Trauma or Fracture Surgery

Trauma or Fracture Surgery

What is bone fracture repair?

When you experience a bone break (also known as a fracture), it’s important that the bone can heal properly in its original position.

There are several treatments for a broken bone, and the one a doctor recommends is based upon several factors. These include how severe the break is and where it is.

While some bones can heal by wearing a cast, others may require more invasive treatments, such as bone fracture repair.

Bone fracture repair is a surgery to fix a broken bone using metal screws, pins, rods, or plates to hold the bone in place. It’s also known as open reduction and internal fixation (ORIF) surgery.

Why is bone fracture repair done?

Bone fracture repair is used when a broken bone doesn’t or wouldn’t heal properly with casting or splinting alone.

Improper healing that requires ORIF surgery can occur in cases when the bone is sticking through the skin (compound fractures) and fractures that involve joints, such as wrists and ankles.

If bones that are surrounding the joints can’t be repaired, a person’s functional mobility could be severely impacted.

Fracture Healing
Our body reacts to a fracture by protecting the injured area with a blood clot and callus or fibrous tissue. Bone cells begin forming on either side of the fracture line. These cells grow towards each other and thus close the fracture.

Medical Therapy
The objective of early fracture management is to control bleeding, prevent ischemic injury (bone death) and to remove sources of infection such as foreign bodies and dead tissues. The next step in fracture management is the reduction of the fracture and its maintenance. It is important to ensure that the involved part of the body returns to its function after fracture heals. To achieve this, maintenance of fracture reduction with immobilization technique is done by either non-operative or surgical method.

Non-operative (closed) therapy comprises casting and traction (skin and skeletal traction).

  • Casting
    closed reduction is done for any fracture that is displaced, shortened, or angulated. Splints and casts made up of fiberglass or plaster of Paris material are used to immobilize the limb.
  • Traction
    Traction method is used for the management of fractures and dislocations that cannot be treated by casting. There are two methods of traction namely, skin traction and skeletal traction.

Skin traction involves attachment of traction tapes to the skin of the limb segment below the fracture. In skeletal traction, a pin is inserted through the bone distal to the fracture. Weights will be applied to this pin, and the patient is placed in an apparatus that facilitates traction. This method is most commonly used for fractures of the thigh bone.

Surgical Therapy

  • Open Reduction and Internal Fixation (ORIF)
    This is a surgical procedure in which the fracture site is adequately exposed and reduction of fracture is done. Internal fixation is done with devices such as Kirschner wires, plates and screws, and intramedullary nails.
  • External fixation
    External fixation is a procedure in which the fracture stabilization is done at a distance from the site of fracture. It helps to maintain bone length and alignment without casting.

External fixation is performed in the following conditions:

  • Open fractures with soft-tissue involvement
  • Burns and soft tissue injuries
  • Pelvic fractures
  • Comminuted and unstable fractures
  • Fractures having bony deficits
  • Limb-lengthening procedures
  • Fractures with infection or non-union

Rehabilitation

Fractures may take several weeks to months to heal completely. You should limit your activities even after the removal of cast or brace so that the bone becomes solid enough to bear the stress. Rehabilitation programs involves exercises and gradual increase in activity levels until the process of healing is complete.

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