The Trauma Department at Ruber International is made up of numerous teams who cover the different areas of this extensive speciality: Trauma and General Orthopaedics, Oncological Trauma, Sports Trauma, Paediatric Trauma, Orthopaedic Surgery and Trauma Unit, etc.
We have the best professionals and the most modern resources, allowing us to address our patients' problems with maximum guarantees of success.
In addition to the clinics, operating theatres, diagnostic imaging and other facilities at the Ruber International Hospital in Mirasierra, we have opened recently the Ruber International Medical Centre on Paseo de la Habana. With this new site in the very financial heart of Madrid, our aim is to improve our patient care even further.
We are leaders when it comes to innovation, application of new treatments and surgical techniques, adaptation of new pre- and post-operative programmes to achieve improved outcomes, a more optimal recovery and with greater patient well-being.
We offer patients a highly individualised treatment. The human factor matters a lot to us.
The knee is the most commonly damaged joint in the body. This is logical as it has to bear the weight of the entire body and to absorb the constant movements more than any other joint. In addition, increased sports practice inevitably results in a greater number of injuries and, furthermore, it is exposed to the same conditions as the rest of the joints.
The soft tissues of the knee, tendons, muscles and ligaments are those that are the most prone to suffering injuries, which does not take away from the fact that bones can also be broken.
It is very common for the knee to twist and for ligaments to stretch more than they support. The same thing happens with muscles and cartilages:
SprainThis is a stretch of the ligaments that causes a tear or even a rupture. Depending on the level of the tear, sprains are classified into three levels.
Ligaments are made up of collagen fibres and their role is to define the mobility of the knee to maintain it within its biomechanical limits.
The lateral internal and external ligaments that help stabilise and support and limit the lateral movement are on the outside of the knee. And on the inside forming a cross between them are the anterior and posterior cruciate ligaments, which in particular stabilise forward and backward movement..
A muscle or tendon tear
- UA tear in the knee muscles or in the tendons that join these to bones will produce inflammation and pain and will limit their movement.
- Patellar tendonitis: The tendon that connects the tibia (shinbone) to the patella (kneecap) is damaged. It is very common for this to be caused by jumping (that is why this condition is also called "jumper's knee").
The meniscusThis is a C-shaped fibrocartilage, that acts as the knee's shock absorber, between the femur (thighbone) and the tibia.
This type of cushion wears away with age, but it is also very common that the meniscus is torn in one way or another by doing sport. This will limit movement, produce pain, inflammation, etc.
Treatment of tears follows the protocol called PRICE, with the steps that have to be followed, which are: Protection – Rest – Ice, apply ice (but never directly on the skin, which could burn it) – Compression – Elevation.
Treatments for knee injuries may be more or less conservative. There are times when physiotherapy will be sufficient, but on other occasions an intervention in which a ligament is repaired or a part of the meniscus is resected will be necessary, and it is even possible that the kneecap has to be replaced by an artificial prosthesis.
Besides age and practising sport, there are conditions such as gout or osteoarthritis that will be determining factors in an area of the knee being damaged. Of course, being overweight is one of the knee's worst enemies. The likelihood of suffering a knee injury is far higher if the individual is overweight, and the effects of any injury, in this instance, will be multiplied.
Other knee conditions
As a result of lack of irrigation in the knee the fibres of the bone and cartilage die by necrosis. This causes the detachment of a section called "joint mouse" that will become loose and the knee will be destabilised.
Osteoarthritis of the kneeThis is the most common degenerative knee condition. Cartilages wear out gradually with age, weight, injuries and also for genetic reasons.
This is a posture problem that occurs in childhood and consists of the knees touching each other, while the ankles remain separated.
(or synovial cyst) Consists of an accumulation of synovial fluid that oppresses the back of the knee. It can be caused by injuries in the cartilage, arthritis, inflammation, gout, etc.
It is usually treated with rest, physiotherapy, drainage with a needle and steroids, if needed. Sometimes the doctor may choose to do a small cut and relieve the pressure, but it will always be necessary to treat the initial cause.
The hip is the joint that connects the legs and trunk, via the femur and the coxal bone (hip joint). The greatest danger of the hips is arthrosis, a degenerative cartilage disease.
To prevent future hip disorders as far as possible, prevention is key and this is achieved with:
- Avoiding being overweight: so that the joints do not have to bear so much pressure.
- Do exercise: to have strong muscles that work instead of the joints.
- Good posture habits: for example, sit straight with your feet on the ground or walk in an upright position.
- Use common sense: This means that you should not do things that may be counterproductive and save unnecessary efforts, etc. For example, use shopping trolleys and go to an orthopaedic surgeon with the first symptoms of a condition.
- Avoiding being overweight: so that the joints do not have to bear so much pressure.
ArthrosisCartilages are worn away gradually which increasingly incapacitates pelvic movements. A sensation is produced such as rubbing of the bones and it manifests as a pain that emerges from the groin area and radiates through the buttocks and thighs until it reaches the knees.
This condition has a genetic component, but other factors such as trauma or the above-mentioned factors influence the prevention. It is more prevalent in men.
It is possible to improve it to a great extent with infiltrations of Plasma Rich in Growth Factors, achieving tissue regeneration. On the other hand, treatments could be with anti-inflammatories, painkillers, rehabilitation and, if the time comes, surgery, in which a hip replacement can be requested..
Rheumatoid ArthritisArthritis is inflammation of the joints that can alsodamage the surrounding muscles and tendons (joint arthritis and non-joint arthritis). It has a chronic nature presenting episodes of pain and swelling, in particular after prolonged periods of rest (when getting up in the morning, for example).
When the inflammation is severe, other symptoms such as asthenia, tiredness or fever appear.
With an early diagnosis, it is possible to keep the condition controlled with medications, and thereby prevent future complications.
These can be caused by major trauma, but hip fractures are common with a small blow in elderly people, in whom osteoporosis occurs (decrease in bone density), or even without a blow due to the individual's own weight.
Treatment in most cases will be surgical and, generally, with a slow recovery.
The head of the femur comes out of the pelvic cavity where it is housed. Depending on the position where the femur is then located, the dislocation can be anterior or posterior. It is very painful and hinders the carrying out of rotational movements of the leg.
Although dislocations can occur spontaneously due to a bone or joint condition, they are normally caused by a heavy blow.
They require rapid medical intervention for repositioning, since the joint can be damaged. It will sometimes be done with surgery.
Quite a common case is that of congenital dislocations, which means that they form in the fetal phase.
When a dislocation is not treated properly it can occur again with small blows.
BursitisThe role of the synovial fluid sacs is to absorb the contact between the bones and tendons of the joint. Bursitis is the inflammation of one of these sacs or bursae.
Depending on the degree of the inflammation, treatment of rest, anti-inflammatories and physiotherapy will be applied. It may be possible to perform a bursectomy (minor surgery to free the fluid) if necessary.
- Trochanteric bursitis
The bursae that are inflamed are those which surround the greater trochanter. They cause chronic pain in the side of the hip. It tends to happen more in women due to their anatomy.
- Transient synovitis
This is an inflammation of the synovial capsule that affects children aged between 2 and 6. It is of an infectious, viral origin. It causes pain in the groin, hip and front part of the thigh resulting in a limp.
Treatment will be with anti-inflammatories, rest and, where applicable, extraction of the synovial fluid.
- Trochanteric bursitis
The upper limbs have an orthopaedic complexity, meaning that doctors usually specialise in a very specific part, in particular with regard to surgery.
Repetitive movements and efforts due to sport or work activity is often the cause of many upper limb orthopaedic problems. On other occasions, there are inflammatory conditions in the joints, such as in rheumatoid arthritis, that become disabling.
Hand and wrist
Treatments of any bone or soft tissue conditions of the hand and wrist, fractures, ligament injuries, nerve injuries, etc. are done with arthroscopy and microsurgery techniques, in addition to the conventional techniques.
More than 30 bones are joined together between the hand and the wrist in a group in which a large number of tendons, nerves and muscles also intervene.
The most common conditions and treatments are as follows:
- Rheumatoid arthritis, arthritis and arthrosis of the fingers and wrist, trigger finger, swan neck deformities, mallet finger, etc.
- Arthrosis of the thumb (rhizarthrosis).
- Dupuytren's disease.
- Hand and wrist fractures.
- Tumours and ganglion cysts.
- Flexor and extensor tendon ruptures, and ligament ruptures (skier's thumb…).
- Ulnar nerve syndrome in Guyon's Canal.
- Carpal tunnel syndrome (endoscopic release).
- Ligament injuries.
- Congenital malformations.
- Scar and post-burn deformities.
- Tendon problems of trauma (injuries) or inflammatory (trigger fingers) origin.
Shoulder and elbow
When there are shoulder and elbow injuries that need surgical intervention, where possible, techniques such as minimally invasive ones through arthroscopy will be used. This is generally the case with:
- Rotator cuff disorders.
- Labrum injuries after dislocations.
- Acromioclavicular injuries.
On other occasions, open surgery is used for the treatment of fractures and for shoulder or elbow prosthesis.
The weak point of the lower limbs is in the knees, which we have discussed separately.
The other anatomical area of major complexity from the orthopaedic point of view is the foot and the ankle.
Foot and Ankle
Foot and ankle injuries are some of the most common injuries. However, these injuries are often misdiagnosed. Our unit expertly treats all conditions:
- Flat feet and claw foot.
- Osteochondral injuries.
- Ligament and tendon injuries, etc. with different techniques: open, percutaneous, arthroscopic surgery.
The Spinal Pathology Unit at Ruber International is made up of a consolidated group of surgeons specialising in spinal surgery with extensive experience in the diagnosis and treatment of conditions which affect the cervical, dorsal or lumbar spine.
The experience of more than twenty-five years of dedication to spinal conditions, more than 400 patients surgically operated on every year, the constant updating of its members and its teaching collaboration with different university institutions endorse this team.
The conditions that we treat include:
- Lumbar, dorsal and cervical herniated disc.
- Spinal stenosis.
- Lumbar pain.
- Dorsal pain.
- Deformities: Scoliosis in its different forms: idiopathic, adult, degenerative.
- Traumas to the spine:
- Spinal fractures: burst, compression.
- Sprains: cervical, lumbar.
- Muscle contracture.
- Spinal tumours: benign, malignant, metastasis.
- Spinal infections.
- Conditions due to spinal osteoporosis.
- Spinal conditions of degenerative cause (arthrosis), Inflammatory (Spondylitis), etc.
Tumours of the musculoskeletal system, due to their rarity and the complexity of the radiological images, of histopathological appearances and of the serious consequences that result from insufficient biopsies and treatments, require a multidisciplinary approach.
Care is provided in an integrated manner with Diagnostic imaging, Medical Oncology, Radiotherapy Oncology, Nuclear Medicine, Pathological Anatomy, Vascular Surgery, Plastic Surgery, Thoracic Surgery, General Surgery, Psychiatry and Psychology. The experience of a multidisciplinary group is evidently greater than that obtained from treatments carried out without unification of criteria, optimising the survival rates and the success rates of surgery.
Treated tumours and their conditions
Benign bone tumours
Osteoid Osteoma, Osteoblastoma, Enchondroma, Chondroblastoma, Osteochondroma, Giant Cell Tumour, Simple Bone Cyst, Aneurysmal Bone Cyst, Fibrous Dysplasia, Non-Ossifying Fibroma, etc.
Malignant bone tumours
Osteosarcoma, Chondrosarcoma, Ewing's sarcoma, Pleomorphic Sarcoma, Adamantinoma, Fibrosarcoma, Chordoma, etc.
Malignant soft tissue tumours
Lipomas, synovial chondromatosis, myxoma, haemangioma, giant cell tumour of the tendon sheath, neural tumour (schwannoma, neurofibroma), etc.
Malignant soft tissue tumours (soft tissue sarcomas)
Liposarcoma, synovial sarcoma, pleomorphic sarcoma, leiomyosarcoma, myxofibrosarcoma, etc.
Metastatic bone tumours
Solitary metastases, risk of pathological fracture, pathological fractures.