Fracture Management: Which Treatment Is Ideal?

The ideal treatment for a fracture depends on factors that are unique for each person. The type, severity, and location of your fracture immediately determine the treatment path that’s best for you.

When caring for a fracture, Andrew B. Richardson, MD, never takes a one-size-fits-all approach. However, fracture management incorporates certain medical techniques that ensure you receive ideal treatment.

Open fractures need specialized care

An open or compound fracture occurs when you have a wound or tear in your skin at the site of the break. The broken bone may protrude through the wound, or the wound may be deep enough to expose the bone.

An open fracture puts you at high risk for infection. Additionally, this type of wound often causes significant damage to the surrounding tissues, including blood vessels and nerves.

The ideal treatment for an open fracture begins by carefully cleaning the wound and taking steps to prevent an infection. Bone infections are hard to treat, so prevention is paramount to your care. Open wounds typically require immediate surgery so we can carefully clean the entire area around the fracture and then align and stabilize the bones.

Fractured bones must be reset

Your bones can’t heal correctly unless the ends of the broken pieces are properly aligned. We place the ends together and make sure the bone is in its normal anatomical position. If the bone isn’t reset, healing occurs with the bone in a deformed position.

For some types of fractures, we can manipulate the bone and set it into its proper position without surgery, an orthopedic procedure called closed reduction. More complex fractures, however, require an open reduction or surgery so we can access all of the pieces and reset the bone.

Immobilization is essential

Once your bone is realigned, ideal treatment demands that we immobilize the bone so the pieces stay in place while they grow back together. The type of immobilization depends on the severity of your fracture.

You may need a plaster or fiberglass cast that holds the broken area in a fixed position. Others may be able to wear a functional cast or brace that allows limited movement at the joints. Severe fractures require specialized hardware to ensure all the bone fragments remain immobilized. We insert the hardware by performing internal fixation or external fixation.

An internal fixation is a surgical procedure in which we reposition your bones and then hold them together with screws, metal plates, or a rod inserted through the center of the bone. During an external fixation procedure, we insert pins into the bones on both sides of the break. Then we connect the pins to a bar on the outside of your body, an external fixator that stabilizes the bones.

Rest for a stress fracture

A stress fracture is an overuse injury that develops from repetitive motions, a sudden increase in the intensity of your training, and poor technique. This type of fracture begins as a tiny crack in the bone that’s painful when you’re active. Without treatment, the crack can turn into a full-blown fracture.

Rest is the ideal treatment for a stress fracture. It’s essential to rest and modify your activities so you stop the movement that caused the crack and give the bone time to heal. 

Rehabilitation is not negotiable

Whether you had nonsurgical or surgical fracture repair, once your bone heals, you start a customized physical therapy and rehabilitation program. While your bone is immobilized, your muscles weaken, and the area gets stiff. Your rehabilitation addresses these problems with exercises to restore muscle strength and your full range of motion.

If you plan to return to sports or if you sustained a stress fracture, your rehabilitation also includes activity-specific training. You may need to learn different techniques or establish a new training regimen that prevents overuse injuries.

If you need expert care for any type of fracture or a sports medicine specialist, call Andrew B. Richardson, MD, or schedule an appointment online. We also offer telehealth services.

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