A fracture is a break in a bone. Fractures range from a hairline crack to a bone broken in several pieces, and from a closed fracture, where the skin is intact, to an open (compound) fracture, where the bone has broken through the skin.
X-rays confirm most fractures. A CT scan gives more detail when a fracture involves a joint or is complex, and helps plan surgery.
Many fractures heal well in a cast, splint, brace or sling, provided the bone ends are in an acceptable position. Sometimes the bone is first manipulated back into position under anaesthetic (a closed reduction). X-rays during healing make sure the position is held.
Surgery is usually recommended when a fracture is displaced and can’t be held in a good position without it, when it involves a joint surface, when there are multiple fractures, or when the bone has broken through the skin. The aim is to restore alignment and hold the bone still while it heals.
Open fractures are treated as emergencies, with antibiotics and surgery to clean the wound, because of the risk of infection.
Most fractures take about six to twelve weeks to unite, and longer to regain full strength. Healing can be slower in older people, in smokers, in people with diabetes, and in certain bones. Occasionally a fracture doesn’t heal (non-union) or heals in the wrong position (malunion), and needs further treatment. Physiotherapy restores movement and strength once the bone allows.
Dr K. Naik, Dr D.D. Beekarun, Dr S. Khan, Dr A.D. Bhatta, Dr P. Reddy (foot and ankle), Dr L. Rajah (upper limb), Dr S. Ragunandan.