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Oxford Trauma and Emergency Care


Illustrations of complex fractures


Complex fractures are fractures of the pelvis, or of an extremity with associated features. Complex fractures make up the minority of the 1.8 million fractures that occur in England each year but are associated with significant morbidity and are a large burden on healthcare resources. They often involve high-energy mechanisms, such as road traffic accidents. Multiple injuries or fractures can be sustained at the same time. In elderly patients, the same spectrum of severe injuries can occur with lower-energy accidents such as a fall down the stairs. The treatment of complex fractures is often complicated and usually involves multiple healthcare professionals and specialists.

A complex fracture may represent a life-changing injury, though when treatment goes to plan patients often experience a full return of function and can return to their job role. When patients experience more severe injuries or complications (e.g. infection) their treatment can be prolonged, resulting in permanent disability and mental health problems. These factors represent high direct and indirect economic costs to the health service and wider society. There is a pressing need to determine the recovery priorities for these patients and their families. This PSP will be the first to systematically investigate this. 

The expansion of the National Institute for Health Research (NIHR) and Trauma Audit and Research Network (TARN), as well as the development of novel methodical approaches, has seen a rise in the number of trials in urgent or emergency care conducted in the NHS over the last 5 years.  We now have the infrastructure to deliver high-quality research in the emergency setting and so there is a need to generate the right research questions.