Fracture and Dislocation Treatment
In fractures and dislocations, the aim is to heal the bone in the right position and preserve joint function. Treatment ranges from a cast to surgical fixation.
A fracture is a break in a bone; a dislocation is when the bones forming a joint come apart. Falls, road accidents, sports injuries and workplace accidents are the most common causes. In older people, osteoporosis increases the risk of fracture even after a simple fall.
Signs
- Severe pain and tenderness to touch
- Swelling and bruising
- A deformed, shortened or rotated arm or leg
- Inability to move the limb or bear weight
- In open fractures, a wound with visible bone
- Numbness, coldness or pallor (nerve or blood vessel involvement)
First aid
The injured area should be moved as little as possible and supported in the position it is in. Untrained people should not try to put a dislocation or fracture back in place. Open wounds should be covered with a clean cloth, and medical care sought as soon as possible.
Diagnosis
The fracture site, circulation and nerve function are examined. X-rays show most fractures. CT is used for fractures involving joints, the spine and the pelvis, and MRI for ligament and soft tissue damage.
Treatment options
Non-surgical treatment
Most fractures that are not displaced, or that can be corrected without surgery, are treated with a cast, splint or brace. Dislocations are usually put back in place under pain control or sedation (closed reduction) and then protected for a short time.
Surgical treatment
Surgery may be needed for fractures that are markedly displaced, involve the joint surface, are unstable, open or in many pieces. The fragments are put back in position and fixed with plates, screws, nails (intramedullary nails) or an external fixator. See our page on fracture fixation for details.
Recovery
Bone healing takes weeks to months depending on age, location, fracture type and general health. Smoking, diabetes and poor nutrition can delay healing. Regular X-rays are taken during recovery. After the cast or splint comes off, physiotherapy is important to regain joint movement and muscle strength.
Possible problems
Non-union or malunion, joint stiffness, infection (especially in open fractures), compartment syndrome and later arthritis are possible consequences of fractures. Correct treatment and regular follow-up reduce these risks.
Supporting bone health
Adequate protein, calcium and vitamin D are important for fracture healing. Smoking clearly delays bone healing. After fractures in older age or from a low-energy fall, an osteoporosis assessment helps prevent further fractures.
Frequently asked questions
How long does a fracture take to heal?
It varies by location and person. Healing starts within weeks in most fractures, while full strength can take months.
What should I watch for while in a cast?
Keep the cast dry, move your fingers or toes often and keep the limb raised for swelling. Seek care immediately if pain increases, or numbness or bluish fingers appear.
Should plates and screws be removed?
In most cases they can stay if they cause no problems. Implants that cause discomfort, or those in certain locations, can be removed after the bone has fully healed.
Is physiotherapy needed after a fracture?
Physiotherapy is important for regaining joint movement and muscle strength, especially after fractures near joints and long periods in a cast. For some simple fractures, home exercises may be enough.
The information on this page is general and does not replace an examination. An examination is needed to decide which treatment suits you.