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Complication and risks of orthopaedic and limb reconstruction treatments

Children’s Orthopaedic surgery has many benefits but there is no certain way to predict the outcome of surgery or treatment. The following are some of the recognised complications and risks of any Orthopaedic treatment. There may be others but they are very rare.

Information:

Your consultant will inform you of any alternative treatment methods for your child including doing no treatment at all. Your consultant will also explain to you that your child’s treatment may not improve their condition and they may be worse after treatment.

Complications related to the bone

Complications related to the bone can include:

  • the bone at the site of surgery is not completely broken during surgery
  • the bone heals too early
  • the bone healing is delayed or does not occur
  • the limb does not heal in the planned alignment
  • broken bone
  • infection in the bone
  • infection in the joint
  • bone death due to lack of blood supply
  • growth plate damage from interrupted growth of bone resulting in limb length discrepancy or alignment deformity
  • over lengthening
  • under lengthening

Complications related to muscles and joints

Complications related to the muscles and joints can include:

  • muscle cramps
  • joint stiffness
  • joint cannot straighten
  • partial joint dislocation
  • full joint dislocation

Complications related to nerves

Complications related to the nerves can include:

  • pain
  • nerve injury (temporary or permanent loss of sensation or power in a limb)
  • cord injury (temporary or permanent loss of use of a limb)
  • chronic regional pain syndrome which is an unpredictable localised long term pain problem

 Complications related to blood vessels

Complications related to the blood vessels can include:

  • bleeding
  • Compartment Syndrome which is a high fluid pressure in muscle compartment
  • aneurysm which is a localised widening and weakening of a blood vessel, which may burst
  • malignant hypertension (extremely high blood pressure)
  • deep vein thrombosis or pulmonary embolus which are a blood clot in a limb or chest

Complications related to external fixator screw or wire sites

Complications related to the external fixator screw or wire sites can include:

  • pain
  • skin tethering (the skin can grow up a wire or screw)
  • loosening
  • infection

External fixator (hardware) problems

Hardware problems can include:

  • wire or screw breakages
  • hardware breakages (hinges or struts and so on)
  • loss of stability
  • confusion about correction or ‘dynamising’ regimes during limb reconstruction programmes. These are usually remedied very fixed

Complications related to surgical wounds

Complications related to the surgical wounds can include:

  • pain
  • severe bruise
  • wound breakdown
  • infection

Complications related to long-term treatments

Complications related to the long-term treatments can include:

  • psychological problems
  • weight loss or gain
  • withdrawal
  • depression
  • regression
  • effect on the whole family

Complications caused by lifestyle

Complications related to lifestyle can include:

  • poor cooperation with the treatment programme
  • poor weight-bearing, when advised
  • poor exercising, when advised
  • smoking or passive smoking can delay healing and cause infection
  • long-term non-steroidal pain killers

Complications during actual surgery or after surgery

Complications related to and after surgery can include:

  • tourniquet complications resulting in nerve and blood vessel injury
  • catheter complications resulting in urinary infection or epididymitis
  • medical complications such as heart attack, stroke, pneumonia and lung collapse
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Disclaimer

Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: ORP20

Resource Type: Article

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