An orthopaedic trauma surgeon treats serious injuries to bones, joints and the soft tissues around them, particularly complex fractures, dislocations, pelvic injuries, open fractures and injuries involving more than one part of the body. They also manage complications such as a fracture that does not heal, heals in the wrong position or becomes infected.
Orthopaedic trauma is not the same as general trauma surgery. After a major accident, a multidisciplinary trauma team may treat life-threatening injuries to the chest, abdomen, head, blood vessels and limbs at the same time. The orthopaedic trauma surgeon focuses on the musculoskeletal injuries.
This article provides general information and does not replace an individual assessment by a qualified health professional.
Is a fracture the same as a broken bone?
Yes. Fracture and broken bone mean the same thing. Fractures vary greatly in pattern and severity. A small stable crack and a bone broken into several displaced pieces are both fractures, but their treatment and risks are different.
A fracture may be:
- closed, with the skin intact
- open, with a wound communicating with the broken bone
- displaced, with bone fragments no longer aligned
- intra-articular, extending into a joint surface
- comminuted, with the bone broken into multiple pieces
- stress-related, developing through repeated load rather than one accident
- fragility-related, occurring after low-force injury because bone strength is reduced
The description helps clinicians decide whether the bone can heal in an acceptable position with a splint or cast, or whether reduction and fixation may be required.
Which injuries does an orthopaedic trauma surgeon manage?
Complex limb fractures
This includes fractures of the upper arm, forearm, thigh, shin, ankle and other limb bones when alignment, stability, joint involvement or soft-tissue injury makes management more complex.
Pelvic and acetabular fractures
The pelvis protects major organs and carries body weight. The acetabulum is the socket of the hip joint. Injuries in this region can be associated with significant bleeding, nerve injury and damage to other organs, so they are often managed within a specialist trauma service.
Open fractures
An open fracture is an emergency because the wound and bone are exposed to contamination and infection risk. Treatment may involve urgent antibiotics, cleaning of damaged tissue, fracture stabilisation and coordination with plastic or vascular surgeons.
Fracture-dislocations and joint injuries
A joint may be dislocated at the same time as a nearby bone is fractured. Restoring alignment, stability and the joint surface can be technically demanding.
Multiple musculoskeletal injuries
After a high-energy accident, a person may have fractures in several limbs as well as chest, abdominal, head or spinal injuries. The trauma team plans the order and timing of treatment around immediate threats to life, the condition of the soft tissues and the patient's overall stability.
Problems after a fracture
Orthopaedic trauma surgeons may assess nonunion, where a fracture has not healed, and malunion, where it has healed in an unsatisfactory position. They may also manage infection, failed fixation, post-traumatic deformity or loss of function after a previous injury.
Which fracture symptoms need emergency care?
Healthdirect advises seeking medical attention if a fracture is suspected. Go to an emergency department or call an ambulance immediately if:
- bone is visible through the skin
- the limb has an unusual shape or colour
- bleeding is heavy
- pain is severe
- the injury followed a major accident
- the person is unconscious
- a head, neck or back injury may be present
Do not try to push a bone back into place. Keep the person still, control bleeding with care, support the injured area and follow emergency-service instructions. Call triple zero (000) for a serious emergency.
Does every fracture need an orthopaedic trauma surgeon?
No. Many uncomplicated fractures are treated effectively in an emergency department, fracture clinic or by a general orthopaedic service. Treatment can include a splint, cast, boot, activity restriction and follow-up imaging.
An orthopaedic trauma specialist is more likely to be involved when the injury is open, unstable, displaced, extends into a joint, involves the pelvis or acetabulum, has major soft-tissue damage, or occurs as part of multiple trauma. Local hospitals also differ in the services they provide and may transfer complex cases to a tertiary trauma centre.
How are serious fractures assessed?
Assessment begins with the mechanism of injury and an examination of the whole patient, not just the painful bone. Clinicians check circulation, sensation, movement, skin and swelling and look for other injuries.
Imaging may include:
- X-rays to identify the fracture pattern and alignment
- CT to show complex bone and joint anatomy in more detail
- MRI for selected stress injuries or associated soft-tissue problems
- vascular imaging when blood-vessel injury is suspected
Blood tests and other scans may be needed after major trauma or before surgery. The appropriate investigation depends on the injury and the person's overall condition.
How are fractures treated?
Non-surgical treatment
A stable fracture in an acceptable position may heal with immobilisation and monitored follow-up. The team checks that alignment is maintained and guides movement and weight-bearing as healing progresses.
Reduction
Reduction means restoring the position of a broken bone or dislocated joint. It may be performed without an incision under suitable pain relief or anaesthesia, or as part of an operation.
Internal fixation
Plates, screws, nails or wires can hold bone fragments while they heal. The implant choice depends on the bone, fracture pattern, soft tissues and load the limb must carry.
External fixation
A frame outside the body is connected to the bone with pins. It may be temporary while swelling, wounds or the person's overall condition improve, or it may be part of definitive treatment.
Staged treatment
Complex trauma may not be treated in one operation. Initial priorities can include controlling bleeding, cleaning an open wound and stabilising the limb. Definitive reconstruction may occur later when the patient and soft tissues are ready.
What happens during recovery?
Bone healing is only one part of recovery. Swelling, muscle loss, joint stiffness, nerve injury, skin damage and confidence can affect the return to function. The plan may include:
- wound and cast care
- instructions about how much weight can be placed through the limb
- physiotherapy and progressive movement
- occupational therapy for daily activities
- pain management
- blood-clot prevention when indicated
- repeat imaging to assess alignment and healing
- return-to-work and driving advice
Follow the treating team's restrictions rather than a general online fracture timeline. Weight-bearing too early can threaten fixation in one injury, while unnecessary immobilisation can delay recovery in another.
Why can a low-impact fracture need more than fracture care?
A fracture after a fall from standing height or another minor event can be a sign of osteoporosis or reduced bone strength. The immediate fracture still needs treatment, but preventing the next fracture is also important.
A GP or fracture liaison service may review bone density, falls risk, nutrition, medicines and other medical causes. This is particularly relevant for older adults and people with repeated fractures. Fixing the bone without assessing why it broke can miss an opportunity for prevention.
How do you find an orthopaedic trauma surgeon in Western Australia?
Urgent and major injuries are directed through the ambulance, emergency and hospital trauma systems; this is not a situation for comparing online profiles first. For a non-urgent opinion about a previous fracture, nonunion, malunion or post-traumatic problem, start with your GP and existing treating team.
If specialist review is recommended, you can compare orthopaedic trauma surgeons in Perth. BOS also has local listings for trauma surgeons in Murdoch and trauma surgeons in Joondalup.
Check the surgeon's current registration on the AHPRA register and confirm that their current practice includes your injury. A surgeon who treats routine joint replacement has a different focus from one who regularly manages complex fracture reconstruction.
Do you need a referral?
Emergency treatment does not wait for a routine GP referral. For a planned private specialist appointment, a valid referral is generally needed to claim the relevant Medicare benefit. WA public outpatient referrals are submitted by an eligible referrer and clinically triaged.
For a non-urgent appointment, read how orthopaedic referrals work in Australia. Bring the original imaging, operation reports, follow-up X-rays, a medicine list and a clear timeline of treatment and symptoms.
Questions to ask after a fracture
- What type of fracture is this?
- Does it involve the joint, nerves, blood vessels or important soft tissues?
- Why is surgical or non-surgical treatment recommended?
- How much weight can I place through the limb?
- What signs of infection, circulation problems or blood clot need urgent review?
- How will healing be monitored?
- When will rehabilitation begin?
- Should my bone health or falls risk be assessed?
Frequently asked questions
Is an orthopaedic trauma surgeon only for car crashes?
No. These surgeons treat complex musculoskeletal injuries from falls, sport, workplace incidents and other causes, as well as complications after a fracture.
What is the difference between a trauma surgeon and an orthopaedic trauma surgeon?
A general trauma surgeon coordinates and treats serious injuries, often involving internal organs. An orthopaedic trauma surgeon focuses on bones, joints and associated soft tissues. Both may be part of the same major-trauma team.
Can a broken bone heal without surgery?
Yes. Many stable fractures in acceptable alignment heal with a cast, splint or boot and monitored follow-up. Surgery is considered when alignment, stability, joint involvement, soft-tissue injury or other factors make non-surgical treatment less suitable.
When should a fracture that is not healing be reviewed?
Attend scheduled follow-up and contact the treating team if pain, swelling, wound problems or function worsen. If imaging shows delayed healing or symptoms persist beyond the expected course, the team may arrange specialist assessment for nonunion or another cause.