A fracture is a broken bone. A bone may be completely fractured or partially fractured in any number of ways (crosswise, lengthwise, and/or in multiple pieces). The severity of a fracture usually depends on the force that caused the break. If the bone's breaking point has been exceeded only slightly, then the bone may crack rather than break all the way through. If the force is extreme, such as in an automobile crash or a gunshot, the bone may shatter.
If the bone breaks in such a way that bone fragments stick out through the skin, or a wound penetrates down to the broken bone, the fracture is called an "open" fracture. This type of fracture is particularly serious because once the skin is broken, infection in both the wound and the bone can occur.
Dr. Moore will do a careful examination to assess your overall condition, as well as the extent of the injury. He will talk with you about how the injury occurred, your symptoms, and medical history. The most common way to evaluate a fracture is with x-rays, which provide clear images of bone, showing whether a bone is intact or broken. X-rays also show the type of fracture and exactly where it is located within the bone.
All forms of treatment of broken bones follow one basic rule: the broken pieces must be put back into position and prevented from moving out of place until they are healed.
Surgery is sometimes required to treat a fracture. The type of treatment required depends on the severity of the break, whether it is "open" or "closed," and the specific bone involved. For example, a broken bone in the spine (vertebra) is treated differently from a broken leg bone or a broken hip.
Dr. Moore will use a variety of treatments to treat fractures, including:
Cast Immobilization: Plaster or fiberglass cast is the most common type of fracture treatment, because most broken bones can heal successfully once they have been repositioned and a cast has been applied to keep the broken ends in proper position while they heal.
Functional Cast or Brace: The cast or brace allows limited or "controlled" movement of nearby joints. This treatment is desirable for some, but not all, fractures.
Traction: Traction is usually used to align a bone or bones by a gentle, steady pulling action.
External Fixation: In this type of operation, metal pins or screws are placed into the broken bone above and below the fracture site. The pins or screws are connected to a metal bar outside the skin. This device is a stabilizing frame that holds the bones in the proper position while they heal. In cases where the skin and other soft tissues around the fracture are badly damaged, an external fixator may be applied until surgery can be tolerated.
Open Reduction and Internal Fixation: During this operation, the bone fragments are first repositioned (reduced) in their normal alignment, and then held together with special screws or by attaching metal plates to the outer surface of the bone. The fragments may also be held together by inserting rods down through the marrow space in the center of the bone.
Fractures take several weeks to several months to heal, depending on the extent of the injury. Even after a cast or brace is removed, movement should be limited until the bone is solid enough for normal activity. Specific exercises will be given to help restore normal muscle strength, joint motion, and flexibility during and after recovery.