Fractures

 

There is a number of fracture classification systems, by shape, number of bone pieces and the direction of the fracture line. All these aspects are relevant when choosing treatment, as well as for prognosis (i.e. to preliminarily determine what the chance for a complete function of a broken bone after treatment is).

Fractures can be closed, where the skin over the broken bone remains intact. They may be non-displaced, which means that the fragments of bone maintain their normal alignment following a fracture.

In such cases, it is enough to immobilise the broken bone and two adjacent joints using plaster cast or a splint for a few weeks. Afterwards, a follow-up x-ray is taken to check whether the bone fragments remain in place and ensure the bone heals properly.

On the other hand, a displaced fracture means the disrupted alignment of bone fragments following a fracture. Soft tissue interposition may occur, that is, a piece of a muscle or tendon may come in between the two bone fragments preventing their proper alignment.

Finally, there can be open fractures, where the continuity if skin over the broken bone is impaired. Further classification of open fractures is based on the size of the wound over the fracture line, its contamination as well as clinical condition of nerves and blood vessels in a fractured limb.

Signs and symptoms

pathological mobility of the bone, unnatural shape of arm/ leg; crackling sounds of bone fragments, pain and swelling, bruising or discoloration, “pins and needles” or numbness, and even loss of pulse below the fracture.

Treatment

This type of treatments should be treated surgically. During an operation, the bone fragments will be properly aligned as an open reduction (i.e. the orthopaedic surgeon will see them) and fixed with an intramedullary rod (nail), plate and screws. The actual type of implant depends on the fracture and knowledge of surgical techniques by your consultant orthopaedist.