by Mark W. McFarland, DO
In my last post, we talked about bone anatomy, the skeleton, how to keep bones healthy and what kind of fractures physicians commonly treat. In this installment, we are going to focus mostly on fracture first-aid and medical treatment.
Why do people fracture bones? The causes are endless, but here are some often reported reasons:
• Automobile Accidents
• Sports Injuries
• Repetitive Use
• Gunshot Wounds or blunt force trauma
Symptoms of Bone Fractures
Obviously, most people with a fracture are going to be in a lot of pain and will not want to move the area that is affected. However, I have seen people who haven’t even known they have had a broken bone or have walked around on a broken foot for weeks. It all depends on the person.
The most noticeable symptom of a bone fracture is pain, which can range from mild to severe. There may also be significant bruising, swelling, deformity, inability to move the affected limb or body part. In the case of an open fracture, the bone or bone fragments may even protrude from the wound. An open fracture can be pretty grisly.
Fracture First Aid
If you or someone you know suspects they have a fracture, what steps can you take to minimize trauma until a physician can administer care? Follow these steps:
• Immobilize – try to splint the affected body part to keep it from moving, whenever possible
• Protect – loosely cover the affected body part, especially if the skin is open or bone is protruding, to protect against infection
• Ice – ice the affected body part intermittently to reduce swelling and bruising
• Elevate – elevate the affected body part to help reduce swelling
• Do not give anything by mouth, like medications or liquids. Surgery may be necessary to reduce the fracture and you don’t want to wait for the stomach contents to clear.
• Seek medical care as soon as possible.
When a fracture is suspected, your OSC Orthopaedic Specialist will ask a lot of questions about how the injury occurred and your medical history, perform a thorough physical examination of the affected body part and will order x-rays to confirm the diagnosis. An x-ray is one of the best diagnostic tests to determine bone fractures because it gives clear images of the bone, how and where it is fractured. In some cases, an MRI or CT scan will need to be ordered to clearly define the fracture.
The treatment for all fractures is the same: put the bones back into their original position and stabilize them in place until they fully heal, which is called “union”. This bone-setting procedure is called “reduction”. It can be done in a closed fashion, without opening the skin surgically, or an open fashion, by opening the skin surgically to visualize the bone. Closed or open reductions can involve the use of pins or screws, only open reductions involve the use of plates and rods.
Treatment of the fracture also depends upon where in the body the fracture is located. A fractured rib is not casted or splinted because doing so would impair breathing. A fractured toe will usually heal very well if simply taped to its neighbor. A fractured vertebrae cannot be splinted, but may need an internal “cast” to be created through a procedure called kyphoplasty, where a balloon is injected into the bone, the balloon is inflated, restoring height and repositioning the bone. Cement is injected into the space created by the balloon, which then hardens, creating the internal cast. Some fractures, like those of the hip, almost always require surgery to reduce.
There is a more information about fracture treatment on our website that really goes into great detail about surgery, recovery and rehab. Feel free to check it out and let me know what you think.