Fracture Care

Whether partial or complete, a fracture is a broken bone. Fractures can be quite painful and debilitating, but with the proper treatment, you can fully regain your normal function and get back to your life.

Fractures can happen for a number of reasons. The most common cause of fractures is trauma, such as a fall, athletic blow or vehicular accident. You may know right away if you’ve broken a bone due to trauma. Other typical causes include osteoporosis, which causes bones to become brittle and break easily, and overuse, which results in stress fractures and is common among athletes.

Fractures can be simple or compound, and can occur in a number of ways. A closed, or simple, fracture is a bone that is broken but the skin remains intact and is not lacerated. An open, or compound, fracture occurs when the skin has been broken along with the bone, or pierced by the broken bone, which may be visible in the wound. The formation of the fracture can produce one of the following types:

• Transverse Fracture: A fracture that cuts horizontally across the length of the bone.
• Buckle Fracture: A fracture seen in children caused by compression. A small bulge is seen on the x-ray.
• Greenstick Fracture: A fracture on one side of the bone, causing a bend on the other side of the bone.
• Comminuted Fracture: A fracture that results in three or more bone fragments.
• Spiral Fracture: A fracture that spirals along the shaft of the bone.

Diagnosis and Treatment
A physical exam is the first step in the diagnosis of a fracture. Indications of a fracture may include a swollen and painful area, a deformed limb, or a bone that has pierced through the skin. An x-ray will verify the presence of a fracture, its type, and whether it is partial or complete.

All broken bones should be in normal alignment for the best healing. Sometimes this requires actually putting the bone back into place. Once in good alignment, the bone should be protected and kept in place, often with a cast. Treatment depends on the severity of the fracture and the specific bone involved. To treat a simple fracture on your forearm, for example, you may have a splint or cast to hold the bone in place. Different types of casts are available, such as waterproof casts in some cases to allow you to continue participating in a certain sport or activity.

For more severe cases such as comminuted fractures, external or internal fixation devices may be required. With external fixation, pins or screws are placed into the bone surrounding the fracture and are connected to a metal bar frame outside the skin, which stabilizes the fracture. Internal fixation is a surgical procedure in which the fragments are first repositioned, and then affixed with special screws or metal plates on the outer surface of the bone. They may also be held together with rods inserted through center of the bone.

Exercise is important during the later stages of the healing, as healthy muscles will help to keep pressure off of the injured bone, and will help to maintain normal muscle strength and flexibility during your recovery. Your orthopaedist will discuss safe exercise with you during your visit.