Broken bones are more common than most people think. Around 50% to 60% of all orthopaedic cases involve fractures, not joint replacements, not spinal disorders, but fractures. Traffic accidents, falls, sports injuries, and workplace incidents send people through emergency rooms every day, and for many of them, the quality of care they receive in the hours and days after the break will determine whether they walk normally again, or whether they ever run again at all.
In Thailand, the field of orthopaedic trauma surgery has grown significantly over the past 15 years, evolving from a general orthopaedic skill into its own subspecialty. Not every surgeon who can fix a broken bone has the training to handle the complicated ones, such as the multi-fracture cases, the pelvic injuries, the fractures that arrive with torn vessels and damaged soft tissue. Those cases require a specialist, the right equipment, and a team that has done this before.
Dr Pongsakorn Bupparenoo is one of a small number of orthopaedic trauma specialists in Thailand who sit at that level. We spoke with him at MedPark Hospital, where he practices, about his career, his techniques, and his philosophy on what it means to truly help a patient recover.
From residency to Berlin: building expertise abroad
Dr Pongsakorn graduated with second-class honours from the Faculty of Medicine at Siriraj Hospital before completing his residency in orthopaedics at Rajavithi Hospital. It was during those early years treating outpatient fracture cases that the speciality found him.
“I love to make the patient go back to their status again,” he told us. “Like you fracture the wrist, so you cannot use the wrist. I’m happy to give their wrist back to normal.”
While many of his fellow residents chose fellowships in sports medicine, spine, or foot and ankle surgery, Dr Pongsakorn pursued orthopaedic trauma, at the time, a subspecialty with few formal fellowship programmes in Thailand. He went abroad, training at Denver Health Medical Center in the United States and then in Berlin, Germany, where he spent time at a dedicated trauma centre.
According to him, Germany was a turning point in his life.
“The German people, they use a much newer technique for surgery.”
The immersive environment, along with three to four complex cases per day, gave him a foundation that he brought back to Thailand.
Techniques that changed what is possible in Thailand
One of the most significant things Dr Pongsakorn brought back was the pararectus approach to pelvic surgery. He is the first Thai physician to have performed it in Thailand. The technique involves a more precise skin incision that reduces wound length by nearly half compared to the conventional approach, allows for longer screws to be inserted for better stability, and results in less bleeding and faster recovery.
“This surgery had never been conducted in Thailand,” he said. “When my professor handed me a scalpel and said he would be my assistant surgeon, I was flabbergasted, but I tried to stay calm.”
The learning curve was significant. He estimated it takes around 20 cases before a surgeon becomes truly comfortable with the approach, which is part of why relatively few doctors in Thailand have adopted it.
Today, the technique is available at MedPark Hospital, which is among a small number of institutions in the country with the equipment required, including a C-arm fluoroscopy unit capable of generating intraoperative 3D imaging.
He also introduced suprapatellar tibial nailing to Thailand, a technique for lower leg fractures that allows surgery to be performed with the knee straightened rather than bent. The result is a smaller incision, less postoperative pain, and better conditions for the surgical team during the procedure.
Motion is life, and what stops people from getting back to it
When asked what the biggest mistake patients make after fracture surgery, Dr Pongsakorn did not hesitate. Fear of pain, insufficient rehabilitation, and returning to activity too early before the bone has healed are the three he sees most often.
“My job is only 50%. The other 50% is the patient, to do rehab and [continue to do] constant self-rehab.”
He spoke about one of his junior residents who fractured his elbow in a complex injury during a football match, a terrible triad fracture requiring both trauma and hand surgery specialists to reconstruct. The resident, knowing the theory behind recovery, pushed through rehabilitation every single day despite significant pain.
At three months, he could do push-ups again and return to operating on patients. Without that commitment, Dr Pongsakorn noted, a stiff elbow would have ended his medical career.
The same philosophy runs through his advice on long-term bone health. “Keep moving, keep exercising from when you are young and continue until you cannot walk,” he said. For older patients, he is direct: even walking three to five kilometres a day loads the bones enough to slow bone loss and reduce the risk of osteoporosis. Stop moving, and deterioration accelerates.
This belief is not just clinical. Dr Pongsakorn runs marathons, including the Berlin Marathon, a personal connection to the city where he trained. He is clear-eyed about the limits, though.
“Running between 5 to 10 km can be very healthy, but going beyond that can increase the risk of injury if you’re not training properly or using the right technique.”
His advice for anyone starting: begin slowly, stay within a manageable heart rate zone (mainly zone 2), and let fitness build over weeks, not days.
For active adults returning to exercise after injury, it is also worth paying attention to warning signs linked to the heart, including conditions such as arrhythmia.
When outcomes speak for themselves
Among the orthopaedic trauma cases that stay with him: a motorbike rider who hit a road barrier and arrived at MedPark with four long bone fractures, having already been treated at another hospital. After multiple surgeries and intensive physical therapy, he can now do push-ups and weight training.
Another patient, a pedestrian struck by a taxi running a red light, had an exposed knee bone on one leg and a fractured knee on the other. He had been a marathon runner. Five months after treatment, he was walking and exercising again and preparing to jog.
“This feat is quite an achievement and the pride of the orthopaedic trauma team, because intra-articular fractures normally take more than six months of healing before a patient can resume running.”
Recovery and training setbacks do not always stay limited to bones and joints, either, as prolonged stress, pain medication, or disrupted routines can sometimes overlap with broader issues such as digestive symptoms.
Motion is life! This is the phrase he returned to more than once during our conversation, and it captures both his clinical approach and his personal one.
Getting patients back to whatever motion means to them, whether that is walking to the shops, operating in a surgical theatre, or finishing a marathon, is the measure he uses for success.
If you have suffered a fracture, are recovering from a complex bone injury, or simply want to consult a specialist about bone health, consider reaching out to the Orthopedic Center at MedPark Hospital. The centre is located on the 5th floor, Counter A (West Lift), and is open from 8am to 8pm on weekdays and 8am to 5pm on weekends. For appointments or inquiries, contact 02-090-3116.
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