What Is Trauma Surgery?
Mr Shanmugasundaram Rajkumar is a Consultant Trauma and Orthopaedic Surgeon based in Glasgow. He has seventeen years of consultant experience in complex trauma care alongside hip and knee surgery. Patients across Glasgow and the wider west of Scotland are seen for assessment of fractures and joint injuries. They are also seen for the longer-term consequences of previous trauma, including stiffness, deformity, persistent pain and post-traumatic arthritis.
Trauma surgery is a surgical treatment used to stabilise and repair injuries to bones and joints. It also treats ligaments, tendons and the surrounding soft tissues. The purpose is not simply to fix a break. It’s about restoring alignment, protecting the joint surfaces and allowing early, controlled movement where that is safe to do.
Depending on the injury, surgery may involve:
- Internal fixation: holding the bone in position with plates, screws, wires or intramedullary nails placed inside the body.
- External fixation: a temporary frame outside the limb, sometimes used for severe or contaminated injuries before definitive surgery.
- Soft tissue repair or reconstruction: repairing torn ligaments, tendons or the joint capsule where injury has caused instability.
- Joint replacement after trauma: for some hip fractures and severely damaged joints, replacing the joint may be more reliable than attempting repair.
- Corrective surgery after previous injury: addressing a fracture that has healed in poor position, or has not healed at all. It can also address a fracture that has led to painful post-traumatic arthritis.
Not all injuries require an operation. Many fractures heal well with a cast, boot, brace or sling, supported by pain relief and physiotherapy. Surgery may be recommended where the fracture is displaced or unstable, or where a joint surface is involved. It may also be recommended where healing has stalled, or where non-surgical treatment has not restored acceptable function. Guidance from NICE on fracture care emphasises assessing each patient individually. This means taking account of the injury pattern, general health and rehabilitation needs.
Who May Benefit From Trauma Surgery?
Trauma surgery may be suitable for adults who have sustained a significant musculoskeletal injury. It may also help those who continue to have problems long after an original injury. It could be considered if you have:
- a confirmed fracture that is displaced, unstable, or involves a joint
- an injury that has failed to heal in the expected time, sometimes described as delayed union or non-union
- a fracture that has healed in a poor position, causing deformity, limping or altered function
- ongoing pain, catching, locking or a sense of giving way in the hip, knee or other joint after an accident
- a knee ligament or cartilage injury causing instability during sport, work or daily activity
- post-traumatic arthritis with pain that limits walking, stairs, sleep or working life
- an implant from previous surgery that is causing irritation, loosening or discomfort
Suitability is never assumed. Age, bone quality, activity level and occupation all influence whether an operation is likely to help. So do other medical conditions, smoking status and the ability to follow a rehabilitation programme. Your clinician will advise based on your assessment, and in some situations will recommend continuing with non-surgical care.
Conditions and Injuries Commonly Treated
Acute injuries
- Hip and femoral fractures, including neck of femur fractures
- Fractures around the knee, including the kneecap, tibial plateau and thigh bone
- Ankle, tibia and fibula fractures
- Fractures around an existing hip or knee replacement, known as periprosthetic fractures
- Ligament, meniscal and cartilage injuries of the knee
- Dislocations and combined bone and soft tissue injuries
Later consequences of injury
- Non-union or malunion of a previous fracture
- Post-traumatic osteoarthritis of the hip or knee
- Persistent stiffness, weakness or reduced range of movement
- Painful or prominent metalwork from earlier surgery
- Cartilage damage that may be suitable for preservation or repair techniques
Potential Benefits
Outcomes vary between individuals, and no operation can promise a return to exactly how a limb felt before injury. That said, where surgery is clinically appropriate, it may:
- stabilise the fracture so that healing can occur in a satisfactory position
- help reduce pain associated with movement of an unstable injury
- allow earlier, safer mobilisation and rehabilitation
- support restoration of joint alignment and mechanics
- reduce the risk of long-term deformity or leg length difference in some injuries
- help protect joint surfaces and may lower the likelihood of accelerated wear
- improve independence, walking distance and quality of life over time
- Day 0–1: Pain control and initial fixation or splinting, with early guidance on safe movement
- Week 1–2: Wound checks, early physiotherapy, and weight-bearing advice specific to your injury
- Week 6–12: Bone healing progressing well for most injuries, with a gradual increase in activity and strength work
- Month 3–12: Continued rehabilitation, with a return to work, sport and full function as healing allows
Consultation and Assessment
Assessment begins with a detailed conversation about how the injury happened, your symptoms and your general health. It also covers medication, previous surgery and the demands of your work and hobbies. A focused physical examination follows, looking at alignment, swelling, movement and stability. It also checks muscle strength, nerve and circulatory function, and the way you walk.
Imaging is usually needed to plan care. This may include X-rays, and where more detail is required, CT scanning for complex fractures or joint surfaces. MRI may also be used for ligament, cartilage and soft tissue injury. Blood tests may be arranged if infection is suspected or before an anaesthetic.
Your options are then discussed openly, including non-surgical management and the type of operation that may suit your injury. This also covers the expected recovery timeline, realistic goals and the risks involved. Nothing proceeds until you have had time to ask questions and give informed consent. Written information and a clear rehabilitation plan are provided so you know what to expect at each stage.
How Trauma Surgery Is Performed
Procedures take place in a hospital operating theatre with a full anaesthetic and theatre team. Anaesthetic may be general, spinal or regional, sometimes combined with a nerve block for pain relief. The anaesthetist will discuss the safest choice for you.
In broad terms, the surgeon restores the bone or joint to as close to its normal position as possible. It is then held in place with appropriate implants, or the damaged soft tissues are repaired. X-ray imaging is frequently used during the operation to check position. Some procedures are performed through small incisions, including keyhole knee surgery, while others require a more open approach.
Length of stay depends on the injury, the operation and your general health. Some smaller procedures are managed as a day case. Major fractures and joint surgery, however, usually need an inpatient stay with input from nursing staff and physiotherapists. Where joint replacement is used, only implants with strong long-term performance ratings are chosen. Outcomes are tracked through the National Joint Registry.
Recovery and Aftercare
Early recovery focuses on pain control, protecting the repair and reducing swelling. It also aims at preventing complications such as blood clots and chest infection. You may be given a sling, boot, brace or crutches. You’ll also get clear instructions on how much weight you can place through the limb.
Physiotherapy is a central part of trauma recovery and often begins in hospital. Bone healing commonly takes several weeks to a few months. Regaining full strength, confidence and stamina can take considerably longer, particularly after major injuries. Follow-up appointments with repeat X-rays are arranged to monitor healing and progress your rehabilitation safely.
Return to driving, work and sport is decided individually and depends on the injury, the limb involved and your job. Contact your surgical team or seek urgent medical advice if you develop increasing pain, spreading redness, wound discharge or fever. Also seek help for numbness, a cold or pale limb, or new calf swelling and breathlessness. Further general information on fractures and injury recovery is available from the NHS.
Risks and Considerations
All surgery carries risk, and being informed helps you weigh up your decision. Possible risks include infection, bleeding, blood clots, wound healing problems and nerve or blood vessel injury. Further risks include stiffness, persistent pain, scarring and anaesthetic complications. Fracture surgery can also be associated with delayed healing or non-union, and implant irritation, loosening or failure. It may also lead to the need for further surgery, including removal of metalwork.
Some injuries lead to long-term changes in the joint despite well-performed surgery, and post-traumatic arthritis may still develop. Smoking, poorly controlled diabetes, certain medicines and low bone density can affect healing. Alternatives, including cast or brace treatment, injections, physiotherapy and activity modification, will be discussed where they are reasonable options. Results and recovery vary from person to person.
Why Choose Mr Shanmugasundaram Rajkumar
Mr Shanmugasundaram Rajkumar is a Consultant Trauma and Orthopaedic Surgeon with a sub-specialist interest in hip and knee surgery. This includes primary and revision joint replacement, knee arthroscopy and cartilage preservation. He is fellowship-trained in lower limb arthroplasty and knee surgery. He also has previous experience at Wrightington Hospital, a hospital long recognised for joint replacement surgery.
- Seventeen years of consultant experience in trauma and orthopaedics
- Honorary Senior Clinical Lecturer at the University of Glasgow
- College Tutor for the Royal College of Physicians and Surgeons of Glasgow
- Use of ODEP 10A rated hip and knee implants, with outcomes evidenced through National Joint Registry and Scottish Arthroplasty Project data
- Experience in day-case joint replacement and cartilage preservation surgery
- Active researcher involved in randomised controlled trials and UK and European multicentre studies
- Published in peer-reviewed orthopaedic journals, and a reviewer and consulting editor for international orthopaedic and surgical journals
- National lecturer and medical educator in Trauma & Orthopaedics
Care is consultant-led from the first consultation through to rehabilitation. The emphasis is on clear explanation, evidence-informed decision making and realistic goal setting.
Location and Areas Served
Consultations for trauma surgery are available in Glasgow. Patients also travel from Paisley, Renfrewshire and surrounding parts of the west of Scotland. Appointments can be arranged for new injuries, second opinions and review of problems following previous surgery elsewhere.
Frequently Asked Questions
Is trauma surgery painful?
The operation itself is carried out under anaesthetic, so you should not feel pain during the procedure. Some discomfort afterwards is normal and is managed with pain relief, nerve blocks where suitable, elevation, ice and early physiotherapy.
How long does the procedure take?
This depends entirely on the injury. Straightforward fixation may take under an hour, while complex fractures or joint reconstruction can take considerably longer. Your surgeon will give you an estimate at your consultation.
How long is recovery after fracture surgery?
Bone healing commonly takes six to twelve weeks, though this varies with the bone involved, your age and your general health. Regaining full strength and confidence often takes several months, and rehabilitation timelines are individualised.
Am I suitable for surgery?
Only a clinical assessment with appropriate imaging can answer this. Suitability depends on the injury pattern, bone quality, other medical conditions and your goals.
Are there alternatives to an operation?
Yes, in many cases. Casts, braces, boots, physiotherapy, injections and activity modification may be appropriate, and these options will be discussed where clinically reasonable.
Will the metalwork need to be removed?
Often it can stay in place permanently. Removal may be considered if the implant becomes irritating, prominent or problematic, and this is discussed individually once healing is complete.
When should I arrange a consultation?
Seek urgent care for a suspected new fracture or a significantly deformed limb. For persistent pain, stiffness, instability or concerns after a previous injury or operation, a specialist orthopaedic assessment is advisable.
At a glance
Anaesthetic
General, spinal or regional, depending on the injury
Operation time
Varies with the injury; commonly 30–120 minutes
Hospital stay
Day case to several nights, depending on severity
Recovery
6–12 weeks for bone healing, longer for full strength
Implants
ODEP 10A-rated, where joint replacement is required
Fees & insurance
New Consultation
£180
Follow-up
£110
Insurers
Bupa · AXA Health · Aviva · Vitality · WPA
Self-pay
All-inclusive quotation on request
A written quotation is provided before any procedure is booked.
Discuss your injury
Request an appointment at Ross Hall Hospital, Glasgow.