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Fracture Diagnosis and Treatment

Fracture diagnosis and treatment — accurate diagnosis of bone fractures and management of healing through casting/splinting or surgical fixation.

Assessment of bone fractures after trauma, with closed reduction and casting/splinting or, when needed, surgical fixation. The aim is to ensure the bone heals in correct alignment.

Indication

  • Suspected fracture of the arm, leg, hand, or foot after a fall, blow, or traffic accident
  • Sports-related fracture or dislocation (wrist, ankle, shoulder, clavicle)
  • Hip or vertebral fracture in the setting of osteoporosis (bone loss)
  • Stress fractures (microfractures due to repetitive loading)
  • Greenstick fracture or growth plate injury in children
  • Pathologic fracture (in the setting of bone cysts, tumor, or infection)
  • Corrective treatment in cases of malunion or nonunion

Preparation

  • When a fracture is suspected, the area should be kept immobile and not loaded
  • Plain radiograph (X-ray), and if needed CT or MRI, are used for evaluation
  • If surgical fixation is planned, blood tests, ECG, and anesthesia evaluation are performed
  • For patients on blood thinners, dose adjustment with physician approval
  • Fasting for 6-8 hours before surgery (if anesthesia is required)

How it's performed

  1. Examination assesses swelling, deformity, tenderness, and circulation/nerve status
  2. Imaging (X-ray / CT / MRI) determines the location, type, and degree of displacement of the fracture
  3. Minimally displaced fractures are immobilized with a cast, splint, or brace
  4. Displaced fractures may be treated with closed reduction (manual realignment) followed by casting
  5. Open, comminuted, intra-articular, or unstable fractures are treated with surgical fixation (plate-screw, intramedullary nail, external fixator)
  6. After the procedure, the fracture position is verified with a control radiograph

Post-procedure

  • Healing is monitored with periodic control radiographs (typically every 2-4 weeks)
  • Elevation, cold application, and appropriate analgesics for pain, edema, and swelling
  • Cast/splint duration varies by fracture type (typically 4-8 weeks)
  • After surgical fixation, physiotherapy and joint range-of-motion exercises at the appropriate time
  • Transition to full weight-bearing is performed gradually, with physician approval

Risks

  • Nonunion or malunion
  • Compartment syndrome (especially due to increased pressure under a cast and impaired circulation)
  • Vascular or nerve injury (related to the fracture itself or surgery, rare)
  • After surgical fixation: infection, implant loosening or breakage
  • Long-term post-traumatic osteoarthritis after intra-articular fractures
  • Joint stiffness and muscle loss due to immobilization

FAQ

How long does fracture healing take?

It varies by fracture location, type, the patient's age, and overall health. Typical durations are 3-6 weeks in children and 6-12 weeks in adults. Hip fractures and some intra-articular fractures may take longer to heal.

Does every fracture require surgery?

No. Most stable fractures with little displacement can be treated with a cast or splint. Significantly displaced, comminuted, intra-articular, or open fractures may require surgical fixation.

What should I do if I have itching or pain inside the cast?

Mild itching is normal, but severe pain, color change in the fingers, coldness, loss of sensation, or a wet cast warrants contacting your physician; these may signal compartment syndrome or a circulatory problem.

Should I take calcium or vitamin D for fracture healing?

Adequate calcium and vitamin D are important for bone healing, but supplementation depends on physician evaluation. Smoking significantly slows fracture healing; cessation is recommended whenever possible.