Fracture & Trauma Care
Urgent orthopedic trauma care with Dr. Steven Ward in Tucson and Oro Valley — external fixation, emergency surgery for compartment syndrome, washing out infected wounds and joints, and putting dislocated joints back in place.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
Some injuries and infections need urgent surgery before, or instead of, a planned repair. This page covers:
- Open fractures — a wound near a broken bone lets bacteria in, so the wound and bone must be cleaned promptly
- Severe fractures with badly injured skin and muscle, or patients with multiple injuries who are not yet ready for a long surgery
- Acute compartment syndrome — dangerous pressure building inside the muscles after a fracture, crush injury, or tight cast
- Infections — infected wounds, abscesses, and septic arthritis (an infected joint that is typically warm, red, swollen, and very tender)
- Dislocations of the shoulder, elbow, hip, knee, or finger joints
Is surgery right for you?
These are usually not “wait and see” problems. In general:
- Open fractures almost always need surgery, along with antibiotics and a tetanus booster in the emergency room
- Acute compartment syndrome has no effective non-surgical treatment
- An infected joint usually needs drainage along with antibiotics; fluid drawn from the joint with a needle confirms the diagnosis
- Dislocations are usually put back in place without an incision (a closed reduction) in the emergency room with sedation, then splinted; surgery is needed if the joint will not go back, will not stay in place, or has a fracture that needs repair
Go to the nearest emergency room for a bone through the skin, a limb that is deformed, cold, or numb, severe pain that keeps getting worse after an injury, or a hot, swollen, very painful joint with fever.
How the surgery is done
- Irrigation and debridement (I&D) — dirt, dead tissue, and infected material are removed and the area is washed out. For septic arthritis, the joint is washed out through an arthroscope or an open incision. More than one washout is sometimes needed
- External fixation — pins placed through the skin into the bone above and below the break are connected to bars outside the limb. The frame holds the bone while the skin and swelling recover, and is usually swapped for internal fixation later; occasionally it stays until the bone heals
- Fasciotomy — for compartment syndrome, the skin and the tight covering over the muscles are opened to relieve pressure. The wound is often left open at first and closed, or covered with a skin graft, after swelling goes down
- Dislocation reduction — the joint is put back in place, closed if possible or open if needed, and torn ligaments or broken pieces are repaired when necessary
Living with an external fixator
Keep the pin sites clean exactly as you are taught, and watch for redness, drainage, or loosening around a pin. The frame is removed in a later procedure.
Large wounds may be covered with a sealed dressing, and sometimes antibiotic beads, until they can be closed with stitches, a skin graft, or a muscle flap.
Recovery overview
Recovery depends entirely on the injury, and Dr. Ward will give you a plan for your situation. These are general expectations based on AAOS OrthoInfo patient education.
In the hospital
- Antibiotics, tetanus protection, and pain control
- Some injuries need a second or third trip to the operating room for more cleaning, final fixation, or wound closure
- Physical therapy starts as soon as it is safe
Weeks to months
- Follow weight-bearing and splint instructions exactly
- Pin site and wound care as taught
- Infections may need a longer course of antibiotics; your team will decide the type and length
Long term
- Stiffness, discomfort, and weakness can keep improving for a year or more after a severe injury
- Fractures of the lower leg, where the bone is just under the skin, often heal more slowly
- Bone infection can become chronic and need further surgery, so keep all follow-up visits
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision or pin site, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- Fingers or toes that turn pale, blue, or cold, or numbness or tingling that does not go away once the anesthesia has worn off
- A cast, splint, or dressing that feels too tight: throbbing pain, swelling, or numbness under it that does not ease after you raise the arm or leg above your heart. Do not cut or remove a cast yourself
- Pain that is not controlled by your prescribed medication, elevation, ice, and rest
- Pain, swelling, or tenderness in the calf that is new or getting worse
- Redness, drainage, or loosening around an external fixator pin
It is normal to have swelling, bruising, and soreness for a while after surgery, and for the arm or leg to feel numb or weak until a nerve block or spinal anesthetic wears off. Follow your weight-bearing and splint instructions exactly. Call if something feels different from what you were told to expect.
Severe pain that keeps getting worse and is far more than expected, pain that gets much worse when you move or gently stretch your fingers or toes, or a arm or leg that feels very tight or full, especially with tingling or burning. Pressure building inside the muscles is a surgical emergency. If a splint is held with an elastic wrap, loosen the wrap, but do not remove a hard cast yourself.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Hip fracture
Dr. Ward’s broken-hip page: fracture types, partial vs. total hip, nails, and the recovery plan.
Open pagePhysical therapy locations
Find a physical therapy clinic near you in Tucson and Oro Valley.
Open pagePost-op packets
Dr. Ward’s post-operative instructions and packets, organized by joint.
Open pageExercise guides
Printable home exercise programs to use with your physical therapist.
Open pageOrthoInfo: Open fractures
Patient education on open fractures, external fixation, and wound care from the AAOS. OrthoInfo also has a page on compartment syndrome.
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