Trauma & Fractures

Fractures of the shoulder are an increasingly common problem, especially in older patients with osteopenia or osteoporosis – conditions which result in weakened bones. Sometimes these fractures will heal on their own without any intervention, but sometimes the fracture is bad enough to warrant fixation or replacement. Dr. Bushnell has extensive experience in shoulder fracture management, and he has presented numerous lectures about shoulder fractures at the national level.

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Shoulder Fractures and Dislocations
Common Shoulder Injuries
Shoulder Blade Fractures

Hip fractures are extremely common in the elderly population, and they usually occur as a result of a fall.  A hip fracture can be devastating to a person’s lifestyle, as these fractures have very high rates of complications if not treated with surgery.  Hip fracture prevention is thus critically important for older patients.

Several common patterns of hip fracture exist, and the geometry of the fracture determines the type of treatment.  Fractures involving the femoral neck (the “ball” of the thigh bone) often require either a partial or total hip replacement.  A partial hip replacement, or hemiarthroplasty, is the most common method of treating a femoral neck fracture.  If the bones are not significantly separated or displaced, a femoral neck fracture may be treated with screws, or percutaneous pinning.  Fractures may also involve the intertrochanteric region, or the upper part of the thigh bone below the ball area.  Fractures in this part of the bone are often treated with intramedullary nailing, or placement of a rod and screw into the bone.

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Hip Fracture Information Page

Hip Fractures

Hip Fracture Prevention

Intramedullary Nailing of the hip involves the placement of a long metal rod into the thigh bone, followed by a large single screw up into the femoral head, or the “ball” of the hip joint.  A smaller screw is then placed at the end of the rod in order to stabilize it.  This procedure requires three relatively small incisions on the side of the leg.  Because of the strength of the rod supporting the fractured hip, the patient is able to walk immediately after surgery.

Fractures of the ankle are common injuries sustained in sports, recreation, and accidental falls.  Most people cannot walk on a broken ankle.  Ankle fractures often involve a break of both bones of the ankle – the smaller fibula on the outer side of the ankle, as well as the larger tibia on the inner side of the joint.  A broken fibula usually requires treatment with a plate and screws.  A broken tip of the tibia usually requires treatment with screws.  Sometimes a cast will suffice for treatment of an ankle fracture.  Dr. Bushnell has treated ankle fractures in all kinds of situations – from simple missteps to major injuries from skydiving and rodeo accidents.

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Ankle Fractures

Fractures around the knee can involve the thigh bone (femur), the kneecap (patella), or the shin bone (tibia) – or a combination of these bones.  Knee fractures sometimes do not require anything more than a brace or a cast and a few weeks on crutches.  Many times, however, fractures of the knee bones can be very serious injuries that require major surgery to repair.  Dr. Bushnell has extensive experience with the treatment of knee fractures.

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Femur/Thighbone Fracture at the Knee

Tibia/Shinbone Fracture at the Knee

Falls onto an outstretched hand can result in a fracture of the wrist.  Usually, the distal radius, or the end of the large forearm bone, is the most common site of the fracture.  These injuries occur in all age groups, but tend to be more common in children and in older patients.  In children, a cast will usually suffice as the mainstay of treatment – although a closed reduction, or “setting” of the break, may be necessary.  In older patients, casts are also common – but surgical treatment may be recommended depending on the pattern and severity of the fracture.  Dr. Bushnell has extensive experience with the treatment of wrist fractures, and has published several articles about this topic in the international literature.

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Broken Wrist

Hip Pinning, also known as “percutaneous screw fixation of the hip,” is a procedure in which the surgeon inserts 3 screws to stabilize the femoral head, or the “ball” of the hip, to the upper part of the thigh bone, or the “neck” of the hip.  After placement of the screws, the fractured hip is stable enough to bear weight – allowing patients to begin walking immediately after surgery.  Although the fracture still has to heal, this procedure usually can be done through a minimally invasive incision of about 3-4cm.

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Hip Pinning Surgery (E-Orthopod)