In cases of fractures that cannot be treated effectively with conservative methods, surgery is usually recommended. Let's discuss the procedure and post-operative care.
The basics of fracture treatment include immobilization, bone reduction or repositioning, fixation, and rehabilitation. These efforts typically begin with conservative methods such as applying a cast or sling. However, not all fractures can be treated with conventional methods.
Forcing a fracture can increase the risk of malunion (incorrect union of the bone), non-union (union of the bone fragments), and various other complications. A comprehensive medical interview, physical examination, and supporting tests are crucial to establish a correct diagnosis and determine further treatment for optimal recovery.
When is fracture surgery necessary?
When diagnosing a fracture, the treating orthopedic specialist will usually consider the best treatment method. If the condition is mild, conservative methods will usually be prioritized. However, if the healing process is not optimal, surgery may be an option. Some cases can usually proceed directly to surgery without conservative methods, such as complex fractures.
Open fractures, where there is an open wound due to bone breaking through the skin, can increase the risk of infection and various other complications if not treated promptly with surgery. Furthermore, fractures with numerous or small bone fragments, fractures with significant displacement, and fractures with a high risk of malunion or non-union are usually recommended for surgical procedures.
Similar to conservative methods, surgical procedures also aim to immobilize, reduce, and fix the broken bone to optimize healing.
The process of healing a broken bone
Bleeding
In a fracture, when a bone breaks, damage occurs to the surrounding tissue. This causes bleeding and forms a hematoma, or blood clot.
Inflammation
When bleeding occurs, the body's response is inflammation. This process is crucial for the healing process. Inflammatory cells travel to the fractured area to prepare for the reparative process.
Reparative
In this stage, new bone cells, or osteoblasts, begin to form, which play a role in the healing process. Initially, a soft callus forms, which then undergoes a process to become hard and stronger. This process usually takes several weeks to months, depending on the location and severity of the fracture.
Remodeling
During this process, the callus that has begun to harden becomes stronger, resembling normal bone. At this stage, osteoclasts play a crucial role in optimal healing, maintaining the same shape and strength. Post-surgery, immobilization is usually performed to optimize the healing process, in terms of time, shape, and strength of the previously fractured bone.
Therefore, it is important to have regular check-ups with your treating orthopedic specialist for regular follow-up. Furthermore, after prolonged immobilization and fixation, the strength of the muscles and other tissues surrounding the bone that help support it can decrease. Therefore, rehabilitation and physiotherapy are highly recommended to help restore the strength of these muscles and other surrounding tissues.
Written by Dr. Valda Garcia. Reviewed by Dr. Ernest Eugene.
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