Comprehensive Fracture care for children and adults

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Fractures, or broken bones, are common injuries that can happen as a result of accidents, falls, or high-impact activities. While they may be painful, fractures can usually be treated effectively with the right care. In this article, we’ll explore the types of fractures, how they are treated, and what patients can expect during the recovery process.

A fracture is any kind of break or crack in a bone. They can vary in severity, from small hairline fractures to complete breaks that cause the bone to split into two or more pieces. Fractures may occur in any bone in the body, with the most common being in the arms, legs, wrists, and collarbones.

There are several different types of fractures, including:

• Closed fractures: The bone is broken, but the skin remains intact.
• Open fractures (compound fractures): The bone breaks through the skin, increasing the risk of infection.
• Stable fractures: The broken ends of the bone are aligned and relatively stable.
• Displaced fractures: The broken bone fragments are misaligned and may need to be realigned.
• Comminuted fractures: The bone is shattered into several pieces.
• Greenstick fractures: A partial fracture where the bone bends, common in children as their bones are more flexible.
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To diagnose a fracture, a healthcare professional will conduct a physical examination and may order imaging tests such as an X-ray or MRI to determine the extent of the injury. These tests help identify the location of the fracture, whether the bone is displaced, and if there is any damage to surrounding tissues.

In some cases, especially with complex fractures, further diagnostic tools like a CT scan may be required to get a more detailed view of the bone and surrounding structures.

The treatment for a fracture depends on several factors, including the type of fracture, the bone involved, the patient's age, and overall health. The primary goals of treatment are to properly align the bone, relieve pain, and promote healing. Here are the common treatment methods:

Most fractures can be treated without surgery, especially if they are stable, non-displaced, or in a location that doesn’t involve major complications. Non-surgical treatments often include:

• Casting: For many fractures, a cast is applied to immobilize the bone and hold it in the proper position while it heals. The cast prevents movement, reducing the risk of further injury. Depending on the location and severity of the fracture, the cast may need to be worn for several weeks to months.
• Splints and Braces: For some types of fractures, especially those involving the wrist, hand, or foot, a splint or brace may be used to support the bone and prevent movement.
• Traction: In cases where a fracture is difficult to realign, or the bone needs to be gradually pulled back into position, traction may be used. This involves applying a pulling force to the limb, often with weights, to help align the bone properly.
• Immobilization and Rest: In addition to using a cast, splint, or brace, rest is crucial for healing. Keeping weight off the injured limb allows the bone to heal and prevents further damage.
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In some cases, fractures require surgery, particularly if the bone is displaced, shattered, or involves a joint. Surgical interventions aim to realign the bone, fix broken fragments in place, and restore function. Common surgical treatments for fractures include:

• Open Reduction and Internal Fixation (ORIF): This is the most common surgical treatment for fractures. During ORIF, the surgeon makes an incision to access the fractured bone, realigns the bone fragments, and then secures them using metal plates, screws, rods, or wires. This method is often used for fractures that are displaced or involve complex break patterns.
• External Fixation: For fractures that cannot be repaired using internal methods, an external frame may be used. Pins or screws are inserted into the bone, and a frame outside the body holds the bone in place. This technique is often used for fractures involving open wounds or complex bone injuries.
• Bone Grafting: In some cases, if the fracture involves a significant loss of bone tissue, a bone graft may be necessary. The surgeon takes bone from another part of the body or from a donor and uses it to help rebuild the injured area.
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Once the fracture has been treated, whether through casting or surgery, rehabilitation is key to restoring strength, flexibility, and function to the affected area. Physical therapy plays a crucial role in recovery, especially if the fracture involved a joint or weight-bearing bone.

Rehabilitation typically involves:

• Range of motion exercises: These exercises help prevent stiffness and improve flexibility in the affected area.
• Strengthening exercises: Gradually increasing strength in the muscles around the injured area to support the bone during healing.
• Pain management: Over-the-counter or prescribed pain relievers may be used during the early stages of recovery. Ice and elevation can also help reduce swelling and pain.

The length of recovery varies depending on the type and location of the fracture. Generally, fractures can take anywhere from 6 to 12 weeks to heal, with weight-bearing activities being gradually reintroduced after this period. More complex fractures, especially those requiring surgery, may take longer to heal fully.

Each fracture is unique, and Dr. Wiemann's expertise in fracture management will get you back to full functioning as quickly as possible.