Definition A broken bone is called a fracture. There are a variety of treatments to repair, or reduce, a fracture. The treatment depends upon the type and severity of the fracture, and the bones involved. The goal is to eliminate any deformity of the bone and to maximise its function. There are two types of repair, open and closed.
Who is a candidate for the procedure? Anyone with 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 is usually done.
An open repair is done for more serious fractures. These include:
fractures in which the two ends of the broken bone can't be lined up correctly
fractures that extend into a joint
broken bones that are visible or stick out through the skin
Open repair may also be used on old fractures that are not healing properly.
How is the procedure performed? In a closed repair, the doctor pulls on the injured bone. 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 repair, or reduction, is a surgery done in the operating room. First, medication to relax the person is given. General anaesthesia 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 orthopaedist, then uses a variety of tools to repair the fracture and hold it in place. These tools 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. A cast is then applied.
What happens right after the procedure? The person is taken to the surgery recovery room until the relaxing medication wears off. The person may be able to go home a few hours later. If the fracture is severe, or there are other serious injuries, the person may remain in the hospital.
What happens later at home? After the procedure, a cast is worn to prevent movement of the bone while it heals. People who have an open repair need to watch for signs of infection, swelling, or numbness.
What are the potential complications after the procedure? A closed repair may have complications such as delayed healing of the bone or loss of function. As with any surgery, open repair carries the risk of infection, bleeding, or damage to blood vessels or nerves. Osteomyelitis, or infection of the bone, can be quite serious. Allergic reactions to the medications used are also possible.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
