In the present climate of hospital and local Casualty closures / reorganisations you might wish to opt for urgent private care for your injury.
We have been able to offer this particular (very much appreciated) service since 1998 for our established patients who wished to have immediate access to a Consultant Orthopaedic Surgeon with facilities of fast imaging, splinting and casting the same day as your injury without the need to wait 4-6 hrs or to attend Fracture Clinic the following day.
Further highly scheduled Trauma/Injury Surgery could be offered to you, scheduled at your convenience the same day or the following days with brand new (repeat)…shortages or issues like repeated starvation, insufficient staff or operating time as in the resource-strapped NHS.
Together with some other devoted colleagues and encouraged by the very positive feedback from our patients we plan now to be more ambitious by developing a private Urgent Injury UNIT offering the full range of services throughout the day (literally walk-in or drive-in) with the exception of some very complex conditions requiring transfer (e.g. severe pelvis fractures).
Acute Injuries can only be seen at the BMI Cavell & King's Oak Hospitals for the time being. Patients with Acute Injuries wishing private care in central London please contact URGENT CARE CENTRE in Princess Grace Hospital.
If you injure yourself in the North London area or abroad (e.g. skiing..) and wish PROMPT Private Injury Care and Advice up until ..do not require a GP referral letter for Urgent Care but please do check to obtain authorisation. Check on Insurance Claim (letter not required)
CALL 020 8362 3606 Secretary Lynne Martin during Office Hours or via our e-mail contact form
CALL THE SISTER-ON-CALL KINGS OAK HOSPITAL 020 8370 9500
CALL THE SISTER-ON-CALL NORTH LONDON HOSPITAL 020 8366 2122
24 HRS / 7 DAYS A WEEK
Useful information to bring to your appointment:
It is helpful if any previous X-rays or scans or reports which are available are brought to the consultation, and the general practitioner may wish to provide the details of previous treatment received and other medical conditions unless there is no time in Urgent Injury Care. We’ll take care of it!
One of the most frequent injured body regions is the wrist, usually after a fall onto an outstretched hand. The amount of energy going through the wrist and the strength of the bone and soft tissues determines the damage done. This damage can be seen as fragment displacement, bone destruction or impaction on X-rays but unfortunately X-rays show only calcified tissues such as bone. Indeed, occasionally an urgent CT-scan or MRI-scan is needed to appreciate damage. for example cartilage and tendon or ligaments. Accurate interpretation of these imaging studies within a certain time scale is critical in order to enable your surgeon to maximize treatment options for the best possible functional outcome. Treatment options could consist of bracing, application of a plaster cast with or without reduction or surgery with assistance of an X-Ray machine (Image Intensifier) and specially designed high tech hardware such as pins, screws, plates, nails, anchors...etc.. Fracture healing in adults usually takes place in three phases: acute (first 2 weeks - conversion of blood clot into a fibrous scaffold), consolidation (following 4-8 weeks- ossification and calcification) and remodelling (up to 2 years - slow reconfiguration of healed bone in response to use and load).
If and when proper treatment has not been instituted within the first 2-3 weeks, one can end up with a rigid, malunited and painful wrist. Therefore seek prompt medical attention and have it X-rayed!
Example of X-Rays of the wrist
Example of a scaphoid fracture (wrist bone at the base of the thumb) fixated with an elegant internal screw.
Anyone walking has or will sprain his/her ankle in a lifetime. Most sprains fortunately are pretty benign and settle within a fortnight with PRICE (link),home exercises and/or physiotherapy(link). Sprains are usually classified as Type 1 (ligaments stretched, bruising, can weight bear), Type 2 (ligaments partially torn, bruising, cannot weight bear) or Type 3 (ligaments torn, bruising++, cannot weight bear at all). Depending on the position of the ankle and the energy going through the joint at the time of the injury, bone or cartilage structures can be damaged with potential bleeding, stiffness, instability or post-traumatic arthritis as result. The key to a successful repair and a good functional outcome is speed of diagnostic recognition of the damage and initialising 'the right treatment on-time'!!
Unfortunately X-rays show only calcified tissues such as bone. Indeed, occasionally an urgent CT-scan or MRI-scan is needed to appreciate damage to e.g. cartilage and tendon or ligaments. Accurate interpretation of these imaging studies within a certain time scale is critical in order to enable your surgeon to maximize treatment options for the best possible functional outcome. Treatment options could consist of bracing, application of a plaster cast with or without reduction or Surgery with assistance of an X-Ray machine (Image Intensifier), keyhole instruments and specially designed high tech hardware such as pins, screws, plates, nails, anchors..etc.. Fracture healing in adults usually takes place in three phases: acute (first 2 weeks - conversion of blood clot into a fibrous scaffold), consolidation (following 4-8 weeks- ossification and calcification) and remodelling (up to 2 years- slow reconfiguration of healed bone in response to use and load).
If and when proper treatment has not been instituted yet within the first 2-3 weeks, one can end up with a rigid, malunited and painful ankle. Therefore seek prompt medical attention and have it at least X-rayed !
The elbow is a rather complex joint consisting of three bones (humerus, ulna and radius) with quite sophisticated joint motions. Depending on the position of the elbow and the energy going through the joint at the time of the injury, bone or cartilage structures can be damaged with potential bleeding, stiffness, instability or post-traumatic arthritis as result. The key to a successful repair and a good functional outcome is speed of diagnostic recognition of the damage and initialising 'the right treatment on-time'!!
Unfortunately X-rays show only calcified tissues such as bone. Indeed, occasionally an urgent CT-scan or MRI-scan is needed to appreciate damage to e.g. cartilage and tendon or ligaments. Accurate interpretation of these imaging studies within a certain time scale is critical in order to enable your surgeon to maximize treatment options for the best possible functional outcome . Treatment options could consist of bracing, application of a plaster cast with or without reduction or Surgery with assistance of an X-Ray machine (Image Intensifier), keyhole instruments and specially designed high tech hardware such as pins, screws, plates, nails, anchors...etc.. Fracture healing in adults usually takes place in three phases: acute (first 2 weeks - conversion of blood clot into a fibrous scaffold), consolidation (following 4-8 weeks - ossification and calcification) and remodelling (up to 2 years- slow reconfiguration of healed bone in response to use and load).
If and when proper treatment has not been instituted yet within the first 2-3 weeks, one can end up with a rigid, malunited and painful elbow. Therefore seek prompt medical attention and have it at least X-rayed !
Tennis elbow or epicondylitis radialis:
What you see are calcifications! not a fracture
Hip and shoulder joints are actually pretty much perfect joints in that the ball-and-socket configuration makes the joint biomechanics very sleek and efficient. For some reason, our knee joint has not been blessed as such. The interactions between femur and tibia and between the knee cap and the femur are quite complicated- bending, stretching, twisting, sliding and gliding etc.. Any acute impact or interference with these fine tuned bone/cartilage/ligament balances can result in minor or major injury. Cruciate ligament injury is a well known entity (for example: Michael Owen) but also the meniscal shock absorber can easily be damaged, let alone true cartilage. In the acute phase the knee joint cannot be properly examined but nevertheless treatment should start on the basis of initial X-rays and occasionally an urgent MRI or CT is needed. In most instances your surgeon would like to hold off with acute surgical intervention until the 'knee cools down' but obviously in the presence of major displaced fracture fragments, a 'locked knee' or an open injury any delay to repair damage is detrimental.
Accurate interpretation of imaging studies within a certain time scale is critical in order to enable your surgeon to maximize treatment options for the best possible functional outcome. Treatment options could consist of physiotherapy, bracing, application of a plaster cast with or without reduction or surgery with assistance of an X-Ray machine (Image Intensifier), keyhole instruments for endoscopic surgery and specially designed high tech hardware such as pins, screws, plates, nails, anchors...etc.. Fracture healing in adults usually takes place in three phases: acute (first 2 weeks - conversion of blood clot into a fibrous scaffold), consolidation (following 4-8 weeks- ossification and calcification) and remodelling (up to 2 years- slow reconfiguration of healed bone in response to use and load).
If and when proper treatment has not been instituted within the first 2-3 weeks, one could end up with a rigid, malunited and painful knee. Therefore seek prompt medical attention and have it at least X-rayed!
Most injuries in the knee however affect soft tissues and the classic is the so-called meniscus or shock absorber tear. There are two in each knee and they are made up of fibro-cartilage, have the shape of a crescent located between the cartilage surfaces of the femur and the tibia. In biomechanical terms, they act a bit like stiff water mattresses anchored to the joint edges. A wrong twist.. and the pancake can tear apart ending up with small or larger fragments amenable for repair or removal. Up until 20 years ago the entire joint had to be opened up with a hospital admission for weeks and rehabilitation for several months. Keyhole surgery nowadays however allows the surgeon to sneak in the joint without the need to interfere with the joint tissue envelope. As a result a knee arthroscopy procedure can be carried out in a day care setting and rehab can be as short as 4 to 6 weeks!
Further Knee info
For several hundreds of years trauma surgeons have dreamt about internally splinting long fractured bones to allow early weight bearing and fast healing but it has taken up until the 1960-1970's with the arrival of modern anaesthesia, dynamic X-ray machines, stainless steel top engineered nails, powerful antibiotics and sophisticated high-tech surgical techniques before 'nailing' became widely accepted. The historical evolution to the development of a hollow rod, not immuno-rejected by the body, inserted into the bone marrow and locked into a stable position, with screws on top and below, thereby respecting the precious blood supply and soft tissue coverage of the fracture site itself, makes fascinating reading. Once healing of the bone has taken place, the nail becomes useless. In physically active people and in weight bearing bones, metal fatigue can occur after years, rendering the metalwork prone to breaks and small particles can start contaminating the surrounding tissues. Removal of nail and screws however is not always straight forward because of rigid ingrowth and therefore any attempts are best made within a time period of 2-3 years. Not all nails require removal though - ask your surgeon.
In special circumstances, a plaster cast, a brace and even an internal nail(link) are not good enough to stabilise a fractured long bone and an external fixator is needed. This is indeed a meccano like device bolted onto large pins or screws inserted into the bone. Obviously, there are good reasons to do this e.g. open wounds close to the fracture site, in the setting of multiple injuries, to maintain length of a badly fractured, collapsed bone structure etc… Nowadays 'an EX-FIX' can be put on swiftly (twenty minutes) in Theatre or in a battlefield hospital. Later, 'when the dust has settled' the nail can be left on for 3-4 months, or exchanged with a nail or a plaster cast.
External fixators look spectacular but they have raised standards of fracture care !!
FAQ's - Frequently Asked Questions
I think I ruptured my Achilles' tendon during my tennis game More...
I was playing doubles and I ran to the net. Suddenly, I felt like someone had kicked me in the back of my heel and calf. I could not walk anymore and I had to limp off the field. Now my calf is swollen and three times as thick as the other side , it hurts.
It sounds like you might have ruptured your Achilles'tendon,the second largest tendon in the body. What next ? Well , first aid - see PRICE REGIME page, make an appointment , more than likely an Ultrasound or MRI scan investigation will be organised for you on an urgent basis to confirm the one or the other. Treatment options then…
Further info
In some injuries a plaster cast is needed - sometimes this cast is a non-circular type to allow some tissue swelling, sometimes the cast materials are of a synthetic resin. Anyway, a proper plaster cast is moulded on top of a cotton layer of padding. This padding material cannot become wet (it could harbour germs!), hence the advice not to expose the cast to water in a shower or in a bath. No more hygiene then ? On the contrary, one could two large bin bags and a elastic ring (or two) on top (good for showering). However, new technology allows you even to swim and still go on vacation !! thanks to the provision of a leak proof vacuum protection plastic sleeve.
Surgery is not always needed for a fractured ankle - not even a cast. Do not forget some airlines do not allow you to board with a tight circular cast (fear for compartment syndrome or Deep Venous Thrombosis). However, we can fit a modern, lightweight, well fitted ankle foot brace for you (e.g. Air-Cast or Pro-Walker)
Be very careful here! This situation requires prompt attention. If you -indeed- have a circular cast, the tissues underneath and inside might be so inflamed and swollen that the blood flow to your hand or foot could be blocked off . This cast has to be split, opened up or removed ASAP or one could develop compartment syndrome with devastating consequences. CALL US OR GO TO CASUALTY.
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CALL 020 8362 3606 Secretary Lynne Martin during Office Hours or via our 
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