Trauma and Fracture Surgery

Acute fracture – Fracture is defined as a discontinuity in the surface of the bone. The clinical feature which can help you to identify an acute fracture is a combination of pain, swelling, abnormal mobility with the inability to us the affected part of the body. There are a number of classifications used to describe a fracture according to

a) mode of injury

b) pattern of the fracture

c) contamination from the outside environment etc.

Types of fracture

It is important to differentiate between a simple and a pathological fracture. A simple fracture is one where the mode of injury and amount of force applied are sufficient to cause the fracture. In a pathological fracture the amount of force applied and the mode of injury are very minimal and insufficient to cause the fracture in a normal individual. It is the abnormally weak bones, due to any cause, which are fractured with very trivial trauma. The pathological fractures usually require investigation into the cause of the weak bone, advanced fixation methods (like special locking plates), need augmentation (from sources like cement, TCP crystals etc.) and also require prolonged periods of immobilization and take a longer time to heal. Apart from the pathological fracture, the underlying pathology causing weak bones also needs to be catered (for prevention of future fractures).

The fractures depending on the part they involve and their complexity may be treated conservatively (with slabs, casts, splints etc.) or may need an operative intervention. The fractures can be classified as

a) Open          (if associated with a wound, exposing the fracture site)

b) Closed (if the overlying skin is intact)

They can also be classified as displaced or undisplaced fractures.

Who is at more risk of fracture?

The following people are more at risk of fracture –

  • patients with osteoporosis
  • advanced age
  • obese
  • corticosteroid use
  • smoking
  • alcohol
  • Patients with malignancy.

How to diagnose a fracture?

Whenever following a fall or any injury, you feel pain, swelling and inability to use the part of the body, follow the primary care instructions as given and seek a medical opinion as soon as possible. The diagnosis of a fracture can be easily made by using a DIGITAL X ray.

Primary care of the patient

Irrespective of the type of fracture, the primary care of any fracture remains the same. As soon as you sustain the fracture –

  1. Remove any encircling objects like rings, bangles etc from the part distal to the fracture.
  2. Keep your limb elevated.
  3. Apply cold compresses to the fractured part.
  4. Seek orthopaedic opinion.