Complex Fractures
About this PSP
Complex fractures are complicated breaks in bones which require specialist treatment. They include open fractures, pelvic fractures, a fracture into multiple pieces and multiple fractures at the same time. They make up a minority of the 1.8 million fractures that occur in England each year but cause significant problems for patients and are a large burden on healthcare resources.
The Complex Fractures PSP was established in 2019 and was a collaboration with AOUK and the Orthopaedic Trauma Society.
The Complex Fractures PSP Top 10 was published in June 2021.
Impact of Top 10s
Top 10 Priorities
- What is the best way to reduce the risk of infection after complex fractures?
- What is the optimal outpatient rehabilitation strategy for patients with complex fractures?
- What psychological support would be useful for patients with complex fractures and when?
- Is it possible to determine which patients will develop complications, arthritis and poor functional outcomes after complex fractures?
- What are the options for preventing and treating chronic (long-term) pain after complex fractures?
- What is important to patients recovering from complex fractures?
- What additional care and support is helpful for patients being discharged from hospital after a complex fracture?
- When is it better to replace, fix or fuse fractures around the ankle, knee or acetabulum (hip socket)?
- Can peer support (from other patients) be used to help patients with complex fractures?
- Can patients be provided with expected recovery times for functional recovery and return to life roles after complex fractures?
The following questions were also discussed and put in order of priority at the workshop:
- When is it safe to start weight-bearing and joint movement after a complex fracture?
- What information would be helpful to give to patients sustaining complex fractures and how would this be best delivered?
- In patients with multiple injuries, which fractures need fixing and when?
- What is the best way to predict which fracture-associated nerve injuries will recover without treatment?
- How can we assess and improve bone health after complex fractures to promote healing and prevent future fractures?
- What is the best strategy for preventing blood clots after complex fractures?
- What is the best bone defect reconstruction option in the acute treatment of complex fractures?
- Should metalwork routinely be removed after surgery and when?
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