Dr. Justin Kauk was examining an amputee during a follow-up visit. How do you feel physically, he asked. And how do you feel otherwise?
“Well, I’ve been kind of depressed,” the patient said.
Kauk, an orthopedic trauma surgeon at Novant Health Orthopedic Fracture Clinic in Charlotte, could immediately offer help that didn’t involve a broken bone or damaged muscle. That assistance is part of the clinic’s strategy to help patients in every aspect of their recovery, as it relates to their physical, emotional, financial and nutritional situations.
“Even if we fix the fractures, there are many other things we have to be aware of,” Kauk said. “We want them to be a contributing member of their family and society. I think it’s important that we help patients in every way that we can.”
The clinic takes a team approach to trauma care, using a variety of different doctors, physician assistants, psychologists, nurses and other assistants to ensure patients get the treatment that fits their situation.
The clinic includes a psychologist, with plans to add another. There also is an orthopedic trauma surgeon, a podiatric surgeon (specializing in foot and ankle procedures) and a physician’s assistant who concentrates on fragility and osteoporosis issues, to help patients work toward preventing future fractures. The clinic can help guide patients who may need a social worker, are dealing with nutrition issues or having financial difficulties.
“We want to meet their needs instead of them having to go to five or six specialists, which isn’t always possible,” Kauk said. “It’s a matter of us coming to them.”
The fracture clinic team, led by Kauk and Novant Health orthopedic trauma surgeon Dr. Todd Hall, is available to diagnose and treat fractures, tears and sprains on a walk-in or by-appointment basis. If you have recently had orthopedic surgery at Novant Health Presbyterian Medical Center, you can get post-operative care at the fracture clinic.
“We want to be a `one-stop shop’ or basically multimodal treatment,” Hall said. “Instead of just concentrating on the surgery and healing from the injury, we're also trying to take into account the emotional and mental effects from having an injury and the time that it takes to recover from that.”
Some patients deal with chronic pain and depression. Others struggle with pain medications, so doctors formulate a treatment plan that minimizes narcotics. Some patients live at the poverty level, when an injury that keeps them from working can quickly lead to financial difficulties.
Hall said the clinic also treats cases of “cold trauma,” where a patient may have been treated by someone else, but continue to have issues months or years after surgery.
“We'll take over those cases and either revise the treatment plan or fix the hardware,” Hall said. “We’ll keep going with them until they've healed.”
Hall said that fracture injuries have become worse in recent years. One reason is faster automobiles, which lead to higher-impact crashes.
“Another is that even though we have seatbelts, we have a whole new type of fractures because of the airbags that go off,” he said. “That creates a lot of hand, wrist and upper extremity fractures. We have people that are surviving their accidents now, when they would not have in the past. Sometimes they are sick systemically, not just the broken bones, but they have other injuries that are complicating their care.”
Also, new techniques and improvements help better treat injuries on the spot, and mobilize injured patients to hospitals faster. Wound care has improved. Recoveries from amputations have steadily improved. That all translates into more survivors, and Kauk wants to treat every aspect of their recovery.
“We want patients to know that they can still lead a meaningful life,” he said. “We want to heal their fracture and wounds, but we want to improve the quality of their care by assessing risk factors. We want to attack those from several different angles.”
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