Is a comminuted fracture of the iliac bone serious?

Written by Wang Cheng Lin
Orthopedics
Updated on September 13, 2024
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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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Written by Na Hong Wei
Orthopedics
1min 23sec home-news-image

Will a comminuted patella fracture cause limping?

Patellar comminuted fractures, as long as treated promptly and correctly, and if the surgery poses no issues, generally heal in about six months, thereby not causing any significant impact. Thus, there's no need to worry about limping. Limping usually means that when walking, one leg appears longer than the other. Under what circumstances can limping occur? If the difference in leg length is within one centimeter, it's imperceptible and won't have any effect. If the difference exceeds two centimeters, then there is a noticeable tilt in the lower limbs, and only then can limping be observed during walking; however, even if limping occurs, it is not severe. It just means that while walking, there is a tilt towards the shorter side. After treatment, patellar comminuted fractures have a complete chance of healing and once healed properly, it's almost like before the injury. Even in severe cases where the fracture is critically fragmented and requires removal, even without patellar replacement, by reinforcing the patellar tendon, it typically does not result in limping. It only impacts the strength in knee extension, possibly creating a mild impediment compared to the other side, and might make walking appear slightly abnormal, but it definitely does not lead to limping. Hence, patellar comminuted fractures do not result in limping.

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Written by Wang Cheng Lin
Orthopedics
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How long does it take for a comminuted tibial fracture to heal?

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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Written by Na Hong Wei
Orthopedics
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How long after a patellar comminuted fracture can one start walking?

Patellar comminuted fractures generally require surgical treatment. If the surgery goes well, patients can start moving around with the aid of crutches one week after the surgery. Initially, changing positions is not allowed. Generally, patients can start by placing the toes on the ground two weeks post-surgery, followed by the middle part of the foot, and finally the heel. This progression occurs from two to six weeks after the surgery.

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Written by Su Zhen Bo
Orthopedics
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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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Written by Li Jin
Orthopedics
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How long will it take to walk after a comminuted fracture of the tibia?

The decision on when to walk depends on the recovery status of the fracture. Generally, a tibial fracture requires about 4-6 weeks of rest. Around 4-6 weeks, you can revisit the hospital for an X-ray checkup. If the callus is growing well, and the fracture line is blurred or disappeared, you can start using crutches to walk and perform functional exercises. However, recovery from a comminuted fracture takes longer, so an X-ray examination is essential before starting to walk. If the examination results show good recovery, then you can start walking. If you walk too early, it may interfere with the fracture healing, and in severe cases, it might even cause the fracture to break again. Therefore, the time it takes for someone with a comminuted tibial fracture to walk depends on the specific circumstances, and an X-ray examination must be performed before walking.