Fractures and Trauma
If you think you or your child has broken a bone, seek prompt medical attention. It’s important to treat a fracture as soon as possible to ensure proper healing.
First, you’ll discuss any symptoms you're having and explain how you injured yourself while the provider examines your injury. Then, your provider is likely to order X-rays to determine the severity of the fracture and pinpoint the location of the break. Occasionally, your doctor may also recommend another scan, such as an MRI, to obtain more detailed images.
Treatment depends on the site and severity of your injury. A simple break may be treated with a sling, ice and rest. However, the bone may require realignment (reduction) in the emergency room. A more complicated break might require surgery to realign the broken bone and to implant wires, plates, nails or screws to maintain proper alignment during healing.
Fractures are classified into one or more of the following categories:
- Open (compound fracture) – The broken bone pierces the skin. This is a serious condition that requires immediate, aggressive treatment to decrease the risk of infection.
- Closed fracture – The skin remains unbroken.
- Displaced fracture – The bone fragments on each side of the break aren't aligned, which may require surgery for complete healing.
- Comminuted fracture – The bone is broken into pieces, which may require surgery for complete healing.
- Greenstick fracture – The bone cracks but doesn't break all the way through — like what happens when you try to break a green stick of wood. Most broken bones in children are greenstick fractures, because a child's bones are more flexible than those of an adult.
- Buckle (torus) fracture – One side of the bone is compressed, which causes the other side to bend (buckle). This type of fracture is also more common in children.
Setting the Bone
If you have a displaced fracture, your doctor may need to manipulate the pieces back into their proper positions — a process called reduction. Depending on the amount of pain and swelling you have, you may need a muscle relaxant, a sedative or even a general anesthetic before this procedure.
Restricting movement of a broken bone is critical to healing. To do this, you may need to wear a splint, sling, brace or cast. If your broken bone requires a cast, your doctor will likely wait until the swelling goes down, usually five to seven days after injury. In the meantime, you'll likely wear a splint. Your doctor may ask you to return for more X-rays during the healing process to make sure the bones haven't shifted.
To reduce pain and inflammation, your doctor may recommend an over-the-counter pain reliever. If you're experiencing severe pain, you may need to take a prescription medication that contains a narcotic for a few days.
Rehabilitation begins soon after initial treatment. In most cases, it's important, if possible, to begin some motion to minimize stiffness while you're wearing your cast or sling. After your cast or sling is removed, your doctor may recommend additional rehabilitation exercises or physical therapy to restore muscle strength, joint motion and flexibility.
Surgery is required to stabilize some fractures. If the fracture didn't break the skin, your doctor may wait to conduct surgery until the swelling has decreased. Keeping your injury from moving and elevating it will decrease swelling. Fixation devices — such as wires, plates, nails or screws — may be needed to maintain proper position of your bones during healing. Complications are rare but can include infection and lack of bone healing.