1 | 2 | 3

At the emergency room, clinic or doctor's office, the physician usually applies a splint to prevent further damage, to lessen the pain and to help stop any bleeding. The patient is usually asked to recline and elevate the injured part. Elevation helps to reduce bleeding and swelling. X-rays can help the physician determine whether there is a fracture, and if so, what type of fracture it is. If there is a fracture, the doctor will "reduce" it, by restoring the parts of the broken bone to their original positions. "Reduction" is the technical term for this process.

All forms of treatment of broken bones follow one basic rule: the broken pieces must be put back into position and prevented from moving out of place until they are healed. Broken bone ends heal by "knitting" back together with new bone being formed around the edge of the broken parts. The specific method of treatment depends on:

• the severity of the break.
• whether it is "open" or "closed"
• the specific bone involved-a broken bone in the spine (vertebra) is treated differently from
• a broken leg bone or a broken rib.

Types of treatment
The following treatments are used for various types of fractures:

• Cast immobilization - A plaster or fiberglass cast is the most common type of fracture treatment, because most broken bones can heal successfully once they have been repositioned and a cast has been applied to keep the broken ends in proper position while they heal.
• Functional cast or brace - The cast or brace allows limited or "controlled" movement of nearby joints. This treatment is desirable for some but not all fractures.
• Traction - Traction is usually used to align a bone or bones by a gentle, steady pulling action. The pulling force may be transmitted to the bone through skin tapes or a metal pin through a bone. Traction may be used as a preliminary treatment, before other forms of treatment.
• Open reduction and internal fixation - In this type of treatment, an orthopaedist must perform surgery on the bone. During this operation, the bone fragments are first repositioned (reduced) into their normal alignment, and then held together with special screws or by attaching metal plates to the outer surface of the bone. The fragments may also be held together by inserting rods down through the marrow space in the center of the bone. These methods of treatment can reposition the fracture fragments very exactly. Because of the risks of surgery, however, and possible complications, such as infection, they are used only when the orthopaedic surgeon considers such treatment to be the most likely to restore the broken bone to normal function.
• External fixation - In this type of treatment, pins or screws are placed into the broken bone above and below the fracture site. Then the orthopaedic surgeon repositions the bone fragments. The pins or screws are connected to a metal bar or bars outside the skin. This device is a stabilizing frame that holds the bones in the proper position so they can heal. After an appropriate period of time, the external fixation device is removed.

1 | 2 | 3