Fractures are a fairly common injury around the world. A person living in a developed country can expect on average to suffer two fractures in the course of his life. In the United States alone, about seven million bone breaks are recorded each year, and the wrist and pelvis are the most affected areas. In most cases, the injured limb must be cast by an orthopedist to heal properly, although there are many things a patient can do to promote recovery.
Steps
Part 1 of 3: Go to the hospital
Step 1. Go to a doctor immediately
If you have suffered severe trauma (a fall or accident) and are experiencing severe pain, especially if you have heard a snap and the area has swollen, then you need to go to the nearest hospital for medical attention. If you have injured a "supporting" bone, such as a leg or pelvis, then don't put pressure on it. Instead, have someone nearby help you and ask them to take you to the hospital or call an ambulance.
- Typical symptoms of a bone fracture are: intense pain, noticeable deformation of the bone or joint, nausea, difficulty moving, tingling or numbness in the affected area, swelling and bruising.
- Doctors can use several diagnostic methods to identify the fracture and assess its severity. For example, you may have an x-ray, MRI, bone scan, or even computed tomography. Small stress fractures are not seen on x-rays until the related swelling subsides (within a week or so). In most traumatic fractures, X-rays are used to arrive at a diagnosis.
- If the fracture is considered complex - there are many bone fragments, the skin has been torn from the bone, or the limb is severely misaligned - then surgery may be required.
Step 2. Get a cast or put on a brace
Before casting the fractured limb, it is sometimes necessary to straighten it and bring the bone segments closer to return the injured area to its original shape. Typically, the orthopedist proceeds with a simple technique called "reduction", in which he extends the two ends of the bone (applying some traction) and manually fitting the various pieces together. When the fracture is quite complex, surgery is required, which often involves the insertion of metal rods, pins, and other devices that offer structural support.
- Immobilization of the limb with plaster or fiberglass is the most common treatment for broken bones. Typically this type of injury heals faster when the bones are well repositioned, immobilized and compressed. The orthopedist, to start, will put a splint, that is, a partial plaster composed of fiberglass. The actual plaster is applied after 3-7 days, when most of the swelling has subsided.
- Gypsum consists of a soft padding and a hard shell (usually made of real gypsum or fiberglass). It normally needs to be worn for 4-12 weeks, depending on which bone has broken and how severe the fracture is.
- Alternatively, the doctor may apply a functional cast (a kind of plastic boot) or a brace, the choice depends on the type of fracture.
Step 3. Take medication
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin are available without a prescription and are good short-term solutions for managing fracture-related pain or inflammation. Remember that these are aggressive medications for the stomach, kidneys and liver, so do not take them for more than two weeks.
- Boys under 18 years of age should not take aspirin, because this drug has been associated with Reye's syndrome.
- Alternatively, you can try over-the-counter pain relievers, such as acetaminophen (Tachipirina), but don't take them without consulting your doctor first if you're already taking NSAIDs.
- The doctor may also prescribe stronger medications while you are in the hospital if the pain is really severe.
Part 2 of 3: Managing the Fracture at Home
Step 1. Rest the injured limb and apply ice
Upon discharge, your doctor will advise you to lift the fractured area and apply ice, even if it has been cast or splinted. This way you reduce inflammation and swelling. Depending on the type of fractured bone and the work you do, you will probably need to stay home for a few days. You may need crutches or a cane as supports.
- In cases of well-stabilized fractures, it is best not to stay completely in bed, because some movement (even in the joints near the injured area) is necessary to stimulate blood circulation and speed up recovery.
- Ice should be applied for 15-20 minutes every 2-3 hours for the first two days; then the frequency must be reduced as the swelling and pain resolve. Never place the ice directly on the skin, but wrap it in a thin cloth.
Step 2. Place some weight on the limb
In addition to doing some slight movement in the joints surrounding the broken bone, after about a week you should start putting some weight on the injured area, especially if the fracture has affected the leg bones and pelvis. Ask your doctor when you can start straining the bone. The absence of activity and complete immobilization, in proportion to the time it takes to heal, induces a loss of minerals which is counterproductive for a bone that is trying to regain its strength.
- The process of healing from a fracture is divided into three phases: reactive phase (a clot forms between the two ends of the fracture), reconstruction phase (specialized cells begin to form the callus that bridges the two segments) and the remodeling phase (the bone has bonded and slowly regains its original shape).
- Broken bones take several weeks or months to heal, depending on the severity of the trauma and the person's overall health. However, the pain subsides when the fracture is stable enough to withstand normal activity.
Step 3. Take care of the cast
Make sure it doesn't get wet as it will weaken and no longer be able to support the injured bone. If necessary, use a plastic bag to cover the limb while showering or bathing. If your doctor has applied a plastic compression boot (which is typically used for foot fractures), make sure it stays at the correct pressure at all times.
- If you feel itchy, don't put anything inside the cast. You could cause injuries that can become infected over time. Return to the doctor if the cast gets wet, breaks, smells, or leaks.
- Move the joints that are not covered by the cast (elbow, knee, toe, foot) to improve blood circulation. The blood carries oxygen and nutrients to the tissues.
Step 4. Get all the necessary nutrients
Bones, like any other part of the body, need all the nutrients to heal properly. A balanced diet, which provides a good supply of vitamins and minerals, has been shown to contribute to the recovery process after a fracture. Eat fresh fruits and vegetables, whole grains, lean meats, and drink plenty of water and milk.
- Minerals such as calcium and magnesium are important for bone strength. Among the foods that are rich in them we remember: dairy products, tofu, beans, broccoli, nuts and seeds, sardines and salmon.
- Avoid consuming foods that prevent good healing such as alcohol, sodas, junk food, and products that contain a lot of refined sugars.
Step 5. Consider taking supplements
While it is always best to get your nutrients from a well-balanced diet, supplements that contain vitamins and minerals essential for bone regeneration ensure that you meet the needs of these elements without increasing your calorie intake. An increase in the calories consumed, together with a reduced physical activity, leads inexorably to a weight gain that is not healthy at all.
- The minerals found mainly in the bones are calcium, phosphorus and magnesium; for this reason, look for supplements that contain all three. For example, adults need around 1000-1200 mg of calcium per day (based on gender and age) but you should increase the dosage slightly, as you are recovering from a fracture. Ask your doctor or nutritionist for advice.
- The important trace minerals you need to consider are zinc, iron, copper, silicon, and boron.
- Vitamins you shouldn't overlook are D and K. Vitamin D is essential for intestinal absorption of minerals and the skin produces it spontaneously when exposed to the strong summer sun. Vitamin K binds to calcium and stimulates collagen formation, which in turn contributes to healing.
Part 3 of 3: Rehabilitation
Step 1. Go to a physical therapist
When the doctor removes the cast, you will notice that the muscles in the limb have shrunk and weakened. If so, you need to consider going through some form of rehabilitation. A physiotherapist will show you personalized and specific stretches, mobilization and strengthening exercises that aim to restore the functionality of the newly healed limb. To be effective, a physiotherapy course usually requires two or three sessions per week for a total of four or eight weeks of work. The therapist will often give you exercises to do at home and often it is not necessary to have to go back to his office many times.
- If necessary, the therapist can stimulate, contract and strengthen weakened muscles with electrotherapy, such as electrostimulation.
- After removing the cast or brace, you will still need to limit physical activity until the bone is solid enough to withstand normal workloads.
Step 2. Go to a chiropractor or osteopath
Both are musculoskeletal specialists whose goal is to restore normal motility and function of bones, muscles and joints. Joint manipulation, sometimes called realignment, is used to unlock and reposition joints that are stiff or misplaced due to the trauma that led to the fracture. Healthy joints allow bones to move and heal properly.
- During the manipulation the patient often hears a "snap" that is not related to the noise emitted by the bone at the moment in which it is fractured.
- Although a single manipulation is sometimes sufficient to fully restore joint motility, in general it is advisable to undergo 3-5 treatments to notice an improvement.
Step 3. Try acupuncture
This practice involves inserting fine needles into specific energy points in the skin or muscles, with the aim of reducing pain and inflammation and potentially stimulating healing. For this reason it is useful in the acute phase of the fracture. It is generally not recommended in cases of bone fractures and is considered a secondary option; however, there is anecdotal evidence that acupuncture is capable of inducing healing in various musculoskeletal injuries. If you can afford this therapy, it's worth a try.
- This practice is based on the principles of traditional Chinese medicine, is able to reduce pain and inflammation by inducing the release in the body of many substances, including endorphins and serotonin.
- Many also claim that it can stimulate the flow of energy, called "chi," which is the element that promotes healing.
- Acupuncture is practiced by various health professionals, including some doctors, chiropractors, naturopaths, physiotherapists and massage therapists. Always make sure the acupuncturist has a great experience and respects hygiene rules.
Advice
- Always go to your orthopedist for follow-up visits to make sure your bones are sealing properly and let your doctor know of any doubts or concerns about the healing process.
- Do not smoke, as smokers have been shown to have greater difficulty healing a fracture.
- Osteoporosis (a disease that makes bones fragile) greatly increases the risk of fractures in the limbs, pelvis and spine.
- Reduce repetitive movements that strain your muscles and strain your bones, as you may end up with stress fractures.
