Common Fractures

Closed reduction is a non-surgical procedure used to realign broken bone fragments to their normal anatomical position. It is typically performed under local or general anesthesia to minimize pain and discomfort. The orthopedic surgeon manually manipulates the bone fragments without making an incision into the skin. This method is often used for simple fractures, where the bone pieces are not severely out of place and the skin is not broken.

After the bone fragments are realigned, immobilization is essential to maintain the proper alignment and promote healing. Casting is the most common method of immobilization. A cast, made of materials like plaster or fiberglass, is custom-fitted to the part of the body where the bone is broken, providing rigid support that keeps the bone in place during the healing process. Casts are designed to encompass the joint above and below the fracture site, ensuring stability. The duration for which a cast is worn depends on the severity and location of the fracture, as well as the patient’s age and general health.

In cases where closed reduction is not feasible, such as with compound fractures or fractures with severe misalignment, open reduction and internal fixation (ORIF) is employed. Surgical intervention may also be needed when nonoperative care fails, the fracture is unstable, there are multiple traumatic injuries in the same area of the body and when the fracture occurs in skeletally immature patients.

This surgical technique involves making an incision at the fracture site to directly visualize and realign the bone fragments. Once aligned, the fragments are held together with internal fixation devices like metal plates, screws, or rods. These devices stabilize the fractured bone internally, allowing for proper healing.

ORIF is advantageous in maintaining precise bone alignment, especially in complex fractures. It also allows for earlier mobilization and rehabilitation compared to non-surgical methods. However, it carries the risks associated with surgery, such as infection, and requires careful postoperative care.

Casting plays a vital role in postoperative care following ORIF. After surgical alignment and internal fixation, a cast or splint may be applied to protect the surgical site and to immobilize the affected limb during the initial phase of healing. The duration of casting varies, depending on the fracture’s complexity and the patient’s healing response.

Rehabilitation is a vital component of fracture care. Physical therapy often begins soon after fracture stabilization, focusing on restoring range of motion, strength, and function. The duration of rehabilitation varies, and a multidisciplinary approach, including physical therapists, orthopedic surgeons, and nursing staff, ensures optimal recovery.

The ultimate goal of fracture care is to ensure the proper alignment and stabilization of the broken bone, enabling it to heal correctly and restore its function.