General Guideline Principles for Acute Fractures
and Dislocations for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Acute Fractures and Dislocations.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Acute Fractures and Dislocations

The precise type of injury and potential for long-term brain impairment will determine if surgery is necessary for acute traumatic injury. If there has been trauma, severe disc rupture may happen.

Halo Immobilization of Acute Fractures and Dislocations

Description: Intervention that limits the range of motion for flexion and extension. Halo vests may be useful for treating unstable cervical spine injuries as they will offer some, but not total, rotational control.

Complications: include sixth cranial nerve palsy, pin infection, and pin loosening.

Surgical Indications: To prevent graft dislodgement, spine misalignment, or pseudoarthrosis, rotational control must be restricted almost entirely in cases with cervical fractures. The surgeon will decide whether to utilize Halo based on the unique damage of the patient.

Operative Treatment: Placing the equipment and pins
Post-Operative Care: For re-alignment and/or fracture reduction, traction (to be decided by the surgeon), active and/or passive treatment, and pin care may be necessary.

Anterior and/or Posterior Decompression with Fusion

Description:

To straighten and stabilize the spine and to relieve strain on the backbone of the neck and nerve roots. The use of bone grafts, frequently in conjunction with spinal instrumentation, may be necessary to provide a firm link between two or more neighboring vertebrae.

Complications may include:

In hospital mortality, discomfort at the location of the bone graft donor, deep or graft extrusion, laryngeal nerve, superficial infection, cerebral spinal fluid (CSF) leak injury (anterior approach), paralysis, and iatrogenic kyphosis are examples of instrumentation failure.

Surgical Indications:

When spinal canal damage and/or spinal instability coexist with a substantial or growing neurological disability.

Operative Treatment:

The surgical decompression of the cervical spine from the anterior or posterior is commonly acknowledged. The location of the compressive pathology and the existence of additional concurrent injuries serve as a guide for the strategy.

Post-Operative Care of Acute Fractures and Dislocations

Following surgery, cervical bracing, physical therapy, and occupational therapy may be necessary (usually sit to twelve weeks with fusion). Early in the rehabilitation phase, home programs including teaching daily walking, ADLs, posture, and sitting programs should be implemented.

Once the fusion is stable and free of complications, referral to a comprehensive rehabilitation program is necessary. This program should focus on strengthening the thoracic, scapular, and cervical regions as well as restoring the range of motion.

Active therapy, which attests patients should have had before surgery, usually necessitates repeating the sessions that were originally prescribed. The treatment program’s objectives should include teaching patients how to follow a long-term, at-home fitness regimen.

What our office can do if you have Acute Fractures and Dislocations

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.