Fracture Care
A bone fracture is the medical definition for a broken bone.
Fractures are usually caused by traumas like falls, car accidents or sports injuries. But some medical conditions and repetitive forces (like running) can increase your risk for experiencing certain types of fractures.
If you break a bone, you might need surgery to repair it. Some people only need a splint, cast, brace or sling for their bone to heal. How long it takes to recover fully depends on which of your bones are fractured, where the fracture is and what caused it.
When does a fracture require a cast?
A fracture typically requires a cast when the bone is broken but still in alignment, and the cast helps to hold the bone in place during the healing process. Casts are used for stable fractures, where the broken ends of the bone can be immobilised and aligned without surgery. The cast provides support, reduces pain, and protects the fracture from further damage, allowing the bone to heal properly over time.
Mentioned below are the medical scenarios when a fracture requires the use of a cast or a splint:
- Swelling: When an injury caused due to fracture causes extreme swelling and discomfort, a cast or splint may be required. The cast helps maintain the bones' alignment and speedy recovery of the broken bones. It also helps to lower the swelling and avoid any discomfort caused to the patient.
- Bruising: An injury leading to significant bruises on the skin can cause worry. A doctor must check such situations to know the root cause and proper injury treatment. A cast may help get rid of the fracture and lower the bruises. The cast helps maintain the bones' position after the surgical procedure, which helps in quick recovery and lower bruising.
- Restricted Movement: If an individual cannot move the injured part of the body and feels restricted, the situation requires a cast. The cast keeps the position of the bones aligned and intact to avoid any heavy movements. The cast helps in supporting the injury and keeping the operative surgery safe.
First Aid After a Fracture
1. Stop any bleeding Use a clean cloth or sterile bandage. Apply gentle pressure if bleeding is present.
2. Immobilize the injured area Do not try to realign the bone. Use a splint or any firm object (like a stick, rolled newspaper, or cardboard) to keep the injured limb in place. Tie it loosely with cloth, shoelaces, or bandage.
3. Apply ice packs Wrap ice in a cloth (never place directly on skin). Reduces swelling and pain.
4. Elevate (if possible and without causing pain) Helps reduce swelling, especially in limbs.
5. Keep the patient calm and still Avoid movement. Support the limb gently. Carefully transport to the nearest hospital.
How is a fracture treated?
- Splints: Used to immobilise broken bones or joints, prevent unnecessary movement, and reduce swelling. Splints act as first aid support for fracture care.
- Stop Bleeding: Excessive bleeding is a serious risk. Bleeding should be controlled immediately by applying pressure with a clean dressing.
- Do not move the injured part: Movement of fractured bones, limbs, or the pelvis should be avoided. Medical professionals manage alignment when required.
- Sling: Slings support arm fractures, reduce pain and swelling, and improve comfort during healing.
- Cold Pack: Ice packs help reduce inflammation, swelling, and pain, aiding faster recovery.
In case of compound fractures, upon arriving at the emergency department, pain relief options include oral or intravenous medications and nerve blocks. Tetanus vaccines and antibiotics may be administered depending on the injury. Treatment follows the P.R.I.C.E. principle—Protection, Rest, Ice, Compression, and Elevation. Surgery may be required to realign bones using plates, rods, screws, or pins, followed by immobilisation with casts or devices.
When Does a Fracture Need Surgery?
- Displaced Fractures: When broken bone ends are not aligned properly (e.g., overlapping forearm fractures).
- Open (Compound) Fractures: Bone protrudes through the skin, increasing infection risk.
- Joint Involvement: Fractures extending into joints require precise alignment to prevent arthritis and stiffness (ankle, elbow, knee).
- Multiple Fragments (Comminuted Fracture): Bone breaks into several pieces requiring fixation.
- Fracture Instability: Bones that cannot remain aligned with casting alone.
- Nerve or Blood Vessel Injury: Urgent surgery may be needed if vital structures are compressed.
- Failed Conservative Treatment: When casting or splinting does not result in proper healing.
What are Implants? And Which Implants are Used in ORIF?
Implants are medical devices placed inside the body to support, reinforce, or stabilise bones after fractures or joint injuries. They ensure proper healing, restore function, and maintain bone alignment.
- Plates & Screws: Commonly used for long bone fractures such as femur and humerus.
- Intramedullary Nails: Inserted inside the bone canal, commonly used for tibia and femur fractures.
- K-wires / Pins: Used for small bones or temporary fixation (wrist, fingers).
- External Fixators: Used in open or infected fractures, often as a temporary stabilisation before ORIF.
