January 13, 2020 12:15 pm Published by Dr. Bursztyn

Unfortunately, broken bones are injuries that can affect anyone – young or old, weekend warrior or professional athlete. Although different segments of the population may be more susceptible to certain types of fractures, common themes exist in regards to recovery.

Let’s begin with what the definition of a fracture is. A couple of misconceptions exist that we should clear up. I often hear people say things like “it’s not broken – it’s just fractured”, or “it’s only a ‘hairline’ fracture”.

By definition, a fractured bone IS a broken bone. The term “hairline fracture” usually refers to what is more appropriately called a “non-displaced fracture”. However, it’s important to recognize that these can still be serious injuries. In this regard, sustaining a fracture can sort of be like getting pregnant. Either you’re pregnant or you’re not- just like either your bone is fractured or it’s not. Technically speaking, a fracture is any structural disruption of a bone.

As orthopaedic surgeons, we treat fractures in order to get them to heal in a manner that allows the injured person to optimally recover. Sometimes they require casts or splints, sometimes they don’t. Sometimes lower extremity fractures require the use of crutches, sometimes they don’t. Sometimes fractures require surgery, but thankfully, they usually don’t. There are several themes that apply to the healing of nearly all fractures.

Fracture healing typically takes place in three stages. The first stage is INFLAMMATION. This is the body’s response to injury. Certain cells that promote healing flock to the sight of injury and go to work. This begins as soon as the fracture is sustained.

The second stage is the REPAIR stage. This is when actual new bone starts to fill in the fracture sight. Usually, this stage begins around two weeks after the injury, and generally takes around six weeks. Once this stage is complete, the fracture is basically considered healed.

The REMODELING stage refers to changes that go on within the bone once the fracture has healed. Remodeling occurs along lines of stress. Therefore, more bone forms where there is more of a load which requires support.

The key to healing most fractures is to first immobilize the broken bone. If a cast or splint can get the job done, then that’s what is used. Unfortunately, some fractures can’t be sufficiently immobilized this way. Sometimes they may also be in such bad positions, that they need to be put back into a more acceptable position. In these cases, surgery is usually necessary. Once the broken bone is immobilized, healing can take place. If there is too much motion at the fracture site, the bone is much less likely to heal.

Once the fracture has healed, the goal is to get the injured person back to optimal function. Usually, the pain has significantly improved once the fracture has healed. However, people that have had splints or casts on may be stiff. In addition, the injured body part may be somewhat weaker shortly after the fracture has healed. These are important factors to consider. Premature return to certain activities may predispose people to further or recurrent injury. Physical therapy can sometimes be extremely helpful in expediting peoples’ safe return to their desired activities. All fractures do NOT heal the same way, so it’s of vital importance that your orthopaedic surgeon’s treatment plan is adhered to.

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