragments.

It provides detailed information that can assist surgical planning.

4. MRI Scan

MRI may be useful when a fracture is not clearly visible on initial X-rays or when associated ligament, cartilage or soft-tissue injuries are suspected.

5. Additional Medical Investigations

Blood tests and other investigations may be required before surgery, depending on the patient's condition and the nature of the injury.

Patients with fragility fractures may also benefit from osteoporosis evaluation.

1. Non-Surgical Fracture Treatment

Some fractures heal successfully without surgery.

Non-operative treatment may include:

Casting and Splinting

A cast or splint holds the injured bone in a stable position while healing occurs.

Bracing

A brace provides support while allowing selected controlled movements when appropriate.

Closed Reduction

Closed reduction involves repositioning displaced bone fragments without making a surgical incision.

Activity and Weight-Bearing Restrictions

Patients may need temporary support using crutches, a walker or other aids.

Physiotherapy

Rehabilitation helps restore movement and strength once it is safe to begin.

2. Open Reduction and Internal Fixation (ORIF)

Open Reduction and Internal Fixation is a surgical procedure used to realign and stabilise broken bones.

During surgery, the orthopaedic surgeon accesses the fracture, restores alignment and secures the fragments using implants such as plates and screws.

ORIF may be considered for:

• Displaced fractures
• Unstable fractures
• Selected fractures extending into joints
• Fractures that cannot maintain alignment in a cast
• Certain complex injuries

The implants hold the bone fragments in position while natural healing takes place.

3. Intramedullary Nailing

Intramedullary nailing involves placing a metal rod inside the central canal of a long bone.

It is commonly used for selected fractures of the femur and tibia.

The nail stabilises the fracture and helps maintain alignment during healing.

4. External Fixation

External fixation uses pins inserted into the bone and connected to a supporting frame outside the body.

It may be used for:

• Severe open fractures
• Significant soft-tissue injuries
• Selected unstable fractures
• Temporary stabilisation following major trauma
• Situations requiring staged surgical treatment

The external fixator may be temporary or definitive, depending on the injury.

5. Percutaneous Fracture Fixation

Certain fractures can be stabilised using screws, pins or other implants inserted through relatively small incisions.

The suitability of this technique depends on fracture pattern and the ability to achieve appropriate alignment.

6. Bone Grafting and Revision Fracture Surgery

Some fractures fail to unite or heal in an incorrect position.

Selected patients may require revision fixation, bone grafting or corrective osteotomy to improve stability and promote healing.

7. Fracture Treatment with Joint Replacement

Certain fractures, particularly displaced femoral neck fractures in older adults, may be treated with partial or total hip replacement rather than conventional fixation.

The choice depends on age, mobility, fracture characteristics and overall health.

Step 1: Initial Trauma Assessment

The treating team evaluates the patient's overall condition and checks for associated injuries.

For major trauma, stabilisation of breathing, circulation and other potentially life-threatening problems takes priority.

Step 2: Fracture Evaluation and Imaging

X-rays or other appropriate imaging studies are used to assess fracture location, displacement and severity.

The surgeon evaluates surrounding tissues, circulation and nerve function.

Step 3: Surgical Planning

The surgeon determines whether the fracture requires immediate surgery, temporary stabilisation or planned fixation.

The selection of implants and technique depends on the fracture pattern and patient condition.

Step 4: Anaesthesia and Preparation

The patient receives appropriate anaesthesia.

The surgical team follows infection-prevention procedures and prepares the affected area.

Step 5: Fracture Reduction

The broken bone fragments are carefully repositioned to restore appropriate alignment.

This may be performed through an incision or by indirect techniques, depending on the operation.

Step 6: Fracture Fixation

The surgeon stabilises the fracture using suitable implants, which may include:

• Plates
• Screws
• Intramedullary nails
• Pins or wires
• External fixation devices

The fixation method is selected according to the injury.

Step 7: Alignment and Stability Assessment

The surgeon checks the position of the bone and implants, often using intraoperative imaging.

The aim is to achieve stability while protecting surrounding structures.

Step 8: Wound Closure and Postoperative Monitoring

The surgical wound is closed when appropriate, and the patient is monitored after the procedure.

Open fractures and injuries with significant tissue damage may require additional wound procedures.

Step 9: Rehabilitation and Follow-Up

Rehabilitation begins when medically appropriate.

Follow-up assessments help monitor fracture healing, implant stability and recovery of movement.

Restoration of Bone Alignment

Surgical fixation helps reposition displaced bones and restore appropriate anatomical alignment.

Improved Fracture Stability

Implants can maintain bone position while healing occurs.

Restoration of Joint Function

Accurate reduction of certain fractures involving joints may help preserve movement and reduce long-term functional limitations.

Support for Earlier Rehabilitation

Stable fixation may permit earlier controlled movement in selected patients, although weight-bearing restrictions may still be required.

Management of Complex Fractures

Surgical procedures can help treat injuries that are difficult to manage with casting or bracing alone.

Reduced Risk of Selected Complications

Appropriate fracture fixation may reduce the risk of certain alignment-related problems in selected cases.

First 2 Weeks

Patients may need a cast, splint, brace, walker or crutches depending on the fracture.

The main priorities include wound care, prescribed medication, follow-up and protection of the injured bone.

Weeks 3–6

Bone healing progresses gradually.

Selected patients may begin or advance controlled joint movement and muscle exercises under medical guidance.

Weight-bearing restrictions may continue.

Weeks 6–12

Many uncomplicated fractures show substantial healing during this period, although not all injuries heal within 12 weeks.

Follow-up X-rays may be used to assess progress and determine whether activity can be increased.

Three to Six Months

Patients with more significant fractures may continue rehabilitation to improve strength, joint movement and functional independence.

Some return to work and daily routines during this period, depending on the demands of their activities.

Long-Term Recovery

Complex fractures, open injuries and fractures involving joints may require six months to a year or longer for functional recovery.

Fracture healing and recovery of normal strength do not always occur at the same time.

Type and Severity of Fracture

A straightforward fracture requiring fixation may involve different costs from a complex fracture involving multiple bones or joint surfaces.

Surgical Procedure

Costs vary depending on whether treatment involves plates and screws, intramedullary nailing, external fixation or revision surgery.

Implant Selection

Different implant materials, designs and manufacturers may have different costs.

Hospital Facilities

Hospital category, room type, operating theatre charges and duration of admission influence the total expense.

Emergency or Complex Trauma Care

Major trauma requiring urgent intervention, intensive monitoring or multiple specialists may involve additional costs.

Diagnostic Investigations

X-rays, CT scans, MRI scans and preoperative investigations may contribute to the overall cost.

Surgeon and Anaesthesia Charges

Professional fees depend on the procedure and treatment setting.

Physiotherapy and Rehabilitation

Postoperative rehabilitation, medication, follow-up imaging and additional treatment requirements may affect expenses.

Insurance Coverage

Many medically necessary fracture treatments may qualify for insurance coverage, subject to policy terms, exclusions, limits and approval requirements.

Orthopaedic Evaluation and Treatment Planning

Dr. Girish Dhanawat, MBBS, D. Ortho., is an Orthopedic Surgeon and Joint Replacement Specialist in Thane who provides evaluation for bone, joint and musculoskeletal conditions.

Individualised Fracture Assessment

Every fracture is different.

Treatment planning takes into account the fracture location, severity, bone quality, soft-tissue condition and patient's functional requirements.

Surgical and Non-Surgical Treatment Options

Patients can receive guidance regarding immobilisation, fracture reduction, surgical fixation and other appropriate treatment pathways.

Focus on Bone Alignment and Healing

Fracture management aims to restore alignment, maintain stability and support natural healing.

Patient Education and Communication

Patients are guided through their diagnosis, treatment alternatives, expected healing period and rehabilitation requirements.

Rehabilitation and Follow-Up Guidance

Recovery planning focuses on regaining movement, strength and functional independence while protecting the healing fracture.