Fracture management is a critical component of orthopedic care involving the diagnosis, treatment, and rehabilitation of broken bones. A fracture occurs when a bone breaks due to trauma, overuse, or medical conditions that weaken the bones, such as osteoporosis or cancer. Effective and timely management ensures proper healing, restores function, and prevents long-term complications..
Whether it's a simple hairline crack or a complex, displaced break, fracture management requires a multidisciplinary approach involving orthopedic surgeons, radiologists, physiotherapists, and sometimes trauma or vascular specialists.
Types of Fractures
Fractures can be classified into several types based on severity and cause:
- Closed (Simple) Fracture: Bone is broken but the skin remains intact
- Open (Compound) Fracture: Bone pierces through the skin, increasing infection risk
- Transverse Fracture: A straight break across the bone
- Oblique Fracture: A diagonal break across the bone
- Comminuted Fracture: Bone is shattered into multiple pieces
- Greenstick Fracture: Incomplete fracture common in children
- Stress Fracture: Hairline crack caused by repetitive stress
- Pathological Fracture: Fracture in a bone weakened by disease (e.g., cancer, osteoporosis)
1. Initial Assessment & Diagnosis
- Clinical evaluation of injury site (pain, swelling, deformity)
- Imaging:
- X-ray – Standard for most fractures
- CT Scan – For complex or joint-related fractures
- MRI – To assess soft tissue or stress fractures
- Evaluation for neurovascular compromise or associated injuries
2. Stabilization
In emergency cases, especially open or multiple fractures, initial stabilization may include:
- Immobilizing the limb with splints
- Controlling bleeding
- Administering pain relief
- Antibiotics and tetanus prophylaxis in open fractures
3. Treatment Options
Non-Surgical Management (Conservative)
Used for stable, non-displaced, or minor fractures:
- Casting or Splinting: Immobilizes the bone during healing
- Traction: Applies pulling force to align the bone (rare today)
- Functional Bracing: Allows limited movement while maintaining alignment
Surgical Management
Required for unstable, displaced, open, or complex fractures:
- Open Reduction and Internal Fixation (ORIF):
- Realignment of bone fragments
- Use of plates, screws, or rods for stabilization
- External Fixation:
- Pins or wires connected to an external frame
- Often used in open or infected fractures
- Intramedullary Nailing:
- Rod inserted into the bone’s marrow canal (e.g., for long bones like femur or tibia)
- Joint Reconstruction:
- In cases where fractures involve joints (e.g., hip fractures)
Rehabilitation & Physiotherapy
Rehabilitation is essential for restoring joint mobility and muscle strength:
- Gentle range-of-motion exercises
- Strengthening and endurance training
- Gait training (for lower limb fractures)
- Pain management techniques
- Occupational therapy (for upper limb or hand injuries)
Early physiotherapy reduces stiffness and speeds up return to normal activity.
Special Considerations
- Pediatric Fractures: Growth plates must be protected; healing is usually faster
- Geriatric Fractures: Often due to osteoporosis, require fall prevention strategies
- Sports-Related Fractures: Emphasize return-to-sport protocols
- Fragility Fractures: Associated with low bone density; require bone health evaluation and treatment
Why Choose a Specialist for Fracture Care?
An experienced orthopedic surgeon provides:
- Accurate diagnosis and classification of the fracture
- Customized treatment plan (surgical or conservative)
- Access to advanced fixation technology and imaging
- Multidisciplinary care involving rehab specialists
- Guidance on bone health and prevention of future fractures
