Fractures

Fracture care and management involve a comprehensive approach to treating bone fractures, from initial assessment and stabilization to long-term rehabilitation and follow-up care. Our commitment extends beyond immediate treatment to long-term recovery. We emphasize patient education and support, ensuring individuals understand their injury, treatment options, and expectations for recovery. Whether you're dealing with a fracture from a sports injury, accident, or osteoporosis-related condition, our team is here to provide compassionate care and personalized attention every step of the way.

Principles of Fracture Management

Fracture management aims to properly align broken bones, promote healing, restore function, and prevent complications such as infection or malunion (improper healing). Key principles include:

Assessment: Initial evaluation to determine the type, location, severity, and stability of the fracture through clinical examination and imaging studies (X-rays, CT scans, MRI).
Stabilization: Immobilization of the fracture to prevent further injury and promote healing. Depending on the fracture type and location, this may involve casting, splinting, traction, or surgical fixation.
Reduction: Aligning bone fragments (reduction) may be necessary to restore normal anatomy and function. The reduction can be closed (manipulation without surgical incision) or open (surgical correction with direct visualization).
Rehabilitation: Rehabilitation and physical therapy to restore strength, mobility, and function of the affected limb or joint following fracture healing.
Monitoring: Regular follow-up visits and imaging studies to assess healing progress, monitor complications, and adjust treatment as needed.

Types of Fractures

Fractures vary in severity, complexity, and location. Common types include:

Closed Fracture: The bone breaks without penetrating the skin.
Open (Compound) Fracture: The bone breaks through the skin, increasing the risk of infection.
Stable Fracture: Bone fragments are aligned and stable.
Unstable Fracture: Bone fragments are displaced and require stabilization for proper healing.
Comminuted Fracture: The bone is broken into multiple pieces.
Greenstick Fracture: Incomplete fracture where the bone bends and partially breaks, often seen in children.

Diagnosis and Assessment

Diagnosis involves a thorough clinical evaluation and imaging studies:

Clinical Evaluation: Assessment of the mechanism of injury, pain, deformity, swelling, and function of the injured limb.
Imaging: X-rays are the primary diagnostic tool to visualize fractures. CT scans or MRIs may be used for complex fractures or to assess associated soft tissue injuries.

Treatment Options

Treatment depends on the type, location, and severity of the fracture:

Non-Surgical Treatment

Immobilization: Casting, splinting, or traction to stabilize the fracture and promote alignment.
Closed Reduction: Manipulation to align bone fragments without surgical incision.
Pain Management: Medications (e.g., NSAIDs, opioids) to alleviate pain and discomfort.

Surgical Treatment

Open Reduction and Internal Fixation (ORIF): Surgical procedure to align and stabilize bones using plates, screws, rods, or nails.
External Fixation: Temporary fixation using pins and an external frame for complex fractures or soft tissue injuries.
Intramedullary Nailing: Insertion of a metal rod into the hollow center of the bone to stabilize fractures, commonly used for long bone fractures.

Surgical Interventions

Surgical management aims to achieve anatomical reduction, restore stability, and facilitate early mobilization:

Procedure Selection: Based on fracture type, location, soft tissue condition, and patient factors.
Anesthesia: General anesthesia or regional anesthesia (e.g., spinal anesthesia), depending on the complexity of the surgery.
Post-operative Care: Monitoring for complications like infection, compartment syndrome, or nerve injury.

Fracture Rehabilitation and Physical Therapy

Rehabilitation plays a crucial role in restoring function and mobility after fracture healing:

Early Mobilization: Gentle range-of-motion exercises to prevent joint stiffness.
Progressive Weight-Bearing: Gradual increase in weight-bearing activities to strengthen muscles and bones.
Functional Training: Activities to improve balance, coordination, and functional abilities relevant to daily living or specific sports.

Complications and Considerations

Delayed Union: Prolonged healing due to inadequate blood supply or poor bone alignment.
Non-union: Failure of the fracture to heal despite treatment.
Malunion: Improper alignment of bone fragments resulting in deformity or functional impairment.
Infection: Risk of infection, particularly in open fractures or those requiring surgical intervention.
Compartment Syndrome: Increased pressure within muscle compartments, requiring urgent intervention to prevent tissue damage.

Long-Term Outlook

Successful fracture management requires collaboration among orthopedic surgeons, nurses, physical therapists, and other healthcare professionals. Patient education, adherence to treatment plans, and regular follow-up are essential for achieving optimal outcomes and minimizing complications. With advances in surgical techniques, rehabilitation protocols, and interdisciplinary care, many patients can expect to regain function and return to normal activities following appropriate fracture management.