Mr Ryan LisleMidland Orthopaedic

Adult Trauma

A bone fracture is a medical condition in which a bone is cracked or broken. It is a break in the continuity of the bone. While many fractures are the result of high force impact or stress, bone fracture can also occur as a result of certain medical conditions that weaken the bones, such as osteoporosis.

The word “Fracture” implies to broken bone. A bone may get fractured completely or partially and it is caused commonly from trauma due to fall, motor vehicle accident or sports. Thinning of the bone due to osteoporosis in the elderly can cause the bone to break easily. Overuse injuries are common cause of stress fractures in athletes.

Types of fractures include:

  • Simple fractures in which the fractured pieces of bone are well aligned and stable.
  • Unstable fractures are those in which fragments of the broken bone are misaligned and displaced.
  • Open (compound) fractures are severe fractures in which the broken bones cut through the skin. This type of fracture is more prone to infection and requires immediate medical attention.
  • Greenstick fractures: This is a unique fracture in Children that involves bending of one side of the bone without any break in the bone.

Fracture Healing

Our body reacts to a fracture by protecting the injured area with a blood clot and callus or fibrous tissue. Bone cells begin forming on the either side of the fracture line. These cells grow towards each other and thus close the fracture.

Medical Therapy

The objective of early fracture management is to control bleeding, prevent ischemic injury (bone death) and to remove sources of infection such as foreign bodies and dead tissues. The next step in fracture management is the reduction of the fracture and its maintenance. It is important to ensure that the involved part of the body returns to its function after fracture heals. To achieve this, maintenance of fracture reduction with immobilization technique is done by either non-operative or surgical method.

Non-operative (closed) therapy comprises of casting and traction (skin and skeletal traction).
  • Casting
    closed reduction is done for any fracture that is displaced, shortened, or angulated. Splints and casts made up of fiberglass or plaster of Paris material are used to immobilize the limb.
  • Traction
    Traction method is used for the management of fractures and dislocations that cannot be treated by casting. There are two methods of traction namely, skin traction and skeletal traction.

Skin traction involves attachment of traction tapes to the skin of the limb segment below the fracture. In skeletal traction, a pin is inserted through the bone distal to the fracture. Weights will be applied to this pin, and the patient is placed in an apparatus that facilitates traction. This method is most commonly used for fractures of the thighbone.

Surgical Therapy

  • Open Reduction and Internal Fixation (ORIF)
    This is a surgical procedure in which the fracture site is adequately exposed and reduction of fracture is done. Internal fixation is done with devices such as Kirschner wires, plates and screws, and intramedullary nails.
  • External fixation
    External fixation is a procedure in which the fracture stabilization is done at a distance from the site of fracture. It helps to maintain bone length and alignment without casting.

External fixation is performed in the following conditions:

  • Open fractures with soft-tissue involvement
  • Burns and soft tissue injuries
  • Pelvic fractures
  • Comminuted and unstable fractures
  • Fractures having bony deficits
  • Limb-lengthening procedures
  • Fractures with infection or non-union

Rehabilitation

Fractures may take several weeks to months to heal completely. You should limit your activities even after the removal of cast or brace so that the bone become solid enough to bear the stress. Rehabilitation program involves exercises and gradual increase in activity levels until the process of healing is complete.

Clavicle Fracture

Clavicle fracture, also called broken collarbone is a very common sports injury seen in people who are involved in contact sports such as football and martial arts as well as impact sports such as motor racing.

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Proximal Humerus Fracture

Humerus is the upper arm bone and it forms two joints —shoulder joint and elbow joint. The proximal humerus is the upper end of arm bone that forms shoulder joint. Fractures of proximal humerus are common in elderly individuals suffering from osteoporosis.

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Humeral Shaft Fracture

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Forearm Fracture

Introduction

The forearm is made up of 2 bones, namely, the radius and ulna. The primary function of your forearm is rotation i.e., the ability to turn your palm up and down.

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Wrist Fracture

The wrist is comprised of two bones in the forearm (the radius and the ulna) and eight other tiny bones. The bones meet to form multiple large and small joints.

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Neck of Femur Fracture

Fractures to the femoral neck can completely or partially disconnect the femoral head from the rest of the femur.

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Femoral Shaft Fracture

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Distal Femur Fracture

The femur or thigh bone is the longest and strongest bone in the body, connecting the hip to the knee. Distal femur fracture refers to fracture of the femur just above the knee joint. Distal femur fracture is less common than other types of femoral fractures affecting mostly elderly individuals. Sometimes it can also occur in younger individuals as a result of high energy injuries.

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Tibial Plateau Fracture

The tibia or shin bone is a long bone in the lower leg. Flat surfaces called medial and lateral tibial plateaus at the upper end of the tibia articulate with the femur (thigh bone) to form the knee joint.

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Tibial Shaft Fracture

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Tibial Plafond Fracture

The tibia and fibula are long shin bones, which articulate with the thigh bone on one end and ankle joint at the lower end. The part of the tibia that articulates with the talus (ankle bone) is called the tibial plafond or pilon.

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Ankle Fracture

The ankle joint is composed of three bones: the tibia, fibula, and talus which are articulated together. The ends of the fibula and tibia (lower leg bones) form the inner and outer malleolus,

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Calcaneus / Midfoot Fracture

The calcaneus or heel bone is the largest bone in the ankle forming the heel and is situated at the lower back part of the foot.

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