How is a fracture treated?

Written by Li Jie
Orthopedics
Updated on September 24, 2024
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The treatment of fractures involves three main principles: reduction, fixation, and functional exercise. First and foremost, a perfect reduction is required after a fracture. If the alignment of the fracture is not satisfactory, the fracture may require either closed or open reduction. After a successful closed reduction, if the fracture position is stable, fixation should be considered. Generally, following a successful closed reduction, a local application of a cast or splint can be done for external fixation. If the results of closed reduction are not satisfactory, surgical open reduction may be needed. In such cases, internal fixation, possibly with steel plates, steel pins, or intramedullary nails among other methods, is necessary. These first two points cover the need for reduction and effective fixation—including both external and internal fixation. After proper fixation, the fracture can gradually heal. During the healing process, active functional exercises are needed to prevent muscle atrophy and joint adhesion. To avoid disuse of the limb, muscle atrophy after removing the cast, whether it be a leg or an arm, functional exercises are imperative. Thus, the three principles of fracture treatment are reduction, fixation, and functional exercise, requiring professional care by medical experts in accredited hospitals.

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Written by Wang Cheng Lin
Orthopedics
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What are the symptoms of a fracture?

After a fracture, three characteristic manifestations occur. The first one is abnormal movement. This abnormal movement is due to the formation of an unusual activity of the fracture ends in the affected limb, known as abnormal movement. The second one is called deformity, which is also due to a significant deformity in the affected limb after the fracture ends. The third one is called bone crepitus, also known as bone rubbing sound, which is the sound produced when the fracture ends rub against each other. These three are specific signs of a fracture. In addition to these three, there will also be severe pain in the affected limb, and this pain is very intense, rendering the limb immobile. Secondly, there will be obvious swelling, which is caused by bleeding in the medullary cavity of the fracture ends. The third is functional impairment, as the affected limb will definitely be immobile after the fracture.

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Written by Li Jie
Orthopedics
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Symptoms of rib fracture

After a rib fracture, the main symptom is pain. This is because the intercostal nerves located in the rib area are very rich, making the pain quite intense. Especially when the patient coughs or sneezes, and when the abdominal pressure increases, the pain can get quite severe. Also, when the patient changes their position, such as moving from sitting to lying down, or from lying down to sitting up to standing, the pain is very apparent. Additionally, another sign that may appear is local crepitus or a sensation of bone rubbing. That is, when pressing with a hand, one might feel the rubbing of the fractured bone and hear a crackling sound under the hand. Moreover, a rib fracture could lead to the accumulation of fluid or air in the chest cavity. If there is fluid or air in the chest cavity, it can be accompanied by difficulties in breathing and poor respiratory function, shortness of breath, and other related symptoms. These are some common symptoms of rib fractures.

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Written by Dai Ru
Orthopedics
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How to immobilize a fracture

Fractures, based on the method of fixation, can be divided into external fixation and internal fixation. External fixation can further be divided into various methods, commonly including plaster fixation, small splint fixation, external fixator brace fixation, orthotic fixation, and traction fixation, among others. Internal fixation, depending on the type of internal fixation device used, can be divided into steel plate screw fixation, simple compression screw fixation, intramedullary nail fixation, etc. Regardless of the type of fixation, the main purpose is to maintain the stability of the fracture and promote fracture healing.

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Written by Li Jie
Orthopedics
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How to care for a rib fracture

For a rib fracture, first, the patient should pay attention to rest. Local effective and secure external fixation should be done. You can tie a chest band or a rib fixation band on the affected area to stabilize the fracture, which can effectively relieve pain and is beneficial for the healing and growth of the fracture. Then, in terms of diet, it is important to consume high-protein, high-energy, high-nutrient, low-fat, and easily digestible food, such as fish, milk, eggs, lean meat, shrimp shells, and some fresh vegetables. These foods are rich in nutrients and also contain a lot of calcium, which helps the healing of fractures. This is the method of recuperation for a rib fracture.

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Written by Li Jie
Orthopedics
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Can you move with a fracture?

Regarding the question of whether fracture patients can move, we need to look at it from two aspects. We say that fracture patients can move and yet cannot move. Why do we say that fracture patients cannot move? Because after a fracture, we need effective reduction and fixation. After the fixation, the fractured area should not be vigorously moved, as the growth of the bone requires a stable environment. Therefore, we say that the fractured area should not move. However, we advocate movement for fractures. Why advocate movement? We can encourage performing activities with other parts of the body, and the distal part of the fractured limb can perform isometric muscle contractions and joint movements. Appropriate exercises are beneficial for reducing swelling locally, but the fractured area itself should be immobilized.