How long does it take for a comminuted tibial fracture to heal?

Written by Wang Cheng Lin
Orthopedics
Updated on September 30, 2024
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The healing time for comminuted fractures of the tibia generally takes about three months, but it still depends on the method of treatment. Generally, there are two methods for treating a comminuted fracture of the tibia:

The first method is conservative treatment, which involves using casts or braces to immobilize the affected limb. Generally, the healing time for this method is about three months.

The second method is used when there is significant displacement at the fracture site, such as obvious shortening, rotation, or deformity, which then requires surgical treatment. After surgery, the healing time may take about three to four months. Additionally, severe comminuted fractures can disrupt the blood circulation at the fracture site, leading to poor local circulation and a condition called delayed union, where healing might take about six months.

Another scenario involves extremely severe disruption of the blood circulation at the fracture site, leading to nonunion where the fracture ends do not heal together at all. Generally, this requires about a year of observation. If after one year the fracture ends still haven't healed, a second surgery might be necessary.

However, for most comminuted fractures of the tibia, the general healing time is about three to four months.

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Why are elderly people prone to fragility fractures?

In clinical settings, elderly individuals commonly experience comminuted fractures, primarily due to their reduced levels of physical activity, which can lead to the loss of proteins, calcium, minerals, and moisture in the bones. This reduces bone strength and density, and if they have osteoporosis, bones can easily break into pieces when subjected to external force. Therefore, it is crucial to apply proper treatment methods promptly after a comminuted fracture occurs. This can involve manual reduction, external fixation, or surgical treatment such as open reduction and internal fixation. Postoperatively, treatments like electrotherapy and physical therapy, along with oral calcium supplements and bone-healing medications, can facilitate recovery. Nutritionally, it is beneficial to consume foods rich in proteins and calcium to aid in the healing of fractures.

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Is a comminuted fracture of the iliac bone serious?

Iliac fractures are assessed based on the severity of the fracture. Generally, there are two types of iliac fractures. The first type is a linear fracture. If this linear fracture does not involve the joint surface and is a simple, non-severe linear fracture, a plaster cast can be sufficient for complete recovery, usually within about two months. The second type is a comminuted fracture, where the fracture ends affect the joint surface; in such cases, surgical treatment may be required to restore the smoothness of the joint and stabilize the fracture pieces, with a recovery time generally ranging from two to three months. Therefore, a comminuted patellar fracture is generally very serious and typically requires surgery. This is because comminuted patellar fractures are likely to lead to the most common form of post-traumatic arthritis, resulting in pain during activity later on.

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Is a comminuted fracture of the hip bone serious?

The answer is definitely yes. A comminuted fracture of the hip bone can affect the stability of the pelvic ring, thus absolute bed rest is necessary, and surgical treatment may be needed when required. Especially in middle-aged and elderly people, early ambulation after surgery can help avoid various complications that can arise from prolonged bed rest, such as three to six months, or even more than half a year, which could exacerbate complications in the elderly and even be life-threatening. Therefore, comminuted fractures of the hip are relatively severe and require active surgical treatment. Post-surgery, appropriate bed rest is also needed, and it is advisable to use a pulsating air mattress to prevent potential complications like pressure sores, and appropriate body massages should be performed to prevent the occurrence of lower limb venous thrombosis. Additionally, turning and patting on the back should be performed to prevent dependent lung pneumonia.

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Post-traumatic sequelae of femoral head comminuted fracture

A comminuted fracture generally refers to a fracture with more than three fragments. When a comminuted fracture occurs in the femoral head, it is also a type of intra-articular comminuted fracture. Generally speaking, after the fracture is reduced and stabilized, there can be some damage to the joint surface as well, leading to unevenness of the joint surface and a higher chance of developing postoperative traumatic arthritis. There is also a possibility that the comminution of the femoral head fracture could affect the blood supply to the femoral head, leading to ischemic necrosis of the femoral head. After treatment for the fracture injury, there will inevitably be some impact on postoperative function. Therefore, after a comminuted fracture of the femoral head, the first sequelae to appear is usually traumatic arthritis, followed by ischemic necrosis of the femoral head, and thirdly, symptoms of restricted movement in the hip joint may occur.

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Will a comminuted fracture of the tibia cause limping?

If a comminuted tibial fracture is treated correctly, with proper alignment and the shortening kept within one centimeter, limping will absolutely not occur. The reason for limping after surgery for a comminuted fracture is due to unequal leg lengths. There are many reasons for differences in leg length, but no matter the cause, if the difference is less than 1 centimeter, a person will absolutely not limp. However, if it is less than two centimeters, or more, it then becomes apparent that one leg is longer and the other shorter, resulting in a limp. Therefore, for comminuted fractures, whether it is of the tibia, femur, or another bone, as long as the alignment is properly maintained and the shortening is controlled to within 1 centimeter, postoperative recovery will be very good, without any limping.