Fracture (cont.)

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What is the treatment of a bone fracture?

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In the field, the initial treatment for fractures of the arms, legs, hands and feet include splinting the extremity in the position it is found, elevation and ice. Immobilization will be very helpful with initial pain control. For injuries of the neck and back, many times, first responders or paramedics may choose to place the injured person on a long board and in a neck collar to protect the spinal cord from potential injury.

Once the fracture has been diagnosed, the initial treatment for most limb fractures is a splint. Padded pieces of plaster or fiberglass are placed over the injured limb and wrapped with gauze and an elastic wrap to immobilize the break. The joints above and below the injury are immobilized to prevent movement at the fracture site. This initial splint does not go completely around the limb. After a few days, the splint is removed and replaced by a circumferential cast. Circumferential casting usually does not occur initially because fractures swell (edema). This swelling could cause a build up of pressure under the cast, yielding increased pain and the potential for damage to the tissues under the cast. However, if the fracture required reduction (putting the bones back into alignment) there might be a need for circumferential cast to keep the bones in place.

Bone fracture surgery

Surgery on fractures are very much dependent on what bone is broken, where it is broken, and whether the orthopedic surgeon believes that the break is at risk for moving out of place once the bone fragments have been aligned. If the surgeon is concerned that the bones will heal improperly, an operation will be needed. Sometimes bones that appear to be aligned normally are splinted, and at a recheck appointment, are found to be unstable and require surgery at a later date.

Surgery can include closed reduction and casting, where under anesthesia, the bones are manipulated so that alignment is restored and a cast is placed to hold the bones in that alignment. Sometimes, the bones are broken in such a way that they need to have metal hardware inserted to hold them in place. Open reduction means that, in the operating room, the skin is cut open and pins, plates, or rods are inserted into the bone to hold it in place until healing occurs. Depending on the fracture, some of these pieces of metal are permanent (never removed), and some are temporary until the healing of the bone is complete and surgically removed at a later time.

Additional resources from WebMD Boots UK on Fractures

REFERENCES:

Bucholz RW, et al. Rockwood and Green's Fractures in Adults, 7th edition. Lippincott Williams & Wilkins. 2009

Robinson, Y. et al. Vertebroplasty and kyphoplasty--a systematic review of cement augmentation techniques for osteoporotic vertebral compression fractures compared to standard medical therapy. Maturitas. 2012 May;72(1):42-9. doi: 10.1016/j.maturitas.2012.02.010. Epub 2012 Mar 16.

Stiell IG, et al. The Canadian CT head rule for patients with minor head injury. Lancet May 5, 2001;357:1391-6.


Medically Reviewed by a Doctor on 4/9/2013

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Fracture - Describe Your Experience Question: Please describe what type of fracture you experienced.
Fracture - Causes Question: What caused your fracture?
Fracture - Treatment Question: Besides surgery, what types of treatment did you have for your bone fracture?
Bone Fracture - Signs and Symptoms Question: How did you know you had more than a sprain or strain? What were your signs and symptoms of a broken bone?
Bone Fracture - Surgery Question: Did you have surgery to fix your broken bone(s)? Which bone(s) did you fracture?