How are comminuted fractures treated?
How are comminuted fractures treated?
You’ll need surgery to repair a comminuted fracture if one of your long or large bones is broken. There are a few techniques used to repair comminuted fractures, and which one your surgeon uses will depend on your injuries, which bone is fractured and any other complications after your trauma.
Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. Internal fixation techniques include:
- Rods: A rod inserted through the center of your bone that runs from top-to-bottom.
- Plates and screws: Metal plates screwed into your bone to hold them in place.
- Pins and wires: Pins and wires hold pieces of bone in place that are too small for other fasteners. They’ll typically be used at the same time as either rods or plates. You’ll probably need pins and wires to hold the pieces of your bone together after your comminuted fracture.
Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.
External fixation
You might need an external fixation. This is often a temporary solution that stabilizes your fracture while your other injuries heal. Your surgeon will put screws on either side of the fracture inside your body then connect them to a brace or bracket around the bone outside your body.
Surgeons sometimes recommend external fixation as a first step before more invasive surgeries to fix your comminuted fracture. If you have lots of other injuries, your body might need time to regain its strength to be able to tolerate internal fixation surgeries.
Bone grafting
You might need bone grafting if your comminuted fracture is severely displaced or if your bone isn’t healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they’ll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:
- Internally from somewhere else in your body — usually the top of your hip bone.
- An external donor.
- An artificial replacement piece.
On their own, comminuted fracture surgeries are outpatient procedures, which means you might be able to go home the same day. However, it’s likely the trauma that led to your comminuted fracture caused other injuries that will require you to stay in the hospital to recover.
After your surgery, the part of your body with the fractured bone in it will be immobilized. Depending on where this is, you’ll need some combination of a brace, splint or cast before you can start putting any weight on it again or using it like you did before your injury.