Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028

Fracture Repair Surgery

Fracture repair surgery is a critical intervention aimed at restoring the integrity and function of bones following severe fractures. Whether caused by accidents, sports injuries, or other trauma, fractures that are displaced, comminuted, or open often require surgical repair to ensure proper healing and prevent long-term complications. This guide explores the various aspects of fracture repair surgery, from diagnosis to postoperative care.

Introduction to Fracture Repair Surgery

Fracture repair surgery involves the surgical realignment and fixation of broken bones to promote healing and restore functionality. The primary goal of fracture repair surgery is to anatomically align the fractured bone segments and stabilize them to facilitate healing. Fracture repair surgery is typically recommended for fractures that cannot be adequately treated with conservative methods such as casting or splinting alone. 

Types of Fractures That Require Surgery

Fractures vary widely in severity and complexity. Hand surgeons commonly recommend surgical repair for fractures that pose challenges to natural healing processes or risk long-term complications. Understanding the types of fractures that typically require surgical intervention helps in recognizing the importance of timely and appropriate treatment.

Fractures that often require surgical intervention include:

  • Open Fractures: Where the broken bone penetrates the skin, increasing the risk of infection and requiring timely irrigation, debridement and stabilization. Surgical debridement and stabilization are sometimes needed to reduce infection risk and promote healing.
  • Comminuted Fractures: Involving the bone being shattered into three or more pieces, making it challenging to heal in many cases without surgical fixation. Surgical fixation helps align and stabilize the fragments for proper bone healing.
  • Displaced Fractures: Where the bone fragments are not in their normal anatomical position, affecting function and alignment. Proper alignment is needed to restore bone function and avoid long-term deformities or joint dysfunction.

Diagnosis and Evaluation of Fractures

Diagnosing fractures that may benefit from surgical intervention requires a comprehensive evaluation process. Hand surgeons utilize various diagnostic tools and techniques to assess the extent and severity of fractures, ensuring the most appropriate treatment plan is implemented. This evaluation not only identifies fractures that necessitate surgical repair but also helps in understanding the underlying factors contributing to the injury.

Diagnosing fractures suitable for surgical repair involves a thorough evaluation, including:

  • Clinical Examination: A detailed physical examination allows the hand surgeon to assess the injury’s location, severity, and potential complications. Range of motion tests and palpation help identify areas of tenderness or instability.
  • Imaging Studies: X-rays provide initial insights into fracture architecture and alignment. Advanced imaging modalities such as CT scans or MRI scans offer detailed views of complex fractures, aiding in decision-making and surgical planning when indicated.
  • Diagnostic Arthroscopy: In some cases, diagnostic arthroscopy may be performed to directly visualize and assess intra-articular fractures or joint damage. This minimally invasive procedure guides surgeons in accurately diagnosing and treating complex fractures.

Accurate diagnosis and evaluation are crucial in determining the appropriate surgical approach and optimizing outcomes for patients with fractures requiring surgical repair. By utilizing a combination of clinical expertise and advanced diagnostic tools, HSSI orthopedic hand surgeons can provide personalized care and ensure effective treatment of fractures.

Surgical Techniques for Fracture Repair

When fractures require surgical intervention, orthopedic hand surgeons employ various techniques tailored to the specific type and location of the fracture. These techniques aim to achieve stable fixation, promote bone healing, and optimize function of the affected bone and surrounding tissues of the upper extremity. Understanding the diverse range of surgical options helps our hand surgeons to select the most suitable method to address each patient’s unique fracture needs. Extensive talks with patients about their objectives are part of the decision making process.

Various surgical techniques may be employed based on the type and location of the fracture:

  • Open Reduction and Internal Fixation (ORIF): This common surgical technique involves aligning fractured bone fragments through a surgical incision (open reduction) and securing them with internal fixation devices such as plates, screws, or wires. ORIF stabilizes fractures, supports bone healing, and allows for early mobilization.
  • Intramedullary Nailing: Used primarily for long bone fractures, intramedullary nailing involves inserting a metal rod into the marrow cavity of the bone to stabilize and align the fracture fragments. This technique minimizes disruption to surrounding soft tissues and promotes biological fixation.
  • External Fixation: External fixation uses pins inserted into the bone above and below the fracture site, connected to a frame outside the body. This technique provides temporary stabilization, particularly in complex fractures or cases where soft tissue damage precludes internal fixation. Bone lengthening may use this technique.
  • Minimally Invasive Surgery (MIS): MIS techniques, such as percutaneous pinning or arthroscopic-assisted fixation, involve smaller incisions and specialized instruments to reduce surgical scars and pain. These techniques are often used for fractures in or near joints or in areas where preserving soft tissue integrity is crucial.

Each surgical technique for fracture repair has specific indications and advantages depending on the fracture type, location, and patient factors. HSSI hand surgeons carefully evaluate these factors to determine the most appropriate surgical option, aiming to restore bone alignment, promote healing, and optimize functional outcomes.

Benefits of Fracture Repair Surgery

Fracture repair surgery offers numerous advantages that contribute to improved outcomes and generally faster recovery for patients experiencing fractures. Inappropriate, non-surgical approaches, surgical intervention provides alignment of fractured bones, promoting optimal healing and reducing the risk of long-term complications. 

By stabilizing fractures with internal fixation devices such as plates, screws, or wires, surgeons restore structural integrity to the affected bone, allowing for early mobilization and quicker restoration of function. Key benefits of fracture repair surgery include:

  • Anatomical Alignment: Surgical intervention strives for precise alignment of fractured bone fragments, facilitating proper healing and reducing the risk of deformity, malunion, or delayed union.
  • Improved Stability: Internal fixation devices provide stability to fractured bones, promoting early rehabilitation and reducing the duration of immobilization.
  • Faster Healing: Surgical stabilization enhances the biological environment for bone healing, leading to quicker recovery times compared to some non-surgical methods.
  • Reduced Complications: By addressing fractures surgically, hand surgeons can mitigate risks associated with prolonged immobilization, such as joint stiffness, muscle weakness, and diminished coordination. Patients undergoing fracture repair surgery receive thorough preoperative consults and ongoing post-operative care to minimize issues.
  • Enhanced Functional Outcomes: Patients undergoing fracture repair surgery typically experience improved functional outcomes, including restored range of motion, strength, and overall joint and extremity function.
  • Long-term Benefits: Properly managed fractures through surgical intervention may reduce the likelihood of future complications, such as arthritis or chronic pain, and weakness, associated with untreated or improperly healed fractures.

Choosing fracture repair surgery involves careful consideration of the fracture type, patient’s health status, and treatment goals. HSSI hand surgeons collaborate closely with patients to determine the most suitable treatment approach, providing optimal recovery and long-term musculoskeletal health and return to activities they love.

Postoperative Care and Recovery From Fracture Repair Surgery

After undergoing fracture repair surgery, patients enter a critical phase of postoperative care and recovery. This period involves comprehensive monitoring, rehabilitation, and support to ensure optimal healing and restoration of function. HSSI hand surgeons play a crucial role in guiding patients through this recovery journey, emphasizing adherence to treatment protocols and personalized care.

Postoperative care and recovery following fracture repair surgery include:

  • Pain Management: Effective pain management strategies, including medications and non-pharmacological techniques, help alleviate discomfort and promote early mobilization. Patients are educated about pain management protocols and encouraged to communicate any discomfort with their healthcare team.
  • Early Mobilization and Physical Therapy: Early mobilization, occupational and physical therapy are important components of recovery. Your hand surgeon designs personalized rehabilitation programs in collaboration with therapists to improve range of motion, strength, and functional abilities. Gradual reintroduction of activities helps prevent stiffness and promotes joint flexibility.
  • Wound Care and Follow-up Visits: Proper wound care, including dressing changes and monitoring supports surgical site recovery. Follow-up visits with orthopedic hand surgeons ensure ongoing evaluation of healing progress and adjustment of treatment plans as needed.

Postoperative care and recovery following fracture repair surgery are tailored to each patient’s specific needs and surgical outcomes. Patient education, support from healthcare professionals, and adherence to rehabilitation protocols contribute to maximal recovery and return to daily activities.

Alternative Treatments to Surgery

While fracture repair surgery is often necessary for optimal outcomes, non-surgical methods may be considered depending on the type and severity of the fracture. These alternative treatments focus on immobilizing the fracture and supporting the natural healing process without surgical intervention:

  • Closed Reduction, Splinting, and Casting: In cases where the fracture can be manipulated back into alignment without surgery, a technique known as closed reduction may be performed. Following reduction, the fractured bone is immobilized with a cast or splint to maintain proper alignment during the healing process.
  • External Support: Braces or splints may be utilized to provide external support and stability to the fractured bone. These devices help prevent movement that could disrupt the healing process and promote alignment without the need for surgical intervention.

Non-surgical methods are typically considered for stable fractures with minimal displacement or alignment issues. Your HSSI hand surgeon will evaluate your specific fracture type, medical history, and overall health to determine the most appropriate treatment approach.

Choosing the Right Hand Surgeon

Selecting a qualified hand surgeon such as Dr. Mark E. Pruzansky or Dr. Jason S. Pruzansky is paramount to achieving successful outcomes in fracture repair and recovery. Here are essential considerations when choosing a hand surgeon:

  • Credentials and Experience: Evaluate the hand surgeon’s credentials, including board certification in orthopedic surgery and hand surgery. Experience in treating a variety of fractures and achieving positive patient outcomes is crucial.
  • Patient-Centered Care: Look for a hand surgeon who prioritizes patient-centered care, emphasizing communication, empathy, and shared decision-making. A surgeon who takes the time to educate patients about their condition, treatment options, and expected outcomes fosters a collaborative treatment approach.
  • Personalized Treatment Plans: Each patient’s fracture is unique, requiring a tailored treatment plan. A skilled hand surgeon develops personalized treatment strategies based on the fracture type, patient’s lifestyle, and treatment goals. This approach ensures that the treatment plan aligns with the patient’s individual needs and promotes optimal recovery.

By selecting a qualified hand surgeon who values patient-centered care and has a proven track record in fracture management, you can feel confident in your treatment decisions and achieve the best possible outcomes in fracture repair. Contact HSSI today to speak with one who has experience successfully treating patients requiring fracture repair surgery.

Do You Need Fracture Repair Surgery?

Fracture repair surgery plays a vital role in treating severe fractures and restoring functionality to injured limbs. Timely diagnosis, meticulous surgical technique, and comprehensive postoperative care are essential for successful outcomes. If you or someone you know has experienced a fracture that may require surgical intervention, please call 212-249-8700 or schedule an appointment with an HSSI hand surgeon immediately to discuss treatment options and begin the road toward recovery.