Bone Fracture Repair
A broken bone is called a fracture. There are many types of treatments to repair a fracture. The treatment depends upon the type and severity of the fracture, and the bones involved.
Who is a candidate for the procedure?
Anyone who has 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 (also known as "closed reduction") will usually suffice.
An open repair ("open reduction") is reserved for more serious fractures, which include the following:
- broken bones that are visible or that stick out through the skin
- fractures in which the two ends of the broken bone cannot be lined up correctly
- fractures that extend into a joint
Open repair may also be used on old fractures that are not healing properly.
How is the procedure performed?
In a closed reduction,, the healthcare professional pulls (applies traction) on the injured bone. This can be done in a healthcare professional's office, the emergency room, or the operating room. 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 reduction is a surgery done in the operating room. First, medicine is given to relax the person. General anesthesia 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 orthopedist, uses a variety of tools or implants to repair the fracture and hold it in place. These implants 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. Next a rigid post-operative dressing is applied. Later, a cast or brace is usually used to protect the repair.
Campbell's Operative Orthopedics, 1998, Canale.
Scientific American Surgery: Trauma, 1988-1999, American College of Surgeons.