How to realign a fractured bone

This article was co-authored by Jonathan Frank, MD. Dr. Jonathan Frank is an Orthopedic Surgeon based in Beverly Hills, California, specializing in sports medicine and joint preservation. Dr. Frank’s practice focuses on minimally invasive, arthroscopic surgery of the knee, shoulder, hip, and elbow. Dr. Frank holds an MD from the University of California, Los Angeles School of Medicine. He completed an orthopedic residency at Rush University Medical Center in Chicago and a fellowship in Orthopedic Sports Medicine and Hip Preservation at the Steadman Clinic in Vail, Colorado. He is a staff team physician for the US Ski and Snowboard Team. Dr. Frank is currently a scientific reviewer for top peer-reviewed scientific journals, and his research has been presented at regional, national, and international orthopedic conferences, winning several awards including the prestigious Mark Coventry and William A Grana awards.

There are 9 references cited in this article, which can be found at the bottom of the page.

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A fractured or broken bone is always considered a traumatic injury, but not all are classified as serious — there are different types based on severity. A hairline or stress fracture of bone is the least traumatic and doesn’t result in misaligned pieces. Fractures that result in pieces that are misaligned, particularly if they poke through the skin, are much more serious and sometimes life threatening. Consequently, realigning a broken bone in a timely manner is crucial, but not a procedure that should be attempted by someone untrained. Fracture realignment should be performed by a surgeon or physician ideally, although other health professionals and first responders may have to suffice in some emergency situations.

How to realign a fractured bone

Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery.

How to realign a fractured bone

Stuart Hershman, MD, is board-certified in orthopaedic surgery. He is the director of adult spinal deformity & complex spinal reconstruction at Massachusetts General Hospital and is on the faculty at Harvard Medical School.

When you break an arm, leg, or any other bone of the body, that bone will often need to be put back into place so that it can heal properly. The process of resetting a bone is called a fracture reduction.

Fracture reduction requires a doctor to manipulate the broken ends of the bone into their original position and fix them in place with a cast, brace, traction, or external fixation. By doing so, new bone can grow back cleanly between the broken edges and better ensure that mobility and bone integrity are restored.

Fracture reductions are typically performed in an emergency room, however, less traumatic fractures may be treated at an urgent care clinic or physician’s office.

How to realign a fractured bone

Steps for Setting a Bone Fracture

This is what you can expect if a fracture needs to be reduced.

Diagnosis

Diagnosis usually involves an X-ray to determine whether the fractured ends are out of place.   The fracture can either be closed (meaning the skin is intact) or open (meaning the skin is broken). Based on the findings, the doctor will decide if the bone needs to be reduced (reset).

Anesthetic Selection

Anesthetic selection is important as it ensures the patient gets the appropriate relief based on the pain level and individual’s medical status. In almost all situations where a fracture reduction is needed, some form of anesthesia will be used.

If the fracture is traumatic or complicated, the person may need a general anesthetic to be put completely asleep. But, more commonly, the doctor will opt for local anesthesia called a hematoma block, which delivers a local anesthetic directly to the area surrounding the fracture.

Sterilization

Sterilization of the skin is performed with alcohol, iodine, or some other type of sterilizing solution. This prevents bacteria from entering any breaks on the skin which may not only lead to infection but to complications such as septicemia.

Hematoma Block

Administration of the hematoma block is done by injecting the anesthesia from a syringe into the fracture hematoma (the collection of blood around the broken bone). Delivering the drug this way allows the broken ends of the bone to be bathed in the local anesthetic, better ensuring sustained pain relief. Hematoma blocks are not used for open fractures.

Performing the Reduction

Performing the fracture reduction involves manipulating the ends of the broken bone so that they are realigned into their original position.

The patient may feel pressure or a crunching sensation but will usually not experience any significant pain.

Immobilization

Immobilizing the bone ensures the broken ends are held firmly in place. After reducing the fracture, a splint may be applied. While the splint can be made of a variety of materials, the most common types are plaster and fiberglass.

If the fracture is severe, it may require external fixation. This is a technique by which pins or screws are inserted into the bone and secured together to an external frame on the outside of the skin using a series of clamps and rods.  

Post-Reduction X-Rays

Post-reduction X-rays are performed to better ensure that the reduced fracture is correctly aligned. If not, further treatment options may be explored, including surgery.

How to realign a fractured bone

Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery.

How to realign a fractured bone

Miho J. Tanaka, MD, is a board-certified orthopedic surgeon who specializes in the treatment of sports medicine injuries.

Broken bones are one of the most common orthopedic injuries. Fractures require treatment which may be as simple as rest, or as invasive as surgery. There are many factors that must be considered to determine the most appropriate treatment of a broken bone including:

  • Location of the broken bone
  • Alignment of the fracture
  • Patient’s expectations  

Some of the most frequently used fracture treatments are described here.

Immobilization

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igor kisselev, www.close-up.biz / Getty Images

The most common type of fracture management is with immobilization. There are different types of immobilization including splint, braces, casts, slings, and others.

Cast immobilization is the most common method where a material (typically plaster or fiberglass) is wrapped around an injured extremity and allowed to harden. Casts come in an endless number of shapes and sizes and require proper cast care.

Fractures treated with immobilization must be adequately aligned to allow for healing with good results. If the alignment of the fracture is not sufficient, further treatment may be needed.

Reducing (Resetting) the Broken Bone

How to realign a fractured bone

A procedure called a fracture reduction, or reducing a fracture, is an intervention to better align the broken bones. A fracture reduction can either be done as a closed reduction (nonsurgical) or an open reduction (surgery).

A typical closed reduction is performed either by providing local anesthetic to the broken bone or a general anesthesia, followed by a specific maneuver to attempt to realign the broken bone. After a closed reduction, a splint or cast would be applied to hold the bones in the improved alignment while they heal.  

Traction

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Xavier Bonghi / Getty Images

Traction is an older form of fracture management that is used much less commonly today. However, there are certain situations where traction can be a very useful treatment option.  

Traction involves gentle pulling of the extremity to align the bones. Often a metal pin is placed in the bone away from the fracture, this is called skeletal traction. Ropes and weights are attached to the pin to gently pull and hold the bone fragments into alignment.

Skin traction is a similar concept, but instead of a pin being inserted into the bone, the traction is placed by pulling externally on the extremity. Skin traction cannot pull with as much force as skeletal traction, so if traction is being used for more than a short time, usually skeletal traction is favored.  

How to realign a fractured bone

Pins can be used to stabilize bones when a closed reduction is used to improve alignment, but a cast is insufficient to hold the bones in place.

Pins are typically placed through the skin in a procedure called a closed reduction with percutaneous pinning (CRPP). The pins are placed in the operating room, but can typically be removed in your healthcare provider’s office and there is little discomfort in most pin removal procedures. If there is discomfort, the removal can be performed in the operating room.

External Fixation

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Jesus Tarruella / Getty Images

External fixation also uses pins that enter the skin but are held together outside the body with a frame to maintain alignment. External fixation can be an excellent option in cases of trauma as they can be applied quickly, they can be adjusted as needed, and they allow access to the skin and soft-tissue wounds. External fixation is often used with open fractures (vs. closed fractures).

External fixation can also be helpful when there is significant swelling that could make surgery too risky. By temporarily immobilizing the fracture, the swelling can improve, and internal fixation can be considered at a later time.  

Open Reduction With Internal Fixation

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Thierry Dosogne / Getty Images

Open reduction with internal fixation (ORIF) means to surgically open the site of the fracture, align the bone fragments, and then hold them in place. The most common type of internal fixation are metal plates and screws, although there are many devices that can be used to stabilize different types of fractures.

(ORIF) is the preferred treatment for a number of different types of fractures:

  • Fractures that tend to displace despite immobilization
  • Fractures that are poorly aligned
  • Fractures around the joints that are poorly aligned

Determining when a fracture should have surgery is a complex decision that must take into account many variables including the type, location, and severity of the fractures, as well as the expectations of the patient. In some situations, metal implants may have to be removed at a later date.  

Intramedullary Rodding

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Verywell / Jonathan Cluett

Intramedullary (IM) rodding is a surgical procedure to stabilize a broken bone by inserting a metal rod in the hollow medullary canal of the bone. This part of the bone (where the bone marrow is) can be used to hold the rod and allow for early movement and weight-bearing in some cases

IM rodding can be utilized for fractures of the lower extremity long bones that are not close to the joints (bone ends). While this treatment can often allow for early movement, how soon one can resume walking after surgery often depends on the fracture type.  

A Word From Verywell

Proper treatment can help move you along with your recovery to ensure a good outcome. While fracture healing often seems slow, there are steps to ensure your healing of a broken bone. Make sure you follow your healthcare provider’s instructions so that your broken bone will heal well!

Closed reduction is a procedure to set (reduce) a broken bone without cutting the skin open. The broken bone is put back in place, which allows it to grow back together. It works best when it is done as soon as possible after the bone breaks.

A closed reduction can be done by an orthopedic surgeon (bone doctor), emergency room physician, or a primary care provider who has experience doing this procedure.

What are the Benefits of a Closed Reduction?

A closed reduction can:

  • Remove tension on the skin and reduce swelling
  • Improve the chances that your limb will function normal and you will be able to use it normally when it heals
  • Decrease pain
  • Help your bone heal quickly and be strong when it heals
  • Lower the risk of an infection in the bone

Possible Risks During a Closed Reduction

Your health care provider will talk with you about the possible risks of a closed reduction. Some are:

  • The nerves, blood vessels, and other soft tissues near your bone may be injured.
  • A blood clot could form, and it could travel to your lungs or another part of your body.
  • You could have an allergic reaction to the pain medicine you receive.
  • There may be new fractures that occur with the reduction.
  • If the reduction does not work, you may need surgery.

Your risk of any of these problems is greater if you:

  • Smoke
  • Take steroids (such as cortisone), birth control pills, or other hormones (such as insulin)
  • Are older
  • Have other health conditions such as diabetes and hypothyroidism

About the Procedure

The procedure is often painful. You will receive medicine to block the pain during the procedure. You might receive:

  • A local anesthetic or nerve block to numb the area (usually given as a shot)
  • A sedative to make you relaxed but not asleep (usually given through an IV, or intravenous line)
  • General anesthesia to make you sleep during the procedure

After you receive pain medicine, your provider will set the bone in the right position by pushing or pulling the bone. This is called traction.

After the bone is set:

  • You will have an x-ray to make sure the bone is in the right position.
  • A cast or splint will be put on your limb to keep the bone in the right position and protect it while it heals.

After Your Procedure

If you do not have other injuries or problems, you will be able to go home a few hours after the procedure.

Until your provider advises, do not:

  • Place rings on your fingers or toes over your injured arm or leg
  • Bear weight on the injured leg or arm

Alternative Names

Fracture reduction – closed

References

Waddell JP, Wardlaw D, Stevenson IM, McMillian TE, et al. Closed fracture management. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 7.

Whittle AP. General principles of fracture treatment. In: Azar FM, Beaty JH, Canale ST, eds. Campbell’s Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 53.

The sternum is a flattened bone that is connected to the first seven pairs of ribs. It can get fractured due to traumatic injuries. Those of you who wish to know more on how to treat a fractured sternum, can scroll down to get an idea on sternal fracture treatment.

How to realign a fractured bone

The sternum is a flattened bone that is connected to the first seven pairs of ribs. It can get fractured due to traumatic injuries. Those of you who wish to know more on how to treat a fractured sternum, can scroll down to get an idea on sternal fracture treatment.

The rib cage, also known as thoracic cage or thoracic basket, is an important part of the human skeletal system. Twelve pairs of ribs, sternum, twelve thoracic vertebrae and costal cartilage together make up the human rib cage. The sternum or breastbone, is a T-shaped bone that is located in the middle portion of the anterior wall of the rib cage. The upper section of this elongated bone supports the collarbones, and its margins are connected to the ends of the first seven pairs of the ribs through costal cartilage.

The sternum is divided into three segments that are known as manubrium, gladiolus and the xiphoid process. Manubrium is the broad upper section of the sternum that attaches to the first two pairs of ribs, while body of the sternum is the elongated part of the sternum. Xiphoid process, the smallest segment of sternum joins with the seventh pair of ribs. It is located at the inferior end.

If one receives a blow to the chest or is subjected to any form of blunt chest trauma, the rib cage acts as a protective covering and protects the organs and blood vessels within the chest region from getting damaged. There could, however, be times, when the rib cage may not be able to withstand blunt chest trauma. If the chest is struck with a great force, it could lead to a sternal fracture. Rest coupled with self-care measures will help in healing minor cracks, but severe fractures may need an elaborate treatment. Here’s some information on the causes of a sternal fracture along with ways to heal a fractured sternum.

What Causes the Sternum to Fracture?

Most of the time, a bruised, cracked or fractured sternum results from blunt chest trauma. Ribs or sternum injuries could occur while playing contact sports or as a result of physical assault. Motor vehicle accidents wherein the chest forcefully hits against the steering wheel is also one of the most common causes of rib or sternum injuries. Cardiopulmonary resuscitation (CPR), which is performed to revive a person suffering from a cardiac arrest, can also cause bruised or cracked sternum. One is likely to suffer from pain and discomfort in case of mild injuries that cause a bruised sternum. Under these circumstances, use of painkillers, application of warm compresses and rest will surely help in speeding up the recovery.

However, surgical intervention may be needed if a severe impact causes a displaced sternal fracture. Surgery might become a necessity if the sternum is pushed further into the chest cavity. For people suffering from conditions such as osteoarthritis or osteoporosis, slight trauma to the chest can also cause a fracture.

Treatment of a Fractured Sternum

Wondering how to treat a fractured sternum? Well, blunt chest trauma is one of the most commons reason behind sternal or rib fractures which is why medical help must be sought by people who suffer from such an injury. If you notice bruising and swelling on chest, and have also been experiencing painful breathing since the injury, let a doctor examine you. Doctors will then determine how to treat sternal fracture once they have ascertained the extent of damage to the sternum. An X-ray examination or imaging procedures such as a CT scan or ultrasound may help in detecting the impact of injury on the rib cage and the organs present within the chest cavity. Lateral radiographs can also help in determining the extent of sternal displacement.

Since a fractured sternum is most likely to cause pain and inflammation, doctors are most likely to prescribe painkillers, non-inflammatory drugs or steroids. In most cases of sternal fractures, one will be asked to take bed rest for about 3 to 4 weeks. After that, one may perform mild physical activities. All sternal fractures do not require surgery. Small cracks may heal with drug therapy and rest, but a severe fracture will require surgical intervention. In severe cases of displaced fracture, there is a risk of complications associated with the organs located in the chest region. In severe cases, oxygen therapy and cardiac monitoring may also be needed. Once the broken sternum is repaired through surgery, one may take three to four months to recover from a sternal fracture. The recovery will be slow if one doesn’t follow the doctor’s guidelines and indulges in activities that may put strain on the sternum.

This was some information on ways to treat a fractured sternum. Since blunt chest trauma can cause a fractured sternum, such traumatic injuries must not be ignored. If the imaging procedures indicate a fractured sternum, drug therapy along with self-care measures can help in alleviating the pain and discomfort. In event of a displaced fracture, the patient may have to undergo surgery for repositioning of the sternum. If one follows the doctor’s guidelines properly, one will be able to recover within a few months.

Articles On Understanding Bone Fractures

  • Basics
  • Symptoms
  • Diagnosis and Treatment

How Do I Know If I Have a Bone Fracture?

Doctors can usually recognize most fractures by examining the injury and taking X-rays.

Sometimes an X-ray will not show a fracture. This is especially common with some wrist fractures, hip fractures (especially in older people), and stress fractures. In these situations, your doctor may perform other tests, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

In some cases, such as a possible wrist fracture with an initially normal X-ray, your doctor may apply a splint to immobilize the area and order a second X-ray 10 to 14 days later when healing can make the fracture visible.

Occasionally, even after the fracture diagnosis has been made, you may need other tests (such as a CT scan, MRI, or angiogram, a special X-ray of blood vessels) to determine whether other tissues around the bone have been damaged.

If your doctor suspects a skull fracture, they will probably skip X-rays and proceed directly to a CT scan, which will diagnose the fracture and any more important related injuries or secondary injuries inside the skull, such as bleeding around the brain.

What Are the Treatments for a Bone Fracture?

A fracture often requires emergency treatment at a hospital. An example of a minor fracture that may not require emergency care is a fracture of the tip of a toe. If you think that bones may be broken in the back, neck, or hip, or if bone is exposed, do not move the person; instead, call 911 for help.

In other cases, you may call for assistance or transport the person to the emergency room. Before transporting the person, protect the injured area to avoid further damage. For broken arm or leg bones, put a splint (made of wood, plastic, metal, or another rigid material padded with gauze) against the area to prevent movement; loosely wrap the splint to the area using gauze. If there is bleeding, apply pressure to stop bleeding before splinting, then elevate the fracture.

Fractured bones must be set in their proper place and held there in order to heal properly. Setting a bone is called reduction. Repositioning bone without surgery is called closed reduction. Most fractures in children are treated with closed reduction. Serious fractures may require open reduction — repositioning using surgery. In some cases, pins, plates, screws, rods, or glue are used to hold the fracture in place. Open fractures must also be cleaned thoroughly to avoid infection.

After setting, most fractures are immobilized with a cast, splint, or, occasionally, traction to reduce pain and help healing. In most cases, medication is limited to painkillers to reduce pain. In open fractures, antibiotics are given to prevent infection. Rehabilitation begins as soon as possible, even if the bone is in a cast. This promotes blood flow, healing, maintenance of muscle tone, and helps prevent blood clots and stiffness.

After the cast or splint is removed, the area around the fracture usually is stiff for several weeks with swelling and bumps. In children, increased hair on the arms and legs due to irritation of the hair follicles from the cast can occur. With fractured legs, there may be a limp. Symptoms generally disappear within a few weeks.

If you have broken a bone, once the cast or splint is removed you should gradually begin using the area again. It may take another 4 to 6 weeks for the bone to regain past strength. Ask your doctor what activity type and intensity is safe for you, based on your fracture and overall health. Exercising in a swimming pool is generally a good way to rehabilitate bones.

How Can I Prevent Bone Fractures?

To help prevent fractures, follow general safety precautions, including:

  • Always wear a seat belt when riding in a motor vehicle.
  • Always wear the proper safety equipment (helmets and other protective pads) for recreational activities, such as bike riding, snowboarding, or contact sports.
  • Keep walkways and stairs free of objects that could cause you to trip.
  • If you have osteoporosis, get regular exercise to improve your strength and balance, which may help reduce falls.
  • Discuss starting bone-building medications and supplements (like calcium and vitamin D) with your doctor.
  • When you’re on a ladder, avoid using the top step, and be sure you have someone holding the ladder.

Show Sources

American Academy of Orthopaedic Surgeons: “Fractures.”

National Institute on Aging: “Falls and Fractures.”

University of Iowa Hospitals & Clinics: “Fracture types.”

Have you ever wondered how a broken bone heals? Broken bones, also called fractures, can heal two different ways. The two types of bone healing are primary and secondary bone healing. Secondary bone healing is more common than primary bone healing.

Secondary bone healing occurs when there is slight, controlled motion between the two ends of broken bone during the healing time. For example, slight motion occurs when the broken bone is set in a cast. Once the broken bone has been aligned back to its normal position and is placed in a cast, proper healing can begin.

In addition, secondary bone healing progresses through different stages. The first stage occurs immediately after the fracture. In this stage, there is swelling and bleeding around the broken bone. The bleeding then becomes a mass around the break. This mass is first known as a soft callus and eventually becomes a hard callus. Once the soft callus becomes hard, the bone is stable. After a cast is removed, the hard callus is gradually remodeled to normal bone. This can take up to several years.

Primary bone healing occurs when there is absolutely no movement between the two ends of a broken bone. The goal of surgery is often to stabilize the bone so that primary healing may occur. Doctors may use rods, pins, plates, or screws to hold the broken bone together. This hardware presses the ends of the broken bone together tightly and prevents any movement. When there is no motion, new bone begins to form immediately across the two ends of broken bone. In this case, there is no callus that forms around the break. At first, the hardware holds the break in a very stable position and then new bone grows across the site resulting in a once again normal bone.

Every broken bone is unique. The decision to cast and allow secondary bone healing to happen or to fix with surgery and allow primary bone healing to happen is made by your doctor. The ability to realign the pieces of bone and have them stay in a good position for healing will be considered. Your doctor will also consider the typical activities you are involved in and your health. With all of these things in mind, your doctor will make a decision that is best for your break and for you so that healing can begin.

Some bones heal quickly and others more slowly. The speed at which a bone heals depends on the size of the bone, the severity of the break, and the amount of nutrients and blood supply around the bone. Other things that affect the body’s ability to heal a broken bone are age, general health, and nutrition. Children tend to heal more quickly than adults do because of the strong tissue around the bone that provides good nutrients for healing. As people get older, their tissue gradually thins and healing can take longer. When health issues are present, such as infection or disease, this can also slow the healing process. A healthy, well-balanced diet will help bone to heal.

X-rays are used to decide if a bone is healed enough to allow use of the injured arm or hand for daily activities. Once the bone is healed enough for exercise and use, your doctor may send you to a hand therapist to guide you through specific exercises. With your therapist you will work to gain back your motion, strength, and function.

Courtney Middleton, OTD, OTR/L, CHT, CLT is a certified hand therapist and a member of the American Society of Hand Therapists (ASHT).

How to realign a fractured bone

A non-healing fracture, also called a nonunion, occurs when the pieces of a broken bone do not grow back together correctly. Usually, bones start rebuilding immediately after the bone fragments have been realigned and stabilized them into place. This process is called setting the bone.

During the following weeks or months, new bone tissue continues to form. As long as the bone fragments receive an adequate supply of blood and nutrients, the new tissue fuses the fragments together into a single bone.

In a nonhealing fracture, bones do not produce new tissue. A fracture in which the bone does produce new tissue but does so very slowly (over months instead of weeks) is called a delayed union. In some instances, the broken bone heals but may not be completely straight. This is called a malunited fracture.

A nonunion, delayed union, or malunited fracture may occur in any bone, but these conditions are most common in the humerus, or upper arm, and the tibia, or lower leg.

How Does a Bone Heal?

All broken bones go through the same healing process. This is true whether a bone has been cut as part of a surgical procedure or fractured through an injury.

The bone healing process has three overlapping stages: inflammation, bone production and bone remodeling.

The Inflammatory Stage

When a bone breaks, the body sends out signals for special cells to come to the injured area. The Inflammation Stage starts immediately after the bone is fractured and lasts for several days. When the bone is fractured, some of these special cells cause the injured area to become inflamed (red, swollen, and painful). This tells the body to stop using the injured part so it can heal and provides the initial structural stability and framework for producing new bone.

Other cells that come to the area during this stage form a hematoma (blood clot) around the broken bone. This is the first bridge between the pieces of the broken bone.

The Reparative Stage

The reparative stage starts within about a week of the injury. A soft callus (a type of soft bone) replaces the blood clot that formed in the inflammatory stage. As healing progresses, the soft callus is replaced with hard bone (known as hard callus), which is visible on x-rays several weeks after the fracture. Over the next few weeks, the soft callus becomes harder. By about 2–6 weeks, this hard callus is strong enough for the body part to be used.

The Remodeling Stage

The remodeling stage starts around 6 weeks after the injury and can last for several months. In this final phase of bone healing, regular bone replaces the hard callus. In remodeling, bone continues to form and becomes compact, returning to its original shape. In addition, blood circulation in the area improves. Over the next few months, the bone is reshaped so that it goes back to looking the way it did before the injury.

How Long Does Bone Healing Take?

Depending on the severity of the fracture and how well a person follows their doctor’s recommendations, bone generally takes six to 12 weeks to heal to a significant degree. In general, children’s bones heal faster than those of adults. This will depend on the location and severity of the fracture, the type of surgical procedure performed and other considerations. People usually stop feeling pain long before the broken bone has healed and the limb is ready for regular activity.

Causes and Risk Factors

With modern treatment methods, most broken bones heal without any problems. After a fracture occurs, new bone tissue forms to connect the broken pieces. When the broken bone fails to heal it is called a “nonunion.” For bone healing to happen, the bone needs adequate stability and blood supply.

Nonunions happen when the bone lacks adequate stability and/or blood flow. Determining the cause of a nonunion is critical to determining the proper treatment. The most common causes of nonunion are:

  • Use of tobacco or nicotine in any form. This includes smoking, chewing tobacco, and use of nicotine gum or patches.
  • Older age
  • Infection
  • Diabetes
  • Severe anemia
  • Medications including anti-inflammatory drugs such as aspirin, ibuprofen, and prednisone.

Orthopedists at Ventura Orthopedics treat common bone healing complications, including:

  • Bone infections (osteomyelitis). Infections can occur when bacteria enter the body during a trauma. Less commonly, infections can happen during surgery to set a bone.
  • Inadequate blood flow to the bone: Healing bones get many factors delivered by the blood supply, including the cells that repair the broken area, growth factors, and oxygen. Some bones have a limited blood supply and in other cases, the supply is disrupted by the injury.
  • Separation of the fractured ends of the bone: The bones may not have been set close enough for a union, or may have separated after stabilization.
  • Inadequate stabilization of the fracture: Stabilization is one of the key parts of treating broken bones. If the fracture was not able to be set properly, a nonunion might result. Sometimes a cast is not sufficient, and the fracture must be stabilized with screws, rods, plates, and other fixation methods

Bone Complications: What to Look For

It is important to know the warning signs of a bone healing complication so you can alert your doctor. Receiving prompt care is critical to treating complications. Call your doctor if you notice any of the following signs:

  • Chronic pain
  • Fever
  • Drainage from a wound
  • Swelling
  • Limping

Diagnosis/Treatment

  • History and physical exam: Your doctor will obtain a history of your problem and perform an appropriate physical exam to find the exact area of concern.
  • Imaging: Usually, imaging of the site in question begins with X-rays. If more information is needed, your doctor may order a CT Scan or an MRI.
  • Surgery: The goal of treatment is to realign your bone in a position that improves the function of the upper extremity. Your surgeon may need to re-break the bone to realign the fracture. Depending on the type of malunion, some of the bone may need to be trimmed to allow for proper orientation of the fractured ends.

Prevention

The best thing a patient can do to prevent a nonunion is to avoid smoking. Other factors that will help prevent nonunions include eating well and adhering to your recommended treatment plan. Patients who are smokers, obese, have diabetes or have other medical conditions, may be at higher risk for developing a nonunion.

A Word From Ventura Orthopedic Today

Bone healing typically proceeds without much problem. However, there are situations where people have problems healing bone after fractures or surgery to fuse the bone together. In these situations, there may be steps to help stimulate the body to heal bone. If you are concerned about your bone health, our specialists are always willing to help you reach your optimal health.

The experienced and dedicated orthopedic surgeons at Ventura Orthopedics are here for you. We are committed to helping you through any procedure until optimum health, strength and mobility are restored. Call us today at 800-698-1280 to schedule an appointment.

Why might Foot Fracture Surgery be needed?

You will need surgery on your foot because the severity and location of your fracture requires you to do so by a healthcare professional. Surgery will repair the fractured bone in a better position to reduce the risk of a deformity or loss of function.

What are the risks with Foot Fracture Surgery?

As with any surgery, there can be risks with surgery of the foot. Whilst small, they can include:

  • Residual weakness in the foot
  • Reduced function which may cause a difficulty in walking
  • Infection
  • Possible further surgery if the bone doesn’t heal properly
  • Possible nerve damage

Our leading expert orthopaedic consultants will be able to help with any concerns you may have.

How to prepare for Foot Fracture Surgery

Your consultant will provide you with all the relevant information before your procedure along with any preparation you may need to do in the days leading up to your surgery. It is important to tell your consultant about any medicines you may be taking, including any over the counter pain medicines such as paracetamol or aspirin.

You may need imaging tests before your surgery, including ultrasound, x-ray or an MRI.

Do not eat or drink XX hours before you are due to have surgery otherwise your surgery may be delayed.

Please ensure you have a companion available to take you home after you leave OneWelbeck Orthopaedics.

What will happen during my surgery?

An anaesthetist will discuss with you the type of anaesthetic used and the process they will follow so you don’t feel anything. You will be given the opportunity to ask any questions and raise any concerns you may have.

Once you are safely anaesthetised, incisions are made through the skin where the bones are broken in the foot. The bones will be repositioned and held in place with implants which are usually metal. Once the bones are repaired, your surgeon will stitch up where the incision has been made and you will be taken back to your room.

There are specific techniques for the various foot fracture surgeries:

Heel bone surgery (Calcaneus) – A fracture of the heel bone can often involve disruption of the joint between the heel bone and ankle bone (talus). To restore the anatomy and realign the joint surface, surgery is needed. By creating an L-shaped incision over the heel, the fracture is realigned, and concentrating on the surface of the joint, is fixed with either a plate, or individual pins/screws.

Inside midfoot (Navicular) – This is a common fracture which causes the bone to break in two. An incision is made over the fracture and the two bones are realigned before being secured with either screws, or a plate and screws.

Outside midfoot (Cuboid) – This type of fracture is caused by a compression injury resulting in shortening of the outside foot. Cuboid surgery aims to lengthen the outside of the foot with a plate and screws inserted directly to the bone. Once the fracture has healed, the plates and screws are removed.

Metatarsal fracture – some metatarsal fractures can be treated without surgery, but sometimes if the injury is more significant, surgery is needed. An incision is made over the fractured metatarsal and is fixed with a combination of pins, screws and plates.

Toes (Phalanges) – Most fractures of the toes can be treated without surgery. Deformities as a result of displaced fracture may need surgery to correct them. The toe is placed into alignment, an incision is made, and a pin is inserted through the tip of the toe to hold the fracture in place. Once the fracture is healed in roughly four to six weeks, the pin can be removed.

What happens after Foot Fracture Surgery?

After your operation, you will be watched by your dedicated nurse at OneWelbeck Orthopaedics for the few hours after your surgery. To stop your foot from moving, you will need to wear a cast or boot which will help the foot to heal. Once you have seen your Consultant you will be able to go home the same day. It is important to keep your foot elevated to give your injury the best chance of healing.

Make sure you follow any advice given to you by your consultant orthopaedic surgeon including any advice on pain relief, wound dressing and any exercises you may be given.

A common result of wearing narrow-toed, high-heeled shoes is that toes can become crooked due to the ligaments and tendons warping. What happens is the chronic pressure and stress inflames the toes; the big toe in particular can develop a bunion. After a fracture or another type of dislocation, toes can remain crooked and any additional trauma will only make your toes worse. There are, however, many nonsurgical methods to straighten toes, depending on the severity of cause. You may require corrective surgery if the problem worsens, but first it is helpful to try some easy ways on your own.

How to Straighten Toes

If you act quickly after a minor toe injury, by trying some of these methods, you may be able to treat the joint problem in your toes effectively without surgery.

1. Change Your Shoes

How to realign a fractured boneLook for shoes with a spacious toe box, stable arch support, and low heels. Shoe that don’t rub your toe, sandals or athletic shoes, for example, are good options. There are custom-made shoes that help people with chronic problems. These are known as orthopedic shoes and can be purchased ready-made or custom-made.

2. Support Your Toes

There are a variety of products available to cushion or help the toes rest in a more comfortable position; you can use moleskin, toe tubes, arch supports, or orthotic inserts. If your toe is still flexible and mobile, this treatment is more effective. Although it’s not a permanent way for how to straighten toes, it can still provide pain relief.

3. Take Over the Counter Medication

Before taking anything, make sure you never cut corns or calluses since this could lead to infection. Rather, try to use moleskin to buffer the friction between a shoe and the area injured. If the pain is severe, try over the counter medicine like acetaminophen, naproxen, or ibuprofen. Double check with your general physician before using these medications, and be sure to read and follow all instructions.

4. Correct Dislocations

It is possible to realign your toe by having a specialist like a podiatrist or a chiropractor actually correct the dislocation manually. There will be an immediate feeling of relief. Also, it is common that a toe can realign on its own after accidental foot trauma like a stubbed toe or even after an intentional trauma like kicking a ball. The sooner the joint is realigned, the less chance there is of lasting damage and the need for surgical treatment for how to straighten toes.

How to realign a fractured bone5. Taping Your Toes

By taping from under the big toe, over the hammer toe, and then under the next toe you can stabilize the hammer toe. This will force it into its standard natural position. This will most likely not keep the toe permanently straightened, but it will assist in the short term.

6. Exercises

  • Toe-Spread: Cross the leg with the injured toe over the opposite leg and using your hand, place one finger between the hammer toe and the adjacent toe. Depending on how flexible your toes are, squeeze your finger with your toes and repeat while interlocking your fingers and your toes. Perform this at least once a day and try to do 10 reps at a time.
  • Toe Taps: Just like you would tap your fingers one by one on the edge of a table, put your barefoot on the floor and flex your toes upward to begin. One by one, starting with the small toe, tap your toe back onto the floor working back to the big toe. Repeat this exercise 10 times per day for relief.
  • Floor Grip: While standing barefoot focus on the pads of your foot when you stretch your toes outward to straighten them as much as possible. This aids in the realignment of the bones in your hammer toe. The proximal phalanx will be able to return to a normal position since the proximal interphalangeal joint will be relaxed from the exercise.
  • Towel Exercises: This is an easy way for how to straighten toes. While sitting or standing, simply crumple up a towel with your toes. Put a small towel on the floor and collect it with your toes and then straighten the towel out again. This will help to loosen up the joints and ultimately straighten out your toes. If you can, experts recommend picking up the towel using your toes to strengthen the muscles to help heal your hammer toe.
  • Manual Stretches: With your legs crossed, pull the injured toes with your hand back and forth. Hold the stretch in each direction for several seconds to deepen the stretch. This will help to reverse the crooked toe.

Do You Need Surgery to Straighten Your Toes?

There are many reasons for needing a surgery to straighten your toes. Ultimately, the biggest reason is because your toe limits regular activity and the joint is completely immobile. This is especially the case if the pain is completely uncontrollable. Surgery will reduce the pain from the crooked or hammered toe despite the atheistic result. If you have a flexible toe with a problem that isn’t healing on its own, then a doctor can surgically move the tendons to release tension from the joint. They may also need to work on the bones if the problem is more severe. After surgery, it is highly recommended to not return to wearing shoes that caused the problem initially.

How to realign a fractured bone

Whether you fell off a ladder or were injured playing sports, walking on a broken foot too soon can set back healing time and cause more injury. Before you ditch the crutches or walking boot, understand how bones heal and the importance of proper weight bearing on your foot for optimal recovery.

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Most foot fractures will allow you to be fully weight bearing, as long as you are in a walking boot or cast. If your injury is in your heel or fifth metatarsal, however, expect to be non-weight bearing for six to eight weeks.

Broken Foot Healing Time Stages

Treating a broken foot isn’t always an exact science, which is why it’s important to have a doctor evaluate your injury. There are several factors that affect healing time; however, a broken bone, in general, takes six to 12 weeks to heal. Younger kids and healthy adults heal more quickly, while older adults or those with pre-existing conditions may take longer to get better.

The location of the fracture also significantly affects healing time and determines if you wear a cast vs a boot for your broken foot. The American Academy of Family Physicians provides guidelines on healing time and weight bearing, depending on the location of the injury. If your broken bone is displaced and requires surgery or pins to help stabilize it, the healing time will be longer than a bone that is not displaced and requires no surgery.

Weight-Bearing Rules for Toes

If you drop something on your big toe or stub it on the sofa and break it, you may be surprised to find that you will need a cast or walking boot. The big toe plays a big role in balance and maintaining a normal walking pattern; therefore, it is important that it heals correctly. You can expect to be in a short walking boot or cast with a supportive toe plate for two to three weeks, followed by a rigid sole shoe for three to four weeks.

The good news is you can have full weight bearing, as long as you have it supported. After the boot is removed, you will work on regaining strength and mobility.

If you luck out (if you want to call it that!) and just break your smaller toes, the treatment is much easier. You will have full weight bearing and normal activity as tolerated. Treatment requires only buddy taping your toes together to provide support, along with wearing supportive, rigid sole shoes for four to six weeks.

Weight-Bearing Rules for Metatarsals

The metatarsals are those long bones in your foot between your toes and ankle. A metatarsal fracture is often caused by an overuse injury and results in pain in the middle of your foot. This injury often causes a stress fracture and requires a short leg walking boot or a cast for up to six weeks; however your doctor will often have you follow up every two weeks to monitor healing.

You will have full weight bearing in the boot or cast. After the walking boot is removed, you will do exercises to work on regaining strength, balance and flexibility.

The only exception to this rule is if you break your 5th metatarsal, which is the bone that connects to your pinky toe. This injury, called a Jones fracture, causes pain and swelling on the outside of your foot and is often seen in athletes and dancers.

Traditional treatment of a fifth metatarsal fracture is much more extensive and usually requires a cast and no weight bearing for six to eight weeks. After the cast is removed, you will progress to partial or weight bearing as tolerated, and then you will start to work on regaining strength and mobility.

A study published in the September 2016 issue of the Journal of Foot and Ankle Surgery is changing the way the Jones fracture is treated, as it shows that earlier weight bearing in a walking boot resulted in better bone healing than extended non-weight bearing.

What About a Broken Heel?

A heel or calcaneus fracture is often the result of a fall, such as falling off of a ladder, or a car accident. The American Academy of Orthopaedic Surgeons recommends a cast and non-weight bearing for six to eight weeks, followed by partial weight bearing for up to 10 weeks, before a gradual return to full weight bearing.

For those that have an injury requiring an extended period of non-weight bearing, such as the heel fracture, using a knee scooter can make it easier to get around than crutches.

Cast Versus Walking Boot

Your doctor’s decision to put you in a cast versus a boot for a broken foot has to do with how much stabilization your injury requires to prevent you from walking on a broken foot too soon. More serious injuries, including those that need surgery or a broken heel bone, require the bone to be completely immobilized for proper healing, while less serious injuries, such as a big toe fracture, should heal just fine in a walking boot.

  • Medical Author: Karthik Kumar, MBBS
  • Medical Reviewer: Pallavi Suyog Uttekar, MD

How to realign a fractured bone

Humerus fractures cause severe pain and swelling. On a scale of 10, pain in patients following a humerus fracture is eight or more. Shortening of the arm is apparent with significant deformity of the bones. Humerus fractures are a very painful injury, and patients may need to take pain relief medications regularly as prescribed by the doctor. The fractured portion may hurt intensely, swell, and feel stiff. Stiffness may continue well after the fracture has healed. It may be very difficult for an individual to move their upper arm. If the nerves are also affected, they may experience unusual sensations and weakness in the hand and wrist. Other symptoms may include:

  • A grinding sensation when the shoulder is moved
  • Deformity
  • Open fracture (occasionally bleeding)

What are the causes of a humerus fracture?

The humerus is the upper arm bone that runs between the elbow and shoulder. Humerus fractures account for a remarkably small proportion of total bone fractures. The causes may include:

  • A direct blow or bending force applied to the middle of the humerus
  • Falling onto an outstretched arm
  • Violent muscle contraction in sports such as weightlifting

An accident or a severe injury is the main cause of humerus fractures. Most injuries result from a direct impact to the body, such as during a fall or motor vehicle crash. Older adults may experience humerus fractures from relatively minor falls due to less bone strength and bone degradation.

Different types of humerus fractures include:

  • Proximal humerus fractures occur near the shoulder.
  • Mid-shaft fractures are located in the middle of the bone.
  • Distal humerus fractures are located near the elbow joint and are more common in children than they are in adults.

Doctors may diagnose a fractured humerus by

  • Examining the arm and pulses.
  • Taking an X-ray of the affected arm.
  • More sophisticated imagery (in rare cases), such as a computed tomography scan is used to provide a more detailed view.

How to realign a fractured bone

QUESTION

How is a humerus fracture treated?

The humerus is the long bone in your upper arm. When broken, it needs specialized care so that you can cope with the problems it brings. It will take a minimum of 12 weeks to heal. Patients may be on pain relief medications for a longer duration. The plaster that is applied for this injury is heavy; this is to help the fracture stay in the correct position, and patients must adapt their lifestyle to get used to this. Treatment options include:

  • If the fractured bones are still in their proper position, a sling or plaster cast can be used. The cast supports and keeps the arm from moving while it heals. This usually takes three months.
  • Most mid-shaft humerus fractures, which have well-aligned bone parts, can heal with immobilization and usually do not require surgery.
  • Doctors may recommend physical therapy depending on bone healing. Therapists will help you move the shoulder joint at first with a passive range of motion exercises. These exercises help improve circulation and reduce stiffness. Patients may then proceed to more advanced exercises to increase strength and motion.
  • If the fractured bones have moved out of position, surgery is recommended. Surgery called an open reduction and internal fixation (ORIF) is used to realign the bones and secure them in position with surgical hardware, such as plates, pins, screws, and wires. Surgery is most frequently used for proximal and distal humerus fractures.
  • For severe proximal humerus fractures, a shoulder replacement surgery is used to remove the damaged bone and insert an artificial implant.
  • Severe proximal humerus fractures may also require reattachment of the shoulder muscles (rotator cuff muscles). Rehabilitation therapy begins as soon as possible.

The recovery process is different for everyone, depending on the severity of the injury and treatment you receive. Most fractures heal in about six weeks, but severe injuries may take longer to heal. Taking calcium and vitamin D supplements and increasing protein intake in the diet can help in hastening the healing process.

A bone fracture may or may not be obvious. There are a range of signs, symptoms and treatment options for fractures.

Signs and Symptoms of a Bone Fracture

The signs and symptoms of a bone fracture will depend on the severity and location of the injury. Generally, the symptoms include:

  • Pain
  • Swelling
  • Difficulty moving
  • Bruising
  • Altered normal limb alignment

Additionally, the injured area may be tender or feel warm. In the case of an open fracture, the bone can be seen from the skin. Sometimes, a person may not realize they have a fracture.

Bone Fracture Treatment

Once the doctor has confirmed the exact location and type of fracture—usually through an x-ray—he or she will develop a treatment plan. There are several different ways to treat a bone fracture.

  • Immobilized cast. A plaster or fiberglass cast will be placed around the fracture once the bone has been aligned. The bone cannot move when in this type of cast, which promotes proper healing.
  • Functional cast or brace. This type of cast allows for limited but controlled movement, and is only applicable to some, usually minor, fractures. Sometimes a fracture is severe enough that it requires more than a cast or brace.
  • External fixation. A surgeon will insert screws and wires into the bone, which then attach to a metal bar on the outside of the skin. This device stabilizes the bone while it heals. Once the fracture heals, the removal of the screws and external device can usually be done in a doctor’s office without anesthesia.
  • Open reduction and internal fixation. A surgeon will realign (reduce) the broken bone into its normal position and then affix metal plates or special screws to hold it in place. In some cases, a metal rod will be inserted down the center of the bone to stabilize it. The screws and plates are typically left in the bone once the fracture has healed, but may be removed in some situations.
  • Traction. This treatment uses weights, pulleys, and ropes to gently realign a broken bone. Traction is typically used as a temporary measure in the event that a person must wait to have surgery.

Traction and fixation techniques are most often used when the bone cannot be held in place by a cast or brace.

The healing time of bone fractures will depend on the individual, their underlying bone health, their activity level, and the location and severity of the injury.

1-2 weeks. If a broken nose has made the nose crooked, then it ought to be set within 1-2 weeks after the injury. Broken nose. Setting a broken nose should be done urgently (first few days) if there is not a tremendous amount of swelling. One week. 7 days.

How much time do you have to set a broken nose? 1-2 weeks. If a broken nose has made the nose crooked, then it ought to be set within 1-2 weeks after the injury. Broken nose. Setting a broken nose should be done urgently (first few days) if there is not a tremendous amount of swelling. One week. 7 days.

How can I deal with a broken nose at home? To manage a broken nose at home: Treat nosebleeds by sitting down and leaning forward to prevent the blood from entering the throat. Apply an ice pack to the injury for 15 to 20 minutes, several times a day. Take over-the-counter (OTC) pain relievers, such as acetaminophen or ibuprofen, to relieve pain and swelling.

How is manual realignment done for a broken nose? When performing a manual realignment on a person with a broken nose, a doctor may: use an anesthetic nasal spray or administer an injection to numb the affected area use a speculum and other medical tools to realign the broken bones and damaged cartilage pack the nose and place a dressing on the outside to keep the bones and cartilage in place prescribe antibiotics to prevent infection

What do I do if I broke my nose? An ice pack, which can help with a broken nose. If a person’s nose is broken, they should see a doctor. Surgery may be necessary for severe nose breaks.

How long does it take to fix a broken nose without surgery?

How long does it take to fix a broken nose without surgery? If your doctor decides your nose can be fixed without surgery, he’ll have to do it within 1 to 2 weeks of your accident. If he waits any longer, the injury will begin to heal on its own, even if the bones are out of place. Your doctor will give you pain medication before the procedure.

When to see a doctor for a broken nose? If the break has displaced the bones and cartilage in your nose, your doctor may be able to manually realign them. This needs to be done within 14 days from when the fracture occurred, preferably sooner.

When to do manual realignment of a broken nose? Manual realignment. If the break has displaced the bones and cartilage in your nose, your doctor may be able to manually realign them. This needs to be done within 14 days from when the fracture occurred, preferably sooner.

What should I do if I Break my Nose? A very broken nose is just an eyesore. If you break your nose, you have two choices for resetting it: set it yourself, or have it reset by a doctor 1. Is This an Emergency? If you are experiencing serious medical symptoms, seek emergency treatment immediately.

A “fracture” is the technical term for a “broken bone,” which is a crack in the bone.

Types of bone fractures

There are two basic types of bone fractures: traumatic fractures and stress fractures.

Traumatic fracture

A traumatic fracture occurs when significant or extreme force is applied to a bone. Examples include broken bones caused by impacts from a fall or car accident, and those caused by forceful overextension, such as a twisting injury that may cause an ankle fracture.

Traumatic fractures may be nondisplaced or displaced.

Nondisplaced fracture

A nondisplaced fracture is one in which the bone cracks or breaks but retains its proper alignment. Nondisplaced fractures often require only bracing, booting or casting treatment.

Displaced fracture

A displaced fracture is one in which two or more portions of broken bone come out of proper alignment. Severe cases can include a comminuted fracture (in which bone shatters into multiple pieces) and/or an open fracture (also called a compound fracture), in which an open skin wound occurs in conjunction with the fracture.

Displaced fractures must be reset by a doctor either by closed reduction or open reduction. In a closed reduction, the bone is manually brought back into place without surgery. In an open reduction, incisions are made and surgical tools are used to realign the bone. The affected bone is then usually fixated in place using pins, screws, wires or other means.

Stress fracture

A stress fracture occurs when a small or moderate amount of force is applied repeatedly to a specific bone over time. With a stress fracture, the bone breaks but does not commonly become displaced (misaligned).

Fractures in different parts of the body

Below, explore further content on fractures of particular bones and regions of the skeletal structure.

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No one wants to experience trauma to the jaw. Not only can a broken jaw be painful, but it impacts so many essential activities like talking, eating, and even breathing. If you’ve experienced an injury to the face, seek out treatment immediately — you might have a fractured jaw. Understand what can cause a fractured jaw, the symptoms associated with it, what you can expect for treatment, and how it differs from a dislocated jaw.

What Causes a Broken Jaw?

Your jaw is comprised of two cooperative bones: the upper jaw called the maxilla, and the lower jaw, known as the mandible. The two bones are connected at the temporomandibular joints (TMJs) located in front of your ears on either side of your head. The mandible handles most of your mouth’s mechanics, including opening, closing, and chewing. A fractured jaw occurs when one of these bones cracks or breaks.

Common causes for a broken jaw include:

  • Accidental falls, especially when you are unable to catch yourself with your hands
  • Motor vehicle accidents, including motorcycles and bicycles
  • Sports-related injuries
  • Industrial work-place accidents
  • Assaults or a punch to the jaw

How to Know If Your Jaw is Broken

If you’ve received an injury and are concerned about a fractured jaw, see your physician immediately. Some broken jaw symptoms include:

  • Pain in the face or jaw
  • Bruising and swelling
  • Missing teeth or bleeding inside the mouth
  • Pain or difficulty when moving the jaw
  • Numbness in your lower lip or chin from a damaged nerve

How Do You Treat a Fractured Jaw?

Because it can impact your ability to breathe, every jaw injury should be treated as an emergency. Seek medical intervention immediately and ensure the jaw is supported and the airway remains open until you receive treatment. Once you arrive at the hospital, the physician will conduct a physical exam and order X-rays to determine the severity of the injury.

Fractured jaw treatment will depend on the severity of your case. If you have a minor fracture or a clean break, your treatment might include wrapping a bandage around your head to support your jaw and prevent it from opening too wide. Your physician might also recommend over-the-counter pain medications to assist with the pain and swelling.

More severe fractures might require the physician to wire your jaw shut so it can heal. These wires or elastic bands help keep your jaw closed and in the correct position, and you can expect to wear them around six weeks. During this time, you will need a liquid diet until you can chew solid food again. Your physician might prescribe painkillers or antibiotics to help with the pain and prevent any infections. Afterward, exercises will help strengthen these inactive jaw muscles so you can return to full strength and function.

What’s the Difference Between a Fractured and Dislocated Jaw?

Pain in the jaw and face could also be the result of a dislocated jaw. A dislocated jaw occurs when your jaw moves out of position at one or both of the TMJs. It can be challenging to tell the difference between a fractured and dislocated jaw without the help of a medical professional. Some symptoms of a dislocated jaw include:

  • Pain in the face or jaw
  • Pain or difficulty when moving the jaw
  • Inability to close the mouth
  • Misalignment between the mandible and the maxilla
  • An over or underbite

To treat a dislocated jaw, a physician will manually reposition the jaw back into place using their hands. This is called a manual reduction. Afterward, the physician might use a supportive bandage to restrict movement for a few days while the area heals.

Jaw injuries are no joke, so always take precautions when possible, including wearing a seatbelt in the car or protective equipment while playing sports. See your dentist or physician if you feel pain in your jaw or have difficulty talking or chewing. You might be experiencing the effects of teeth grinding, TMJ disorder, periodontal disease, or a fractured jaw. Your medical professional can help you determine the cause of your discomfort and take steps to get your smile back to normal.

How to realign a fractured bone

How to realign a fractured bone

A fracture occurs when there is a break in the bone. It is an injury that can be caused by a fall, accident or other physical trauma. Children and the elderly are two groups that are more prone to getting a fracture. While not usually a life-threatening injury, a fracture needs to be treated by a medical professional and may even require surgery if the damage is severe. A fracture can be of two types:

  • Open fracture: An open fracture occurs when the broken bone tears through the surrounding skin tissue. This is also known as a compound fracture and is a more serious injury.
  • Closed fracture: A closed fracture is when the broken bone has not pierced through the skin tissue.

Recognising a fracture

Knowing what the signs and symptoms of a fracture are can help you assess the situation and manage immediate care better. Following are a few that may be experienced after a break in a bone:

  • Hearing a snapping sound at the time of the fall or accident
  • Extreme pain at the site, which may worsen with movement
  • Numbness or swelling at the site
  • Heavy bleeding in case of open fractures
  • The broken bone protruding through the skin
  • Bluish colour of skin at or immediately around the site
  • Warmth, redness or bruising at the site of the injury
  • The inability of the injured part of the body to bear any weight

First aid for fractured bones

Since a fracture is usually a result of an accident or fall, it may be accompanied by other injuries as well. The bone that is suspected of being fractured may also dictate whether you should move at all or not.

  • CPR: Check if the person is conscious. If they’re not breathing or they don’t have a heartbeat, perform CPR if you know how to.
  • Bleeding: Use a sterile bandage or a clean piece of cloth to apply pressure on the wound to stop bleeding.
  • Stabilize: Avoid movement if possible, especially if the fracture is suspected in the neck, back or head. In such cases, call emergency services and make sure the person is in a stable position and not in danger of further injury. In other fractures, make sure they do not try and realign the fracture themselves and transport them to a hospital. If you’ve been trained in making a sling or splint to immobilize the affected area, do so with their permission.
  • Cold compress: Use ice packs to manage the swelling, numb the area and alleviate some of the pain.
  • Shock: The trauma of a major injury can make the person go into shock. Make them comfortable and reassure them to prevent this. If they feel faint, provide support and encourage them to lie down (if possible) with their legs elevated.

Complications of fractures

Severe complications often depend on the specific location of the fracture. For example:

  • Rib fractures could lead to a collapsed lung, compromising your ability to breath
  • Fractures near arteries could damage the vascular system and prove to be life-threatening
  • Pelvic or spinal fractures in the elderly could result in loss of mobility, increase the risk of pneumonia, thromboembolic disease or rhabdomyolysis

Other complications, associated with the healing process, are:

  • Infection: At the time of the break and in the time following it, microorganisms can be introduced into the wound (blood or bone) in the case of open fractures. This could lead to infection, which would require antibiotic treatment.
  • Delayed union or nonunion: When a fracture takes longer than normal to heal, it is known as a delayed union. Similarly, when it fails to heal, it can be known as nonunion. Bone grafting may be required in such cases.
  • Deformities: Fractures that haven’t been set properly or bones that are misaligned may heal in the abnormal position and cause a deformity. Fixators like screws or rods may need to be attached to the bone to stabilize it.

Things to keep in mind after a fracture

Bones can take six to eight week to heal and this time can increase or decrease depending on many factors like age, diet, underlying medical conditions and overall health status. Following are a few things you should keep in mind while recovering from the fracture:

  • Cast care: Commonly, the fracture may be encased in a cast for it to heal properly. Follow all the instructions given regarding caring for the cast and keep it clean to avoid infection. You’ll need to keep it dry, which may be achieved by wrapping it in plastic when you bathe.
  • New symptoms: If you start to experience any new symptoms, like a rash appearing or a foul odour coming from the injury, you should reach out to your doctor in case they point to an infection. Additionally, make sure that the symptoms you’re already experiencing, attributed to the fracture, do not become more severe. Consult with your doctor in case that happens.

When children and teenagers come to the emergency room (ER) with a broken bone, it’s important that they are offered medications quickly to help reduce their pain. Therapies outside of medications are also used to help combat the patient’s pain. Splinting, distractions (reading and playing), and lowering the room lights to encourage sleep can help. Patients, or their guardians, can refuse any medications.

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What is this measure?

How to realign a fractured bone

If a patient comes to the ER with a broken arm, leg or joint fracture (these types of breaks are known as “long bone” fractures), he or she should be offered pain medications within 60 minutes of their arrival. This medicine is the first step in treating the patient and is given to reduce the patient’s pain level. The Joint Commission, a health care accreditation organization, adopted this national measure to help reduce pain levels in pediatric patients.

Why is it important?

When patients suffer a bone fracture there is typically pain involved. Often, patients wait a long time in the ER for an X-ray to determine the appropriate treatment plan. It is important that patients are offered pain medications to help make them comfortable. Patients may decline the medications if they choose.

How Does Johns Hopkins Medicine Perform?

Johns Hopkins Children’s Center

Median time to pain management for long bone fracture patients in the ER

Note: A lower score indicates a better performance

Data Source: Johns Hopkins Medicine

Target: Set by Johns Hopkins Medicine based on comparisons to other Pediatric hospitals

What is Johns Hopkins doing to improve?

Throughout Johns Hopkins Medicine, we are educating our doctors and nurses on the importance of offering pain relief quickly to patients who suffer long bone fractures. We are also developing plans that allow nurses to make the decision whether to offer pain relief, and to offer it as quickly as possible.

Finally, we provide monthly reports to our care teams on how well we do in meeting the 60-minute goal. Leadership and the care teams review any cases that don’t meet the goal.

Frontline Perspective

Carolyn M. Neste, R.N., M.S.N.
Emergency Department/Pediatrics Patient Safety Nurse
Department of Emergency Medicine
Johns Hopkins Bayview Medical Center

“Patients who come to the emergency room with a long bone fracture, such as a broken bone in the arm or leg, are often in significant pain. Providing these patients with quick pain relief is important for both their comfort and experience.

“A couple of years ago, our hospital developed a report that tracked the timeliness of administering pain medications to patients who came to the emergency room with a long bone fracture. Whenever we did not meet our time goal for giving pain medicine to a patient, an email was sent to every doctor and nurse to make them aware of the failure. The email included an explanation of why meeting the time goal was important and clarified everyone’s role in being successful. Within a couple of months, our performance improved and we started meeting our goal.

“Every month, we continue to review our data and share it with our leadership team. When there are times that we aren’t meeting our target, we’ll discuss during our safety meetings possible reasons for the failures and solutions to the issues. This sharing of data promotes transparency and encourages the staff to meet our established goal as a team.

“This is all about improving the patient experience and patient safety. I am proud of the teamwork that has resulted in our staff members working to improve our performance in this area.”

How can patients and family support safety?

Patients and their guardians should communicate openly about their pain level. This includes what is working and what is not working in reducing the pain. Also, feel free to ask the doctors and nurses about other pain relief options. For example: splinting, distractions such as reading and games, and lowering the lights for a nap.

Quality and Safety Performance During COVID-19

The organization’s quality and safety performance may have been impacted by the COVID-19 pandemic. We would urge patients to consider more recent performance in combination with historical performance. Patients may benefit from discussing with their healthcare provider the disruptions COVID-19 may have caused on quality and safety of care.

Overview:

After a bone is broken (fractured), the body will start the healing process. If the two ends of the broken bone are not lined up properly, it can heal with a deformity called a Mal-union. With fractures in the hand, wrist, and forearm, a certain amount of angulation is tolerated. Doctors use criteria to determine if the position of a fracture will allow for functional use of the hand or arm after it heals. In many cases, when a fracture heals in a position that interferes with use of the involved limb, surgery can be performed to correct it. Some examples of common upper extremity fractures that may result in mal-union include the distal radius (i.e. wrist fracture), metacarpals (hand bones), and phalanges (fingers or thumb).

Symptoms:

Note: The following symptoms are not meant to diagnose a condition. If you have these or other symptoms, you should be evaluated by a qualified healthcare provider.

These occur following healing of the initial fracture:

  • Angulation and/or rotation of the fractured bone.
  • A wrist that does not flex or extend to allow normal use.
  • A finger that “scissors” onto or away from an adjacent finger
  • Altered use or function of the involved limb.
  • Stiffness in finger, hand, wrist, or elbow.

Treatment:

  • History and Physical Exam: The doctor or midlevel provider will obtain a history of the problem and perform an appropriate physical exam to find the area of concern.
  • Imaging: Usually, imaging of the site in question begins with x-rays. If more information is needed, the doctor or midlevel provider may order a CT Scan or an MRI.
  • Surgery: The goal of treatment is to realign the bone in a position that improves the function of the upper extremity. To realign the fracture, the bone is re-broken in the operating room after the patient is under anesthesia. Depending on the type of mal-union, some bone may need to be trimmed to allow for proper orientation of the fractured ends. To keep the straightened bone in proper alignment, screws, plates, and/or pins are inserted. Additionally, bone graft may be used to aid in fracture healing.

Pre-operative Care:

If you have a significantly altered use of a finger, hand, wrist, of elbow following the healing of a fracture, you should seek an opinion from a doctor who knows the upper extremity. If a decision for surgery is made after seeing one of our Orthopaedic Hand Surgeons, you may require pre-operative medical clearance by our Anesthesia department or your Primary Care Provider. This depends on your other chronic medical conditions.

Post-operative Care:

  • After surgery, you will be placed in a post-operative dressing/splint which you must wear until your first post-operative visit with one of our providers. You must keep the dressing CLEAN and DRY to avoid risk of infection and other wound healing complications.
  • Someone should be with you for the first 24 hours after surgery.
  • You will be given a prescription for post-operative pain medicine. Do not take it with other pain medicines unless directed by your doctor. Do not drive, drink alcohol, or make important decisions while taking the pain medicine.
  • Do not smoke, use smokeless tobacco, nicotine gum, or nicotine patches. Nicotine is a vasoconstrictor, and can impede healing by limiting blood flow to the surgical site(s).
  • You must remain non-weight bearing (no use) with the surgical hand and arm until cleared by one of our providers. This may be several weeks, depending on your healing.
  • At the first post-operative visit, your stitches will be removed. You will be placed in either a cast or a splint, depending on your surgeon’s preference. If your cast becomes wet or soiled, you should come into the office for a new cast.
  • To evaluate healing of the fracture at your follow-up appointments, the doctor will order imaging such as x-rays or a CT scan.
  • After several weeks of immobilization, you will likely be stiff and weak in your hand / wrist. Often, patients are sent to an Occupational Therapist, with the goal of regaining functional use of the operative hand. Remember, you are an active participant in your care, and part of your recovery depends on your desire to participate in therapy.

When you break a bone, it will usually start to heal straight away. A bone is a living tissue, and given time a fractured bone will heal itself. It is important however that the bone heals in the correct position.

When a patient is diagnosed with a fracture, a doctor will try to reduce a patient’s pain and make them as comfortable as possible until the fracture heals. They should also take steps to manage the fracture in such a way that allows joint movement to be regained as best as possible.

If the bone is misaligned the doctor will have to decide whether to treat the fracture conservatively such as in plaster or carry out surgery or some form of manipulation of the bone to realign it.

When deciding the most appropriate treatment option the doctor will have to take into account a number of different factors in addition to the nature and severity of the fracture. For example your age and general health will be an important factor. Patients who are old or frail may not be able to undergo an anaesthetic or surgery. Other patients will be able to undergo surgery.

The same fracture may therefore be treated differently depending on the health and circumstances of the person who has suffered the fracture.

The doctor has a duty to discuss each treatment option with you, explaining the usual risks and benefits of each, so that you can be involved in making the decision of how to treat the fracture and can properly consent to any treatment going forward.

If the doctor fails to discuss the treatment options with you fully then you may have a claim for compensation.

Conservative Treatment

A fracture will often require no medical intervention whatsoever if the bones that have fractured are in alignment.

In many cases, the fractured bone can be held in the correct position by methods such as a plaster cast or sling.

Also, some fractures will be deliberately left untreated. Fractures of small bones (such as toes) or ribs often do not need medical intervention, as they will heal on their own.

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Medical Intervention

Sometimes the fractured sections of bone must be realigned before the break mends, otherwise it is possible that it will heal in the wrong position.

A fracture is usually still mobile for two weeks after the fracture occurs. During that time, the alignment of the fracture can be altered by manipulation from a medical professional.

It is important this realignment takes place as it is very unlikely the bone will knit together in the correct place leaving a patient with reduced function.

Sometimes, depending on the type and location of the break surgery may be necessary to insert metal plates or pins into the bone to keep the parts of the broken bone aligned.

After two weeks the bone glue (bone callus) begins to form. Even at this stage it is still relatively easy to move the bone apart, although this procedure will usually need a general anaesthetic.

A surgeon usually has up to three weeks to realign a fracture and not cause any long term functional problems. After three weeks there may be a small loss of movement in the limb although usually alignment of the bone will be achieved.

By six weeks the fracture will usually be united and it will not be so easy to put the pieces back together as they were before the break, although even then it is fairly straightforward to re-open the fracture and realign it.

After six weeks, the fracture has really united and the new bone has formed. At this stage the only way to realign the fracture is to formally re-fracture it.

If the fracture is left untreated for longer than six weeks the bone is likely to unite poorly. This will result in you having significantly reduced function in the limb, increased pain and suffering and may require surgery to realign the bone. It is possible that even after undergoing surgery you may be unable to regain full function.

Missed or Misdiagnosed Fractures

Sometimes a fractured bone will be missed by the hospital and may go untreated. This may be because an x-ray was not carried out or an x-ray is performed but the medical practitioner does not identify the fracture on the x-ray. Sometimes fractures can be difficult to spot and it is not always negligent for a doctor to miss a fracture on an x-ray.

Doctors will not only base their diagnosis of a fracture on x-rays but will also consider the circumstances in which you have suffered the injury (such as a fall or a sporting injury). They will also carry out an examination of you looking for symptoms that may suggest a fracture such as:-

  • Pain;
  • Swelling;
  • Bleeding;
  • Dislocation;
  • Numbness;
  • Paralysis.

If a fracture is suspected, then the doctor will usually request an x-ray.

If a broken bone is missed and left untreated, not only will you have increased pain and suffering, but it is possible the fracture will heal incorrectly. It may then be necessary for you to have an operation to reposition the bone.

How to realign a fractured bone

Some folklore is passed down from generation to generation within families. My grandmother insisted that “if you don’t throw-up, it isn’t broken.” I was finishing my bachelor’s degree from the University of Florida before heading to medical school at CU. When leaving a Gators football game, I fell, landed on and possibly fractured my outstretched hand. My mother asked, “Did you throw up?” I didn’t. Her response was, “Well, then you didn’t break it.” A malunion is when a fractured bone heals in an abnormal position. It can be caused by not seeking medical treatment after a break. The bones in my hand had to be rebroken to surgically realign the fracture to heal correctly. Later, I graduated from the University of Colorado as an orthopedic surgeon. I can tell you with certainty that throwing up is not a sure sign that you broke something.

A broken bone is the same as a fracture. It can be caused by a fall, a car accident, sports injuries, or osteoporosis which is when bones weaken from aging. How do you know if it is really broken? The hallmarks of a broken bone are swelling, warm bruising, redness, tenderness to the touch, weakness, “pop” at the time of the injury, and pain. Usually, the pain from a fracture is so severe that you can’t put any weight on the injured leg or foot or lose grip strength with the arm or hand. Another obvious sign of a broken bone is deformity. The injured area might look crooked or have lumps from swelling. I had all of these hallmarks but didn’t throw up. If you have any of the real symptoms of a broken bone, you need to have an orthopedic surgeon evaluate it as soon as possible. You don’t want fractures to heal incorrectly like my hand.

As a practicing physician, if I suspect a fracture, I discuss all symptoms with the guest, examine the injury and order X-rays. X-rays provide images of dense structures, like bone, to show fractures, displacement, dislocation, bone spurs, and more. Fractured bones must be set in their proper place and held there in order to heal properly. Some fractures can be stabilized with immobilization. Serious fractures may require open reduction and surgical repositioning, using pins, plates, screws, and rods to hold the fracture in position to heal. My hand has a plate and six screws. My mother and grandmother are smart women. They just had a false narrative that was passed down to them from previous generations. The generational throw-up folklore will not be passed on to my children. Instead, the hallmark symptoms of broken bones will empower them to recognize possible fracture symptoms and respond by going to DOC as soon as possible.

– David Hassinger, MD, CEO, Direct Orthopedic Care

Check out our services page to learn how DOC can benefit you!

How to realign a fractured bone

How to realign a fractured bone

We usually think of cats as graceful and agile animals that can make impressive jumps. However, even the best athlete can miss. Falls and collisions with cars are the most common ways a cat breaks a bone. Attacks by other animals (and sometimes humans) can also result in bone fractures. The bones most commonly broken (or fractured) are the femur, pelvis, jaw, and tail.

What to Watch For

The primary symptoms seen are from pain. Cats will try to hide their pain, so watch for these signs:

  • Crying, howling, moaning, or growling, especially if touched
  • Not walking, or not using a limb or tail
  • Not eating or grooming
  • Swelling or bruising at the injured area

Sometimes a broken bone will poke through the skin. This is called a compound fracture. In addition, there may be other injuries associated with the traumatic event that broke the bone, such as cuts, bruises, or disorientation.

Primary Cause

A fracture is a crack or break in the bone caused by abnormal stress on the bone, usually from a traumatic event like a fall or being hit by a car.

Immediate Care

The first thing to remember is that your cat is in pain, and animals in pain can bite, no matter how gentle they are normally. The second thing to remember is that an event severe enough to fracture a bone could cause shock and other not so obvious problems, some of which may not be detectable for days. Therefore, any home treatment is just to stabilize the injury until your cat can be seen by your veterinarian.

Any areas that are bleeding or where bone is sticking out should be covered with sterile gauze or a clean cloth if possible. The broken bone(s) should be disturbed as little as possible. Wrap your cat in a thick towel or put him on a rigid surface to carry him to your veterinarian.

Veterinary Care

Diagnosis

Your veterinarian will evaluate your cat’s overall health to assure that more serious problems are under control. Once your cat is stable, multiple X-rays of the suspected fracture(s) will be taken.

Treatment

There are many factors that will determine how the fractures are treated. The most important are overall health, age, the bones broken, and the type of fracture that has occurred. A splint or cast may be sufficient for the lower leg, but not always.Often surgery will be needed to realign the bones and to place screws, pins (metal rods), wire, and/or metal plates to hold the pieces together.

Some fractures may be so severe as to require amputation, especially if the tail is involved. Fractures of the spine and pelvis will be treated by severely restricting activity (cage rest), with or without surgery. Pain medication will also be part of the treatment plan, and in some cases, antibiotics.

Other Causes

Pathologic fractures are caused by anything that can weaken the bone, such as certain hormonal imbalances, bone infections, and bone cancer.

Living and Management

The most important, and hardest, part of home care is restricting your cat’s activity, especially jumping. Any bandaging material will need to be kept dry. If it gets wet, especially from urine, or if there is odor or evidence of chafing, you will need to have the bandages checked and probably replaced. You also need to keep your cat from chewing on the bandages. The Elizabethan collar is the most commonly used device, but new collar styles and bandages that taste bad are also becoming more available.

Bones usually take 4 to 6 weeks to heal. Follow-up X-rays are normally taken to monitor healing. Fortunately cats seem to heal bones pretty well. Any metal parts that were surgically implanted to stabilize the bone will be left in place, unless they start causing problems.

Prevention

Since most breaks are caused by traumatic events, limiting access to the outdoors will minimize injuries from automobiles and animal attacks. Pay attention to where your cat likes to go inside. If he likes walking along balcony edges or making risky jumps, try to restrict access to these areas.

After a bone is broken (fractured), the body will start the healing process. If the two ends of the broken bone are not lined up properly, the bone can heal with a deformity called a malunion. A malunion fracture occurs when a large space between the displaced ends of the bone have been filled in by new bone.

With fractures in the hand, wrist and forearm, a certain amount of angulation, or bend, occurs when the bone heals. Doctors determine if the position of a fracture will allow for functional use of the hand or arm after it heals. In many cases, when a fracture heals in a position that interferes with the use of the involved limb, surgery can be performed to correct it.

Some examples of common upper extremity fractures that may result in malunion include fractures of the wrists (distal radius), hand bones (metacarpals), and fingers or thumbs (phalanges).

If you fractured a finger, hand, wrist or elbow, and it has healed but no longer functions well, you should seek an opinion from a doctor who knows the upper extremity of the body well.

For decades the University of Michigan Department of Orthopaedic Surgery — one of the oldest and most well-regarded orthopaedic units in the nation — has provided excellent treatment for malunion fractures.

Our goal is to restore you to pre-fracture function as much as possible, as well as improve your long-term bone health. We are also part of the American Orthopaedic Association’s Own the Bone Program to improve the care of fracture patients age 50 and up.

In addition, the University of Michigan is a Level 1 Trauma Center, which means you will receive the highest level of care by experts who regularly treat patients with complex fractures and multiple bone breaks.

Symptoms

These symptoms usually occur after the healing of the initial fracture/break:

  • Angulation (bend) and/or rotation of the fractured bone.
  • A wrist that does not flex or extend to allow normal use.
  • A finger that “scissors” onto or away from an adjacent finger.
  • Altered use or function of the involved limb.
  • Stiffness in finger, hand, wrist or elbow.

Diagnosis/Treatment

  • History and physical exam: Your doctor or mid-level health care provider will obtain a history of your problem and perform an appropriate physical exam to find the exact area of concern.
  • Imaging: Usually, imaging of the site in question begins with X-rays. If more information is needed, your doctor or mid-level provider may order a CT Scan or an MRI.
  • Surgery: The goal of treatment is to realign your bone in a position that improves the function of the upper extremity. While you are under anesthesia in the operating room, your surgeon will re-break the bone to realign the fracture. Depending on the type of malunion, some of the bone may need to be trimmed to allow for proper orientation of the fractured ends. To keep the straightened bone in proper alignment, your surgeon may insert screws, plates, and/or pins. Additionally, the surgeon may perform a bone graft to aid in fracture healing.

Pre-operative Care

If a decision for surgery is made after seeing one of our Orthopaedic Hand Surgeons, you may require pre-operative medical clearance by our Anesthesia department or your Primary Care Provider. This depends on your other chronic medical conditions. Your surgeon will let you know if this clearance is necessary.

Post-operative Care

Your physician will give you specific instructions. In general:

  • After surgery, you will be placed in a post-operative dressing/splint which you must wear until your first post-operative visit with one of our providers. You must keep the dressing CLEAN and DRY to avoid risk of infection and other wound healing complications.
  • Someone should be with you for the first 24 hours after surgery.
  • You will be given a prescription for post-operative pain medicine. Do not take it with other pain medicines unless directed by your doctor. Do not drive, drink alcohol or make important decisions while taking the pain medicine.
  • Do not smoke, use smokeless tobacco, nicotine gum or nicotine patches. Nicotine is a vasoconstrictor, and can impede healing by limiting blood flow to the surgical site(s).
  • You must remain non-weight bearing (no use) with the surgical hand and arm until cleared by one of our health care providers. This may be several weeks, depending on your healing.
  • At the first post-operative visit, your stitches will be removed. You will be placed in either a cast or a splint, depending on your surgeon’s preference. If your cast becomes wet or soiled, you should come into the office for a new cast as soon as possible.
  • To evaluate the healing of the fracture at your follow-up appointments, your doctor will order imaging such as X-rays or a CT scan.
  • After several weeks of immobilization, you will probably be stiff and weak in your hand / wrist. We often send patients to an Occupational Therapist with the goal of regaining functional use of the operative hand. Remember: You are an active participant in your care, and part of your recovery depends on your desire to participate in occupational therapy.

Contact Us / Make an Appointment

  • Orthopaedics, 734-936-5780

Selecting a health care provider is a very important decision. Because we are highly experienced in treating malunion fractures and all conditions of the musculoskeletal system, we would like to help you explore your options. Visit our Contact Us page to see a list of clinics and their contact information. Our staff will be glad to talk with you about how we can help.

How to tell if a bone is broken and ways to help your child heal

How to realign a fractured bone How to realign a fractured bone

Broken bones can happen to children or teens of any age or activity level. These breaks, also called fractures, can be caused by a variety of injuries, including overuse injuries or acute injuries.

Overuse injuries, such as stress fractures, occur when your child experiences repeated forces on a part of the body without adequate time to rest and recover. Acute injuries result from sudden impact, such as when a limb is bent or compressed. This can happen during sporting activities, trampoline accidents, or falls from playground sets or a bike.

“Unfortunately, bone breaks can happen no matter how careful we are,” says Christopher Redman, M.D., Pediatric Orthopedic Surgeon at Children’s Health℠ Andrews Institute for Orthopaedics and Sports Medicine. “We have to be aware of our children’s activities and make sure they are as safe as possible.”

How to tell if a bone is broken versus a sprain or strain

Often when a child falls or is injured, the result can be a strained or sprained muscle or joint. Strains and sprains affect ligaments, muscles and tendons, whereas a fracture is a partial or complete break in the bone.

Symptoms of strains and sprains include:

  • Pain
  • Swelling
  • Warmth or redness
  • Bruising
  • Limited range of motion in the injured joint or muscle – however, in many cases, a child is still able to put weight on or use the injured limb

When a bone breaks, the injury can be much more severe. Signs and symptoms of a fracture include:

  • Pain
  • Swelling
  • Bruising
  • Difficulty using or moving the injured limb
  • Deformity in the injured area, such as an arm, leg or finger sticking out at an odd angle

While the symptoms of sprains, strains and fractures can be similar, with a broken bone, the child will most likely be unable to put any weight on the limb. An examination from a doctor and imaging tests can confirm your child’s diagnosis.

What to do if your child breaks a bone

Overall, breaks to the legs, wrists and forearms are relatively common in children. If you suspect your child has broken a bone:

  • Stabilize the limb immediately
  • Keep weight off the injured limb
  • Help him or her avoid movement, which could cause further injury and pain
  • Give your child Motrin or ibuprofen which should help with pain and swelling
  • Take your child to the doctor as soon as possible for a proper diagnosis

While there is no way to completely prevent fractures, with proper treatment, fractures in children typically heal without long-term side effects.

How are broken bones treated in children and teens?

The treatment of a broken bone will vary depending on what kind of fracture your child has and its severity. For minor fractures, a simple splint, brace or cast acts as a stabilizer, keeping the fractured bone in place so it can heal.

A more serious injury, such as when a bone is displaced, may require surgery.

Can fractures affect growth plates?

Growth plates are the weakest part of the bone, so injuries there are a common childhood problem. Fractures near a growth plate can be difficult to diagnose. Growth plates are made up of cartilage, not bone, so many breaks do not show up on X-rays. These fractures, however, are treated similarly to other broken bones.

Long-term issues stemming from these injuries are uncommon. Children with growth plate fractures may be followed over time by their physicians, to ensure the injury does not affect their growth, joints or cause arthritis.

How long does it take a child or teen’s broken bone to heal?

Although a child’s bones are softer than adult bones, a child’s broken bone will heal faster than an adult bone. The time it takes for a break to heal will vary depending on which bone is broken but the average recovery takes from three weeks to two months. Fractures generally take longer to heal in teens than they do in children.

Parents can help keep recovery on track by following a few simple steps:

  • Follow instructions given by the doctor including office visit follow-ups.
  • Some fractures may require close monitoring and weekly appointments to check alignment for the first three weeks.
  • Help your child avoid further injury by limiting activity to prevent re-injury or injury to the opposite limb.

“Anytime a kid has a cast, you need to keep two feet on the ground,” advises Dr. Redman.

After the cast comes off, your child will likely experience stiffness in the joints around the break. This stiffness can make it difficult to get back into sports, increasing chance of injury. Your child’s physician may remove the cast before healing is complete and put on a brace to speed up the process of regaining full range of motion.

“Stiffness tends to be a much bigger problem for adults. Often children get their range of motion back just by using the extremity,” says Dr. Redman.

Ensuring your child builds up his or her strength again can help to reduce the risk of follow-up injury. Typically, once a bone is healed, it is healed, and there are no limits on a child’s activity.

Learn more

Children’s Health Andrews Institute for Orthopaedics and Sports Medicine offers same day and next day appointments for fractures and acute injuries. With onsite imaging services, our pediatric orthopedic specialists can diagnose and treat fractures quickly and effectively. Learn more about our fracture care services.

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athlete, bone, joints, limbs, orthopedic, orthopedic surgery, sprain

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Orthopedics and Sports Medicine

Children’s Health Andrews Institute for Orthopaedics & Sports Medicine specializes in sports injuries, injury prevention, rehabilitation and performance. Our team provides treatment for spinal conditions, concussions and more, and offers individualized sports performance training and nutrition plans.

  • Medical Author: Karthik Kumar, MBBS
  • Medical Reviewer: Pallavi Suyog Uttekar, MD

How to realign a fractured bone

A patient with a broken metatarsal may be able to walk, depending on how painful the injury is. Despite this, the patient with a metatarsal fracture is advised to avoid excessive walking, especially on uneven ground, to eliminate the risk of displacement. Displacement means the broken bones shift farther than the natural alignment. This is dangerous because it will cause poor healing, visible foot deformity, and even compromised nerve and blood supply to the foot.

  • It is best if the patient avoids putting too much pressure on their foot if they have a serious injury; rest will help aid recovery.
  • Many people continue to walk on their injured foot despite having a fracture. This can cause further damage to the foot or toe.
  • The patient may have been walking around on a broken bone for weeks. Sometimes, stressfractures don’t show up on X-rays for up to 2 weeks after the injury.
  • If the pain is not going away, the patient may need a second X-ray.
  • The patient should always get a metatarsal fracture evaluated by a podiatric surgeon. A fracture that doesn’t heal correctly can lead to arthritis, making the fractured area painful even after healing.
  • Walking on an injured foot with multiple metatarsal fractures is not recommended, and it may cause further displacement of the broken bones and ultimately require surgical intervention.

What are the causes of metatarsal fractures?

The metatarsals are the long bones in the forefoot that lead up to the toes. Metatarsal shaft fractures are common injuries and cause pain and swelling in the mid and forefoot.

  • Metatarsal shaft fractures are typically caused during sports.
  • An accident such as the drop of a heavy object on the foot or sudden bend of the forefoot (i.e., a trip and fall on uneven ground) may cause a metatarsal fracture.
  • Metatarsal shaft fractures can also be caused by direct loading and twisting of the foot.
  • Sometimes, an automobile accident can cause an injury and a fracture to the metatarsal.
  • If a patient has osteoporosis (fragile bones), it takes minimal impact to cause metatarsal fractures such as a miss-step or a sudden twisting movement.
  • In addition to acute fractures of the metatarsals, repetitive intense activity (i.e., military marching) or a change in intensity of a particular activity can lead to a stress fracture of one of the metatarsals.

The symptoms of a broken metatarsal may include:

  • Pain
  • Swelling
  • Bruising of the foot
  • Inability to walk normally or sometimes
  • Inability to walk at all

How to realign a fractured bone

QUESTION

What are the treatment options for metatarsal fractures?

Most metatarsal fractures can be treated non-surgically if the fractured metatarsals are in an acceptable position. The other possible treatment options may include:

  • The RICE method (rest, ice, compression, and elevation method)
  • Removable/plaster cast
  • Using a brace or support
  • Rehabilitation exercise
  • Surgery (rare cases)

Treatment of a single metatarsal fracture involves protecting the injured foot until the bone is healed. During this time, limited weight bearing in a stiff-soled boot or very stiff-soled shoe is recommended to support the fracture. Multiple metatarsal fractures are rare and normally are treated with restricted weight bearing.

Surgery is required in the following conditions:

  • In rare occasions, manipulation of the bone to reposition them in an acceptable position is necessary.
  • Occasionally, an “open reduction internal fixation” procedure is required to stabilize the bone. This may involve the placement of small plates and/or screws or using pins to realign the bone.
  • Surgery may be indicated in the case of either a significantly displaced metatarsal shaft fracture or in the case of multiple displaced metatarsal shaft fractures.

Recovery:

  • It typically takes 6-8 weeks for the bone to heal and get strong enough for the patient to resume full weight bearing in a normal shoe.
  • It is often 4-6 months before a full recovery is obtained (return to unrestricted activities such as jumping and sprinting).
  • There are some proofs that surgical stabilization for a displaced metatarsal shaft fracture can produce a slightly faster recovery time, albeit with the associated risks of surgery. These risks include infection and residual numbness around the toe or surgical site. In rare cases, excessive scar formation around the surgical site may cause toe deformity in the long term.

Recommendations:

  • Smoking cessation is recommended to all patients with broken bones.
  • Take regular pain relief (acetaminophen and ibuprofen) as needed.
  • Elevate the leg while sitting by using pillows or a stool, which will help with swelling and pain.
  • The doctor may recommend the patient to take vitamin D and calcium daily.

Broken bones can happen after an accident like a fall, or being hit by an object. Anyone can break a bone. Older people and those with osteoporosis may fracture bones more easily. Get medical help immediately for a broken bone. Call 999 for an ambulance if the injury is severe.

Signs of a broken bone

The three most common signs of a broken bone are:

  • pain
  • swelling
  • deformity

It can sometimes be difficult to tell whether a bone is broken if it isn’t displaced.

If you have broken a bone, you may experience the following:

  • you may hear or feel a snap or a grinding noise as the injury happens
  • there may be swelling, bruising or tenderness around the injured area
  • you may feel pain when you put weight on the injury, touch it, press it, or move it
  • the injured part may look deformed – in severe breaks, the broken bone may poke through the skin

In addition, you may feel faint, dizzy or sick as a result of the shock of breaking a bone.

If the break is small or it’s just a crack, you may not feel much pain or even realise that you’ve broken a bone.

Common fractures

Bones which are commonly fractured include:

  • ankle
  • arm or wrist
  • collarbone
  • hip
  • leg
  • nose
  • ribs
  • toe

When to seek medical help

You should seek medical help as soon as possible if you think you’ve broken a bone. If you think you may have broken your toe or finger, you can go to a minor injury unit.

Go to your nearest emergency department for a broken arm or leg.

Call 999 for an ambulance if the injury seems severe or you’re not able to get to an emergency department quickly.

Very severe suspected breaks, such as a broken neck or back, should always be treated by calling 999.

Treatment for a broken bone

The broken bone must be properly in line and held in place, often with a plaster cast, so it heals in the right position.

If you don’t receive the right treatment, you could develop a serious infection or a permanent deformity. You may also develop long-term problems with your joints.

It’s important not to eat or drink anything if you think you’ve broken a bone, as you may need a general anaesthetic (where you’re asleep) to allow doctors to realign it.

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Bluewater Orthopedics

Orthopedic Surgery located in Niceville, FL, Destin, FL & Crestview, FL

Millions of Americans fracture bones every year and need expert medical attention to ensure proper healing. At Bluewater Orthopedics in Niceville, Crestview, and Destin, Florida the experienced orthopedic surgeons offer comprehensive treatments to set broken bones and support the healing process. If you think you’ve fractured a bone, call Bluewater Orthopedics or schedule a consultation online today.

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Fractures Q & A

What are the signs of a fracture?

The most common signs of a bone fracture are pain, swelling, and deformity. However, as fractures range in severity, you may experience other symptoms.

For example, you might not notice a stress fracture in your foot right away. Over time, the injury could cause tenderness, swelling, and stiffness. Your pain may become more severe when you put weight on the injured foot.

A more severe fracture could cause a snapping or grinding sound or sensation. It could cause immediate and severe pain, with rapid swelling and bruising. A compound fracture may even force part of the broken bone through your skin.

What should I do if I break a bone?

Fractures require medical attention. If you have a severe injury, don’t try to realign the bone yourself, as this could increase the damage. Instead, apply ice packs and use a splint or padding to immobilize the injury. Call Bluewater Orthopedics immediately to schedule an appointment.

Even minor fractures need medical attention. If you continue to use a body part with a stress fracture, the pressure can make the fracture worse and lead to complications requiring more advanced treatments.

How are fractures diagnosed?

At Bluewater Orthopedics, the team provides thorough exams and tests to diagnose bone fractures. They review your symptoms, medical history, and the details of what you were doing when you injured yourself.

Your orthopedist examines your injury, gently feeling for deformity or other palpable signs of a fracture. They may also order X-rays to confirm a broken bone and evaluate the severity of the fracture.

How are fractures treated?

The most common treatment for a fracture is immobilization with a plaster cast. This keeps the bone in the proper position while it heals. Depending on the severity of your injury, your physician may provide a functional cast or brace that allows some movement of the nearby joints.

Most severe fractures require more advanced treatment, such as traction to realign your bone with a steady pulling force.

Your orthopedist may also recommend surgery to realign your fractured bone and secure the ends together. Depending on your needs, they may use internal or external pins to stabilize the bone.

Call Bluewater Orthopedics today or make an appointment online if you think you’ve broken a bone and need expert medical attention.