If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures the skin, it is called an open fracture (compound fracture). A stress fracture is a hairline crack in the bone that develops because of repeated or prolonged forces against the bone.
It is hard to tell a dislocated bone from a broken bone. However, both are emergency situations, and the basic first aid steps are the same.
Some fractures require surgery to fix a broken bone using plates, nails, screws, or pins. Grafts may be used to allow for proper healing or to speed the healing process.
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.
The clinical staff of Virtua's Fracture Center is experienced and compassionate. They use the most advanced diagnostics and treatments to optimize care and recovery. Virtua also has a comprehensive Sports Medicine Program.
Each patient is co-managed by an orthopedic surgeon and a primary care doctor or geriatric specialist. The team collaborates to manage pain and, when necessary, expedite surgical intervention. This proven approach helps patients achieve a faster recovery than traditional treatment approaches.
Virtua's comprehensive and interdisciplinary program includes board-certified orthopedic surgeons, a board-certified geriatric specialist, primary care physicians, nurses with advanced training in orthopedics and gerontology, physical and occupational therapists, and social workers.
Surgery may be needed for some fractures. While the patient is pain-free, using general or local anesthesia, a surgical cut is made over the fractured bone. The bone is placed in proper position. Screws, pins, or plates are attached to or placed in the bone temporarily or permanently. Or, 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, the bone may be taken from a donor.
If bone grafting is not necessary, the fracture can be repaired by the following methods:
- One or more screws may be inserted across the break to hold it.
- A steel plate held by screws may be drilled into the bone.
- A long, thick metal pin (sometimes called a rod or nail) with holes in it may be driven down the shaft of the bone from one end. Screws are then passed through the bone and through a hole in the pin.
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.
For patients who need hospital care after surgery, there are floors dedicated to orthopedic patients at Virtua Marlton and Virtua Memorial. These units specialize in the care of orthopedic patients and are staffed by nurses with additional education in orthopedics. Physical therapy is also provided right on these orthopedic units.
Virtua offers a multi-disciplinary team led by a surgeon and supported by orthopedic nurses, case managers to help make the transition from the hospital to home, as well as physical therapists.