About Fractures

''Fracture' is the medical term for any type of broken bone. This can range from an invisible hairline crack to a completely shattered bone with pieces lost via an open wound. The bone injury itself however is only part of the problem, the surrounding damage to the 'soft tissues' ie skin, muscles joints etc make the management of any fracture unique.

Treatment of fractures

Historically, the treatment of fractures has been by keeping the bone ends still to allow them to heal, and hence the use of plaster casts, traction, splints etc. This is still the best way of treatment for many fractures, and the complications are minimal. Unfortunately it usually involves immobilizing the joints adjacent to the fracture site, so a plaster for a fractured tibia for example has to extend from the mid thigh to the foot.

Four to six months in a plaster like this leads to muscle weakness, stiffness of the joints, pains in the upper limbs and back from prolonged use of crutches, and a risk of blood clots in the leg from lack of muscle use.

These problems have led to a huge variety of techniques for treating fractures by fixing with metal, either by plates with screws (Open Reduction and Internal Fixation, ORIF) or rods in the hollow centre of bones (intramedullary nailing). The techniques, types of fixation and indications are highly complex, and the pros and cons of any method should be discussed with your Orthopaedic Surgeon.

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