Fracture Treatment

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KEY POINTS

• A fracture is a crack or break in a bone. There are many different kinds of fractures.
• Some fractures can be treated without cutting the skin. Many fractures may need a cast, surgery, pins, or other treatment.

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What is a fracture?

A fracture is a crack or break in a bone. When a bone is broken, it may be just a bend or small crack in the bone, or the bone may break into pieces or shatter. Some fractures may stick out through the skin.

The pain and damage may make it hard or impossible to use the part of the body that is injured. The broken pieces must be put back into the correct place and protected until healing is complete.

The different types of fractures include:

• Nondisplaced: The broken pieces of bone are still in the correct position.
• Displaced: The broken pieces of bone are not in the correct position.
• Comminuted: The bone is broken into more than 2 pieces.
• Closed: The broken bone has not broken through the skin
• Compound (open): The broken bone has broken through the skin.
• Impacted: Ends of the broken bone were pushed into each other.
• Avulsion: A tendon or ligament has pulled part of the bone away from where it was originally attached.
• Pathological: The bone has been weakened or destroyed by disease (such as osteoporosis) so that the bone breaks more easily than healthy bone.
• Stress: The bone has small cracks caused by overuse, such as from running, gymnastics or basketball. These fractures often happen in the lower leg or foot.

What are the different types of fracture treatment?

The treatment of a fracture depends on the type and location of the fracture.

Some fractures need only rest, ice, and possibly a brace, boot, splint, or cast to hold the pieces of broken bone in place and keep the bone from moving while it heals.

If your child has an open wound with the fracture, he will need treatment to control bleeding or prevent infection.

If the broken bone is crooked, your child’s healthcare provider will straighten the bone by moving the pieces of bone back into their proper places. There are different ways this may be done.

• Closed reduction: Closed reduction means that your child’s healthcare provider moves the bone back into the correct position without cutting the skin. If your child needs this form of treatment, he will receive medicine to help him relax and not feel pain.
• Traction: Traction is the use of weights or elastic bands to help pull the bone into place. Traction also helps keep the bone in place while it heals.
• External fixation: After the bones are put in place with closed reduction, metal pins or screws may be put through the skin into the bone above and below the fracture. The pins or screws are connected to metal bars on the outside of the skin to form a frame around the fracture. The frame keeps the bone pieces in place. When the bone has healed, your healthcare provider will remove the metal frame.
• Open reduction and internal fixation: Open reduction surgery involves cutting the skin over the fracture and then putting the bones into the correct position. The pieces of bone are held in place with metal pins, rods, plates, or other types of hardware. Usually the metal is left in place and the bone heals around the metal. In some cases, the metal may be removed in a follow-up surgery.

Your child may need to do exercises recommended by his healthcare provider during and after healing to make the muscles and joints strong and flexible again.