Bone fractures

The average person fractures two bones during his or her lifetime. Whether it is a fractured bone in your arm, leg, foot or even ribcage, your body will need enough time to heal appropriately.

The exact time it’ll take for the broken bone to stabilise all depends on the severity and type of fracture.  The bone can have a small slender crack known as a greenstick fracture (more common in children), a comminuted fracture where the bone is shattered into small pieces, or a simple fracture where the broken bone has not pierced the skin.

A bone fracture occurs when a force that is stronger than what the bone can withstand, is exerted onto it. Medical conditions such as osteoporosis or certain types of cancer can also weaken the bone resulting in bone fractures. Diagnosis of a bone fracture is done with X-rays. Computerised tomography (CT) and magnetic resonance imaging (MRI) scans may also be used.

Depending on which bone fractured and whether surgery is required to stabilise it, traditional treatment includes immobilisation of the bone or joint affected. Doctors make use of splints, slings, braces, plaster casts or traction to immobilise the affected arm or leg.  

Usually, soft tissue injuries occur alongside fractures and will require treatment in the long-term. After plaster or splints have been removed, you have to be careful how you use your limb. Leg fractures take a few months to heal and muscles will be weak from not using them. It is very important that you follow your doctor’s instructions carefully to ensure your body heals optimally.

Things to be aware of with a bone fracture:

The acute phase

• During the first 48 to 72 hours swelling may occur due to your injury. This can cause pressure on your splint or cast.  The doctor might replace your cast with a new one once the swelling has gone down.
• Elevate your injured arm or leg to keep the swelling down. This will lessen your pain and help the injury to heal. Prop-up your arm or leg with pillows or other support.
• Exercise your uninjured fingers or toes by moving them often to prevent stiffness.
• Warning signs include:  increased swelling or a feeling that the cast is too tight; tingling or numbness in your foot or fingers; a burning or stinging sensation of the skin under the cast and a loss of active movement of your toes or fingers. Contact your doctor when you have one or more of these symptoms. 

Taking care of your cast

• Keep the cast dry. Take extra care when taking a bath or shower. Moisture will weaken the plaster and may cause skin irritation. Cover it with a double layer of plastic or buy a waterproof shield.
• Inspect your cast regularly. If you see cracks or soft spots contact your doctor’s office.
• Skin redness around the cast might be a sign that something is wrong. If it persists, contact your doctor.
• Itchiness. Don’t apply deodorants and powder to itchy skin. Never use a coat hanger to scratch inside the splint. If itchiness persists, contact your doctor.

Rehabilitation

While you still have a cast or splint, your physiotherapist or doctor might give you simple exercises to improve your muscle condition.  Once the cast is removed, exercises to improve joint mobility as well as muscle strength, flexibility and endurance will be given to you. Should you have a leg fracture, you’ll be advised when you can bear weight on your leg again. It will vary from one person to the next and depends on whether your fracture has stabilised or not.

Functional exercises such as walking, jogging and eventually running (in the case of athletes) will be introduced to your rehabilitation programme as you progress.  

Healing of a fractured bone takes time and can sometimes make you feel impatient with your own body. Follow the advice of your doctor and physiotherapist to prevent potential complications.

(Sources: American Academy of Orthopaedic Surgeons; Brukner P, Khan K. Clinical Sports Medicine. McGraw-Hill Book Company Australia Pty Limited. 1999; 131-151;