Fracture

It is a break in the continuity of any bone of the body. Usually the result of injury or fall. However sometimes bones may break with minimal or no injury; these are called Pathological fractures. These are fractures through bones weakened by some other pathology like infection, tumors, Osteoporosis and some genetic causes of fragile bones.

Open fractures

These are fractures with a breach in the skin and soft tissues overlying the bone. Gun shot injuries, blast injuries and penetrating accidental injuries are examples.These are challenging problems because:
  • Increased blood loss from the wound
  • Higher chances of infection
  • Slow healing of the fracture
  • Damage to nerves and blood vessels

Closed fractures

There is no break in the soft tissues and no open wounds. There however may be superficial abrasions at the injury point.

Symptoms and Signs
  • History of fall or injury
  • Sharp pain over bone
  • Sometimes a ‘crack’ is felt
  • Immediate swelling
  • Unable to move limb or stand/walk
  • Bump or crookedness visible
  • Watch for tingling or numbness in hand or toes

Immediate care

Rest
Ice
Compress
Elevate

You must show your local Orthopaedic surgeon and get suitable X-rays done.

Treatment

  • Non operative management
    • Reduction of the fracture and plastering under anaesthesia; usually in children and adolescents
    • Hairline cracks can be treated in splints and braces
    • Plaster boots for foot and ankle injuries
    • Rest for 3 to 6 weeks; crutches for leg fractures
  • Operative management
    • Displaced fractures especially in adults will need surgery
    • Open reduction and plating (titanium or stainless steel)
    • Closed reduction and Intramedullary nailing for long bone fractures like the thigh(femur) and leg(tibia)
    • once well fixed there is usually no need for plaster or splints.
    • Early movements and physiotherapy are started


Most fractures heal completely in 3 months. implants can be removed if desired at 18 to 24 months after surgery. With good fixation and rehabilitation most patients including the elderly return to normal function.

Dr Ashish Jain is a dedicated Trauma(fracture) surgeon and has specialised in the management of these complex injuries. In his experience a well done fracture fixation will leave no long term disability to the limb or the patient.