SERIOUS INJURIES – Fractures

FRACTURES – Fractures are a common injury in accidents. The types of fractures are listed below:

• Closed or simple fracture. The bone is broken, but the skin is not lacerated.
• Open or compound fracture. The skin may be pierced by the bone or by a blow that breaks the skin at the time of the fracture. The bone may or may not be visible in the wound.
• Transverse fracture. The fracture is at right angles to the long axis of the bone.
• Greenstick fracture. Fracture on one side of the bone, causing a bend on the other side of the bone.
• Comminuted fracture. A fracture that results in three or more bone fragments.

The following treatments are used for various types of fractures.

Cast Immobilization – A plaster or fiberglass cast is the most common type of fracture treatment, because most broken bones can heal successfully once they have been repositioned and a cast has been applied to keep the broken ends in proper position while they heal.

Functional Cast or Brace – The cast or brace allows limited or “controlled” movement of nearby joints. This treatment is desirable for some but not all fractures.

Traction – Traction is usually used to align a bone or bones by a gentle, steady pulling action. The pulling force may be transmitted to the bone through skin tapes or a metal pin through a bone. Traction may be used as a preliminary treatment, before other forms of treatment.

Open Reduction and Internal Fixation – In this type of treatment, an orthopedist must perform surgery on the bone. During this operation, the bone fragments are first repositioned (reduced) into their normal alignment, and then held together with special screws or by attaching metal plates to the outer surface of the bone. The fragments may also be held together by inserting rods down through the marrow space in the center of the bone. These methods of treatment can reposition the fracture fragments very exactly. Because of the risks of surgery, however, and possible complications, such as infection, they are used only when the orthopaedic surgeon considers such treatment to be the most likely to restore the broken bone to normal function.

External Fixation – In this type of treatment, pins or screws are placed into the broken bone above and below the fracture site. Then the orthopedic surgeon repositions the bone fragments. The pins or screws are connected to a metal bar or bars outside the skin. This device is a stabilizing frame that holds the bones in the proper position so they can heal. After an appropriate period of time, the external fixation device is removed.