Trauma & Orthopaedics

Ankle-fracture management is driven by skin and neurovascular status, mortise stability and patient factors: urgent reduction for deformity, appropriate radiographs and CT for complex patterns, weight-bearing treatment for stable injuries, and timely fixation or specialist non-operative care for unstable injuries.

Acute or rapidly progressive compression of the lumbosacral nerve roots below the spinal cord, threatening permanent loss of bladder, bowel, sexual and lower-limb function unless decompressed urgently.

Rising pressure inside a closed fascial compartment collapses the capillary perfusion gradient, so muscle and nerve die while the major artery stays patent and the distal pulse stays palpable.

Fracture complications range from immediate haemorrhage, neurovascular injury and compartment syndrome to later infection, venous thromboembolism and failure of union; serial assessment and rapid specialist escalation are the safety-critical skills.

A hip fracture is an orthogeriatric emergency: image promptly, control pain, correct reversible physiology without avoidable delay, and operate on the day of or day after admission with the operation matched to the fracture pattern and pre-fracture function.

A scaphoid fracture after a fall onto an outstretched hand can be occult on initial radiographs; immobilise clinical suspicion, obtain definitive imaging promptly, and escalate proximal or displaced injuries because retrograde blood supply makes non-union and avascular necrosis clinically important.

A traumatic glenohumeral dislocation is usually anterior after a fall onto an abducted, externally rotated arm; urgent controlled reduction depends on pre- and post-reduction neurovascular assessment and imaging, followed by rehabilitation and recurrence-risk review.