A bone fracture is a medical condition in which a bone is cracked or broken. It is a break in the continuity of the bone. While many fractures are the result of high force impact or stress, bone fracture can also occur as a result of certain medical conditions that weaken the bones, such as osteoporosis.
A bone may fracture completely or partially. Fractures are commonly caused from trauma due to fall, motor vehicle accident or sports. Weakening of the bone due to osteoporosis in the elderly can cause the bone to break easily. Overuse injuries are common cause of stress fractures in athletes.
Types of fractures include:
- Simple fractures in which the fractured pieces of bone are well aligned and stable.
- Unstable fractures are those in which fragments of the broken bone are misaligned and displaced.
- Open (compound) fractures are severe fractures in which the broken bones cut through the skin. This type of fracture is more prone to infection and requires urgent medical attention.
- Greenstick fractures: This is a unique fracture in children that involves bending of one side of the bone without any break in the bone.
Our body reacts to a fracture by forming fracture callus. This process involves bone cells laying down new cartilage and, ultimately bone, on the either side of the fracture line. These cells grow towards each other and thus close the fracture.
The objective of early fracture management is to control bleeding, prevent ischemic injury (bone death), improve pain and to remove possible sources of infection if they exist. If the fracture is displaced, the next step in fracture management often is the reduction of the fracture. This is followed by immobilization in a splint or brace. If the fracture remains displaced or is considered unstable, surgical fixation may be recommended. If the fracture remains well-reduced or is considered stable, definitive treatment may consist of splint, cast or brace immobilization
Non-operative (closed) therapy comprises of casting and traction (skin and skeletal traction).
Open Reduction and Internal Fixation (ORIF)
This is a surgical procedure in which the fracture site is often exposed and reduction of fracture is done directly. Certain, fractures can be aligned through indirect reduction techniques without exposing the fracture site. Regardless of the reduction technique, internal fixation is this performed with plates, screws rods or nails to stabilize the fracture. This fixation is often permanent and rarely requires implant removal.
External fixation is a procedure in which the fracture stabilization is done at a distance from the site of fracture. It helps to maintain bone length and alignment without casting by placing pins through the skin and into the bone. These pins are then connected to each other with bars, essentially stabilizing the bone with an external scaffold.
External fixation may be performed in the following conditions:
- Open fractures with soft-tissue involvement
- Burns and soft tissue injuries
- Pelvic fractures
- Comminuted and unstable fractures
- Fractures having bony deficits
- Limb-lengthening procedures
- Fractures with infection or non-union
Fractures may take several weeks to months to heal completely. Often you will be asked to limit your weight bearing on the affect extremity. Dr. Melvin will clearly give you instructions on any restrictions. Physical therapy may be introduced prior to the fracture fully healing to improve mobility and healing in certain cases.