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Bone Fracture
Alternate Names : Broken Bone
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What are the treatments for the injury?
Emergency treatment consists of splinting the limb above and below the
suspected fracture. This keeps the area from moving. Ice should be applied. The
injured area should be elevated to reduce swelling and pain.
Repairing the bone can prevent a deformity of the bone as it heals. The bone
repair may be classified as a closed repair, which is done without cutting into
the skin, or an open repair, which involves surgery.
A closed repair is used if the bone is cracked completely, but the pieces are
not quite in the right place. The healthcare provider pulls on the bone to get
the bone pieces back in their proper position. For some fractures, splints or
casts that restrict motion are used. Fractures of the
collarbone, shoulder blades, ribs, toes, and fingers generally heal
well with such treatment.
An open repair is done for more serious fractures, including:
fractures in which the 2 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
An open repair is done in the operating room. A variety of tools are used
to repair the fracture and hold it in place. These include surgical nails,
screws, wires, rods, and metal plates. The surgeon may need to clean out the
area around the fracture. This will reduce the risk of infection from the open
wound.
Sometimes a fracture must be completely immobilized in order to heal. This can be done
with a splint, brace, cast, traction, or open repair.
A splint is a firm object that is affixed to the areas surrounding the
bone. A fractured finger is an example of a fracture that can be splinted.
A cast is a firm material made of either plastic or plaster. The cast is
wrapped around the area of the broken bone. A layer of softer material is
placed against the skin to protect it from injury and irritation. A fractured
wrist is an example of a fracture that could be casted.
Traction holds a limb in alignment using pulleys and weights. It is not
used very often anymore. However, it is sometimes used as a temporary measure until
surgery can be done on a hip fracture.
Open repair uses a variety of tools to hold the bone pieces in place.
These include surgical nails, screws, wires, rods, and metal plates.
What are the side effects of the treatments?
A closed repair may have complications. The bone may not heal properly or it
may not function properly. An open repair carries the same risks as any
surgery. These include infection, bleeding, damage to blood vessels or nerves,
and
allergic reactions to the anesthesia.
What happens after treatment for the injury?
Fractured bones need at least 4 weeks to heal solidly. In the elderly or
someone with
diabetes, healing may take longer. A cast may be worn to prevent
movement of the bone while it heals. Muscles in a leg or arm can become weak
and tight while the bone heals. Therefore, many people who have a bone fracture
need
physical therapy. The therapy begins while the bone is immobilized
and continues after the splint, cast, or traction has been removed.
A person who has had an open repair needs to watch for signs of infection,
swelling, or numbness. Any new or worsening symptoms should be reported to the
healthcare provider.
The bone is usually strong and fully functional once it has completely healed.
The healthcare provider should be consulted about an appropriate weight-bearing
exercise program to minimize the risk of future bone fractures.
To avoid further bone fractures in elderly individuals, the home
should be made safe to prevent accidents. Ways to increase safety include:
keeping areas safe, well-lit, and uncluttered to prevent falls
avoiding the use of throw rugs on floors
taking care with icy, wet, or slippery surfaces
using nonskid mats in the shower and bathtub
wearing comfortable shoes with nonslippery soles
using a cane if needed
trying not to lift heavy objects
using proper back support and lifting methods
wearing undergarments that have a protective pad around the hips to
prevent hip fractures
Intriguing new research done in older individuals with
arthritis found that brisk walking or weight training improved balance in those
individuals. Improved balance could very well help such individuals avoid hip fractures and wrist fractures resulting from falls.
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Author: Gail Hendrickson, RN, BS Reviewer: Eileen McLaughlin, RN, BSN Date Reviewed: 07/13/01
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