Post-Traumatic Reconstruction

Overview

Post-traumatic reconstruction is the branch of orthopedic trauma surgery dedicated to restoring function after a previous injury has healed poorly. Even with excellent initial care, some fractures heal with residual deformity, loss of motion, shortening, or arthritis. In other cases, the original injury was severe enough that a staged reconstructive approach was always the plan. Our San Diego fellowship-trained trauma surgeons have dedicated advanced training in this complex and often gratifying area of orthopedic care.

Patients who come to us for reconstructive trauma care often have been told their options are limited. We believe in honest second opinions and in the principle that it is rarely too late to improve a patient’s situation. Modern techniques make it possible to correct problems that would have been considered untreatable a generation ago.

Common Reconstructive Problems

Patients seek post-traumatic reconstruction for a wide range of issues, including:

• Malunion — a fracture that healed in the wrong position, causing deformity, loss of motion, or altered mechanics
• Nonunion — a fracture that failed to heal, leaving persistent pain and instability
• Post-traumatic arthritis — joint cartilage damage from an old injury causing chronic pain and stiffness
• Limb length discrepancy — shortening from an old fracture or growth disturbance
• Failed or painful hardware — plates, screws, or rods from a prior surgery that are loose, broken, or irritating soft tissues
• Chronic osteomyelitis — lingering or recurrent bone infection after an old open fracture
• Angular or rotational deformity — bones that healed with a bend or twist that interferes with function
• Soft tissue deficits — skin or muscle loss from the original trauma that limits healing or function

Reconstructive Techniques

The right surgical approach depends on the specific problem, the quality of the bone and soft tissues, and the patient’s goals. Our surgeons are trained in a full range of reconstructive options:

• Corrective osteotomy — a precisely planned cut through the bone to restore alignment, often stabilized with plates and screws
• Bone grafting — filling gaps or stimulating healing at nonunion sites using the patient’s own bone or biologic substitutes
• External fixation and frame-based correction — the use of Ilizarov or hexapod frames to gradually correct deformity or lengthen a limb over weeks to months
• Revision internal fixation — removing old hardware and replacing it with improved fixation
• Arthroplasty (joint replacement) — for post-traumatic arthritis that is no longer responsive to conservative treatment
• Combined bone and soft tissue reconstruction — in coordination with plastic surgery when soft tissue coverage is needed

Planning a Reconstruction

Reconstructive trauma surgery requires careful preoperative planning. The process typically begins with a detailed evaluation of your history and prior treatments, followed by imaging — usually X-rays and often a CT scan — to fully characterize the problem. In some cases, additional studies such as MRI, nuclear medicine scans, or lab work are needed to evaluate for infection or bone healing biology.

Your surgeon will then develop a plan that accounts for your specific anatomy, functional goals, and life circumstances. For many reconstructive procedures, a thorough discussion of expected outcomes, realistic limitations, and alternative options is an essential part of deciding whether surgery is the right choice.

Recovery

Recovery from reconstructive trauma surgery varies widely based on the complexity of the procedure. Some operations — such as straightforward hardware removal — allow rapid return to activity. Others — such as frame-based limb reconstruction — may involve months of protected weight bearing and close outpatient follow-up. Whatever the scope, our goal is always to set realistic expectations up front and support you through the full arc of recovery.

If you have an old injury that is still causing problems, a fellowship-trained orthopedic trauma surgeon can offer a thorough evaluation and honest guidance about what may be possible. Contact our San Diego office to schedule a consultation.