Many trauma patients sustain injuries to other parts of their bodies, so we work closely with the general surgery trauma service. We also work in conjunction with plastic surgeons in cases of complex soft-tissue injuries and with vascular surgeons when injuries occur in the large blood vessels.

Injuries we treat

Non-surgical Treatment

Some fractures and dislocations--particularly in the clavicle, scapula, humerus, wrist, hand and foot--can be treated nonoperatively (without surgery). These fractures can often be healed with casts, braces, or splints. We have two orthopaedic technologists in the Hillcrest Orthopedic Clinic, both of whom have extensive experience. Additionally, we work closely with physical therapists to optimize early range-of-motion in the joint to prevent stiffness and weakness.

Minimally Invasive Procedures and Techniques

• External Fixation - External fixation involves the placement of pins into bone and then connecting the pins to bars on the outside of the skin. This is often temporary and used when it’s unsafe to perform definitive surgery immediately, as in the case of periarticular fractures (those in and around joints), where soft tissue swelling may preclude early surgery. Other types of external fixators (small wire fixators) are used for certain nonunions (fractures that do not heal), malunions (fractures that do not heal in the correct alignment) and bone transport.
  
  
• Intramedullary rodding - commonly used for fractures of the femur and tibia. This procedure is done with small incisions and often allows patients to bear weight on the extremity soon after the surgery. The rod is placed inside the canal of the bone and then screws are placed through the rod and bone to maintain alignment of the limb. Additional casting is not needed.
• Plates and screws - This is most often done when the break is in or near a joint, which includes certain shoulder and elbow fractures, forearm fractures, hip fractures, knee fractures, and ankle fractures. The fracture is reduced to its proper position, and a plate with screws is used to hold the fracture in place until it heals. Most often, additional casting is not needed and patients are allowed to begin moving their joints soon after surgery.
  
  
• Minimally invasive plate fixation -- This is an advanced technique that involves placing plates and screws through small incisions.  This allows for smaller scars, less soft tissue problems, and faster healing.

When indicated, we use the newest technology in plating, which includes locking plates--the screws lock into the plate so they cannot loosen--and periarticular plates, which are specially designed pre-contoured plates that make hardware problems less common.

Initial Consult or Evaluation

To schedule an appointment, patients may contact:

• La Jolla: (858) 657-8200
• Hillcrest: (619) 543-6312

To transfer patients, the attending physician on call can be paged at (619) 543-6222.