FRACTURE REPAIR

General Information

DEFINITION--Rejoining ends of a broken bone. The term "broken bone" means the same as "fractured bone."

BODY PARTS INVOLVED--Any bone in the body.

REASONS FOR SURGERY--Restoration of normal position and function of a broken bone.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity.
• Smoking.
• Poor nutrition.
• Recent illness.
• Alcoholism or chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--Orthopedist, general surgeon or family doctor.

WHERE PERFORMED--Hospital, outpatient surgical facility, doctor's office or emergency room.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-ray of affected area.
• During surgery: X-rays.
• After surgery: X-rays through cast or splint to determine if rejoined pieces remain in good position for healing.

ANESTHESIA

• Local anesthesia by injection.
• General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• The bone fragments are aligned as close as possible to their normal position without injuring the skin.
• Once the broken ends of bone are "set", the affected part is kept rigid with a plaster cast or splint.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Improper fit of joined bone ends.
• Pressure on nearby nerves.
• Delayed healing.

AVERAGE HOSPITAL STAY--0 to 6 days.

PROBABLE OUTCOME--Children's bones usually heal relatively rapidly. Fractured bones of elderly patients may never heal properly, particularly if nutrition is poor. The time required for healing depends on the type of fracture and the extent of tissue damage.

Postoperative Care

GENERAL MEASURES

• Do not allow pressure on any part of the cast until it is completely dry. Drying time varies, depending on the thickness of the cast, temperature and humidity.
• If the cast gets wet and a soft area appears, return to your doctor's office to have it repaired.
• Whenever possible, raise the part enclosed in the cast. This decreases the possibility of swelling. For example, prop a leg cast on a pillow when in bed and on a footstool or hassock when sitting; prop an arm cast on a pillow on the chest. See Care of Casts in Appendix.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks following surgery. > Resume driving when your doctor determines that healing is complete.

DIET--Eat a well--balanced diet to promote healing. Increase fiber and fluid intake if constipation occurs due to decreased activity.

Call Your Doctor If

Any of the following occurs:

• Severe, persistent pain under the cast.
• Color change, coldness or numbness in tissues beyond the cast.
• Tissue swelling greater than before the cast was applied.
• New, unexplained symptoms. Drugs used in treatment may produce side effects.