Health Topics for Bones, Joints and Muscles

Bone and Muscle Cancer

Department of Orthopaedics

Sports Related Injuries

Rheumatology Clinic

Pediatrics Rheumatology

UI Spine Center

Fracture treatment

Fractures are broken bones. Fractures cause pain and make it difficult or impossible to use the part of the body that is injured. The treatment of a fracture depends upon the type and location of the fracture, if there are other injuries, and how serious those injuries are.

The goal of treatment is to have a completely healed well-aligned bone that functions well. The bone should not be deformed and should look good when healed. The treatment should allow the person to go back to work as soon as possible. The broken pieces must be put back into the correct position and kept in proper alignment until healing is completed. The types of treatment include:

• closed reduction
• traction
• open reduction and internal fixation
• external fixation
• casts and splints and
• functional casts or braces

X-rays help determine the proper diagnosis and type of treatment. Sometimes fractures do not affect bone alignment and only require protection of the bone with a splint or cast while it heals. However, if the fractured bone is not lined up correctly, it may need to be reduced. This means re-aligning the bone. A closed reduction re-aligns a bone by manipulation without surgery. Sometimes it is not possible for the provider to get the bones in the right position with a closed reduction. If this happens, traction can be put on the bones to gently pull them into position. Traction is usually used for a short period of time and before other forms of treatment are used.

An open reduction and internal fixation of the bone requires an orthopedic surgeon. The surgery requires cutting open the skin of the area over the fracture so bone fragments can be put back into place and the bone fixated or held in place. The bone fragments are held in place with special screws or by attaching metal plates to the bone. Pins that go through the bone or rods that go inside the length of the bone are used to keep the bone in place.

External fixation is done without making a cut. First a closed reduction is done to put the bones in place. Next, pins or screws are put through the skin and bone above and below the fracture. These are connected to metal bars on the outside of the skin to form a frame around the fracture. This frame keeps the bone pieces in place. When the healing is complete, the fixation device is removed.

The most common treatment is a plaster or fiberglass cast. Casts are used for bones that are in the correct position. A cast holds the broken bone in position and prevents movement of the bone while it heals. A splint is a partial cast. Sometimes a splint is used instead of a cast. A splint is usually held in place with an elastic bandage. Some fractures require limited or controlled movement of nearby joints. A functional cast or brace allows a little movement of nearby joints while keeping the bones in the right position.

Treatment also involves the person with the fracture. The providers' instructions must be followed. Even though a cast or fixation device is uncomfortable, it is needed for the bone to heal right. Most fractures heal without problems. A properly healed bone will work normally without pain. Exercises are usually necessary during and after the healing process. Exercise helps to make the muscle strong, flexible, and help the joint move. After a cast or fixation is removed, physical therapy may be needed.

Not all fractured bones, like ribs, need treatment. A stress fracture may only need rest, ice several times a day, and non- steroidal, anti-inflammatory medicines. Non-steroidal anti- inflammatory drugs (NSAIDs) should be taken with food or milk to prevent stomach upset. NSAIDs should not be taken by anyone who has been diagnosed with asthma, ulcer disease, or a bleeding disorder. Taking NSAIDs increases the risk of bleeding with trauma, dental work, surgery, or if taking blood thinners (anticoagulants).

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File BONE3427.RF2 VRS# 7614 Data Version 7.0 Copyright 1999, 2003 McKesson Health Solutions LLC. All rights reserved.