A fracture is a break in the bone, usually occurring as a consequence of an injury. Some of the bone fractures are stable and for adequate healing, they may only need a period of immobilisation or restricted weight-bearing. Many fractures, however, need a formal fixation to stabilise the bone fragments, prevent any deformity and promote fracture healing. An adequate, fracture–specific surgical technique is necessary and may involve the use of various implants, such as plates, screws, pins, rods, nails or external fixation devices, to hold the bone fragments in place. The primary goal of fracture fixation is to restore the normal alignment of bones and joints, to facilitate bone healing, to allow for early motion and physiotherapy and ultimately to restore the function of the injured limb.
Fracture fixation is indicated in various scenarios, including:
There are instances where fracture fixation is contraindicated:
Fracture fixation surgeries can provide several benefits for patients recovering from fractures. However, these procedures also carry certain risks. Here are the benefits and risks of fracture fixation surgeries:
Stabilisation: Fracture fixation surgery provides immediate stabilisation of the broken bone, reducing pain and preventing further displacement of the fracture. This helps promote better healing and accelerates mobilisation.
Alignment: The surgery ensures that the fractured bone is properly aligned, which is essential for optimal healing and functional recovery.
Accelerated Healing: Fixation hardware, such as screws, plates, or rods, helps hold the bone fragments together, allowing for faster healing and reducing the risk of non-union (failure of the bone to heal).
Restoration of Function: By correctly aligning and stabilising the fracture, these surgeries aim to restore or preserve the function of the affected limb or bone, enabling patients to regain mobility.
Reduced Pain: Proper fixation of the fracture often leads to reduced pain and discomfort, facilitating the patient’s recovery and rehabilitation.
Lower Risk of Complications: Fracture fixation can reduce the risk of complications associated with delayed or non-surgical management, such as compartment syndrome or nerve damage.
Infection: Surgical site infection is a potential risk, although the use of sterile techniques and antibiotics can help minimise this risk.
Hardware Problems: Implants used for fixation can sometimes cause issues, such as loosening, migration, or irritation of the surrounding tissues.
Non-Union or Malunion: While surgery aims to promote proper healing, there is still a risk of non-union (failure of the bone to heal) or malunion (improper healing), especially if the patient’s overall health is compromised.
Nerve and Blood Vessel Damage: There is a risk of damaging nearby nerves or blood vessels during the surgical procedure, which can lead to sensory or motor deficits.
Blood Clots: Surgery can increase the risk of deep vein thrombosis (DVT), a blood clot in the deep veins of the leg with its catastrophic consequences. Blood-thinning medications and compression stockings may be used to mitigate this risk.
Anaesthesia-Related Complications: Patients undergoing fracture fixation surgery are at risk of complications related to anaesthesia.
Scarring: Surgery typically results in some degree of scarring at the incision sites. Scarring can vary in appearance and may be more or less noticeable depending on factors like wound care and healing.
Post-operative Pain: After surgery, patients may experience post-operative pain, which is typically managed with pain medication and careful post-operative care.
Restricted Mobility: Following fracture fixation surgery, patients may initially experience limitations in their mobility and function. Rehabilitation and physiotherapy are often necessary to regain strength and function.
The surgical is determined by fracture location, type, fixation method and coexisting injuries or patient’s comorbidities. The most common surgical approaches include:
Regular follow-up appointments with the team will help monitor your progress and address any concerns:
A tailored rehabilitation program will help regain strength, flexibility, and mobility.
As the fracture heals and the bone remodels and strengthens, patients are gradually allowed to resume normal activities. The timeline for returning to light daily life activity ranges from 3 to 12 weeks, for sports between 3 and 12 months, and is based on the type and location of the fracture.
By restoring proper alignment and stability, fracture fixation allows for accelerated rehabilitation and return to normal activities as well as avoidance of serious complications such as delayed fracture healing, failure to heal at all or healing with deformity in the bone or joint. Recovery from fracture can take several months and commitment to rehabilitation as well as follow-up appointments is essential for optimal outcomes. Always consult with your healthcare provider for personalized guidance and recommendations.
If patients are worried about their level of pain, experience significant bleeding, or notice fever or redness around the surgical site, they should contact the office immediately. If assistance is needed after hours, patients can contact the hospital where the surgery was performed, and they will contact Professor Al Muderis on their behalf.
Norwest Private Hospital: (02) 8882 8882
Macquarie University Hospital: (02) 9812 3000