Bone fracture repair is surgery to fix a broken bone using plates, nails, screws, or pins. Bone grafts may be used to allow for proper healing or to assist in the healing process.
While you are pain-free under general or local anesthesia, a surgical cut is made over the fractured bone. The bone is placed in the proper position. Screws, pins, or plates are attached to or placed in the bone temporarily or permanently. Long bones may be fixed with nails placed in the bone cavity.
Any disrupted blood vessels are tied off or burned (cauterized). If a lot of bone has been lost due to the fracture (especially if there is a gap between the broken bone ends), the surgeon may decide to do a bone graft. Bone grafting may be performed using the patient's own bone, usually taken from the hip. Or, bone taken from a donor can be used.
If bone grafting is not necessary, the fracture can be repaired by the following methods:
In some cases, blood vessels and nerves are repaired with microsurgery. The opening in the skin is then closed. If the broken bone has pierced the skin, the bone ends need to be washed with sterile fluid in the operating room to prevent infection. The washing process may need to be repeated if the wound is dirty or becomes infected.
Surgical repair is recommended for complicated fractures that cannot be realigned (reduced) by nonsurgical methods. This is especially true of fractures that involve joints. Poorly aligned joint surfaces may contribute to the development of arthritis.
Risks for any anesthesia include the following:
Risks for surgery include the following:
Surgery often allows patients to regain movement and heal faster than nonsurgical treatment. Your long-term outlook depends on the severity of the fracture.
It is usually not necessary to remove an internal fixation device unless it causes problems.
The length of the hospital stay depends on the:
Most fractures heal in 6 - 12 weeks. Children's bones heal rapidly, usually in 6 weeks.
Browner BD, DeAngelis JP. Emergency care of musculoskeletal injuries. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 21.