Lower limb trauma
Both UHSM and RMCH are designated ‘Trauma Centres’ and as such we have stream of patient being brought to our hub hospitals with lower limb trauma.
We also offer support to our surrounding orthopaedic units in providing soft tissue coverage to the more severe open tibial fractures.
- Low energy injuries and pretibial haematomata are frequently seen in our trauma clinics and undergo debridement and skin grafting if necessary or are followed in the complex wound clinic if either the patient or the wound is not suitable for operative intervention.
- High energy injuries, particularly Gustillo 2B open fractures are managed according to the joint BOA/BAPRAS guidelines and are fed into the care of one of our microsurgeons with a special interest lower leg free tissue transfer. We continually audit our adherence to the national guidelines.
- Limbs with a vascular injury are primarily managed by Plastic Surgery with a revascularisation technique if the patient presents to UHSM or RMCH, if the first presentation is off site the arterial continuity may be re-established by a local vascular surgeon prior to transfer.