A fracture is a broken bone. The bone can be fractured partially or completely and in a multitude of ways such as lengthwise, crosswise, or into multiple pieces. An open fracture means that the bone has broken completely and fragments have penetrated through the skin. A stable fracture means the broken ends of the bone are still lined up and in place. A transverse fracture means the fracture line is horizontal while an oblique fracture line is angled. A comminuted fracture means the bone has shattered into many pieces. Bone fracture care for each type of injury has similar aspects as well as different aspects.
The goal of healing a fracture is to realign the bones if necessary and then immobilize the area so that the body can heal naturally. Depending on the severity of the injury, this may need to be done surgically. If the fracture is clean, meaning there aren’t any fragments and the skin hasn’t been broken, then the doctor may be able to realign the bone without surgery. The patient will need to wear a cast that is made from plaster or fiberglass to keep the site immobilized for several weeks. Once the swelling from the fracture site has gone down, the patient may be able to switch to a removable brace. More severe fractures or those located in certain areas of the body may require surgical treatment. Often the doctor will need to implant surgical screws, nails, plates, or wires into the bone to hold the fractured bone together and in place. These items are generally left in permanently, even after the bone has healed. External fixators are placed surgically but are removed once the bone has healed. Small bones such as toes and fingers are often wrapped using the buddy system. The bone is immobilized by being wrapped to the finger or toe next to it. Bone infections are very dangerous, so doctors will often prescribe prophylactic antibiotics.
The healing process begins when the blood coagulates between the broken bones. After a few days the surrounding blood vessels grow within the blood clot creating a jelly-like matrix. The phagocytes that are located within the blood remove the non-viable material while the fibroblasts multiply to create collagen fibers. Eventually the blood clot is replaced by the collagen fibers which allows little movement between the bones. At this stage the fibroblasts begin to lay down collagen monomers which will create the bone matrix. The mineralization of the matrix is what creates the new bone material. This process takes up to six weeks. Bone fracture care is key when you wish to heal a fracture quickly and completely.