FRACTURE CARE
A fracture is when the normal structure of a bone is broken or disrupted usually caused by a trauma or fall. Fractures are diagnosed through x-rays, which can be done in the office. Treatment for fractures varies depending on the bone broken, the position of the broken bone, and the type of fracture.
Fractures can be treated with or without surgery. A fracture requires surgery when it is displaced. A fracture is considered displaced when the broken portions of bone shift out of their normal position.
Whether or not a fracture is treated with surgery, bone healing takes 6-8 weeks. Often, physical therapy is required once the fracture is healed to regain functional use of the injured area.
Treating a fracture without surgery:
Treatment of a fracture without surgery varies widely depending on the fracture pattern. Immobilization is the most important component of non-operative treatment of fractures. Immobilization involves holding the broken bones in position to allow them to heal without displacing.
Examples of immobilization include:
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A cast applied to affected area, such as the wrist or ankle
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A removal brace, such as a boot or wrist splint
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An arm sling
In addition to immobilization, limiting weight bearing and use of the arm or leg associated with your fracture is very important. Using, lifting with, or putting weight on a broken bone can cause displacement and can also increase pain. Ice, elevation, and anti-inflammatory pain medications are also helpful treatment measures diminishing pain associated with a fracture.
Treating a fracture with surgery:
Displaced fractures often require surgery to realign the bone to allow for proper healing. Displacement is an important consideration in treating fractures: if a fracture heals out of normal anatomic position, there will be residual stiffness, weakness, and chronic pain in the area.
Some characteristics of fractures in need of surgery include:
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Side to side displacement (shifting)
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Longitudinal displacement (shortening)
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Comminution (many small pieces)
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Significant angulation (bending)
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Significant rotation (twisting)
The procedure used to fix displaced fractures is an Open Reduction and Internal Fixation (ORIF): a surgical procedure performed in an operating room under anesthesia. Through an incision over the fracture site, fracture fragments are visualized and brought back into normal position. Once realigned, implants such as a small plate and screws are placed to fix the bone in this position. In most cases, these implants need not ever be removed.
Minimally displaced 5th metacarpal (hand bone) fracture
Displaced humerus fracture
minimally displaced distal fibula (ankle) fracture
Forearm fracture after surgical fixation (ORIF)