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bone fracture repair

Alternative Names
bone fracture reduction

Definition

A broken bone is called a fracture. There are many types of treatments to repair a fracture. The treatment depends upon the type and severity of the fracture, and the bones involved.

The goal of any treatment is to eliminate any deformity of the bone and to maximize its function. There are two types of repair, open and closed.

Who is a candidate for the procedure?

Anyone who has a broken bone may be a candidate for fracture repair. If the bone has just a minor crack, no repair may be needed. A cast or splint may be placed over the skin covering the broken bone. The body is then allowed to repair the fracture on its own.

If the bone is cracked completely but the pieces are not quite in the right place, a closed repair (also known as "closed reduction") will usually suffice.

An open repair ("open reduction") is reserved for more serious fractures, which include the following:

Open repair may also be used on old fractures that are not healing properly.

How is the procedure performed?

In a closed reduction,, the healthcare professional pulls (applies traction) on the injured bone. This can be done in a healthcare professional's office, the emergency room, or the operating room. This helps get the bone pieces back into their proper position. A splint or cast is then applied to prevent movement of the injured bone.

An open reduction is a surgery done in the operating room. First, medicine is given to relax the person. General anesthesia may be used to put the person to sleep. The skin over the broken bone is then cleaned and shaved. The skin is cut open and the bone is exposed.

The bone surgeon, or orthopedist, uses a variety of tools or implants to repair the fracture and hold it in place. These implants may include surgical nails, screws, wires, rods, and metal plates. After the bone pieces are back in the proper place, the cut in the skin is closed with staples or stitches. Next a rigid post-operative dressing is applied. Later, a cast or brace is usually used to protect the repair.

What happens right after the procedure?

The person is taken to the surgery recovery room until the anesthesia or sedating medicines have worn off. The person may be able to go home a few hours later. If the fracture is severe, or if there are other serious injuries, the person may remain in the hospital.

What happens later at home?

After the procedure, a cast or brace may be worn to prevent movement of the bone while it heals. Physical therapy may be helpful to maintain or restore normal function.

What are the potential complications after the procedure?

A closed reduction may have complications such as delayed healing of the bone or loss of function. Open reduction carries the risk of infection, bleeding, or allergic reaction to the anesthetic. Osteomyelitis, an infection of the bone, can be quite serious and must be treated with long-term antibiotics or further surgery.


Author:Minot Cleveland, MD
Date Written:04/27/00
Medical Review:Jeff Ginther, MD
Date Written:10/3/2006
Reviewer:Reginald Finger, MD
Date Reviewed:10/24/2006
Contributors
Potential conflict of interest information for reviewers available on request