Management of Fractures When a Cast Cannot Heal
Fractures can affect people of all age groups and they are of different types. The cause and the location of the condition decide what type of fracture it would be. Based on the condition, the treatment of the fracture will be decided.
Fractures have multiple causes, and some of them include traumatic injuries like automobile accidents, sports injuries, falls, poor or sedentary lifestyles, and conditions like osteoporosis. Broken bone conditions could be mild, moderate, or severe, and if we talk about severe cases, then their treatment requires surgical intervention in maximum cases. Plus, ortho surgical implants like orthopedic implants plates and screws may also be required for the fixation of broken bone fragments.
Now, let us make one thing clear, surgery is not the only option for the fixation of fractures as it is considered a last option. When a fracture occurs, the first thing a healthcare service provider does is try to fix the condition without surgery. If feasible, a closed reduction is done, and a cast is applied for the immobilization of the fracture. But sometimes, the cast fails to heal the fracture or a non-union occurs. Plus, in some cases, it is even not possible to reduce the fracture and apply a cast. In such cases, several alternative treatment methods are required to be used.
In this post, the main discussion will be on the methods used for fracture treatment when a cast is not enough.
How to Manage a Fracture When the Cast Fails?
Fractures can be of multiple types including open, closed, transverse, linear, spiral, greenstick, and comminuted, and their treatment may require different methods. Thus, we cannot expect a cast to be effective for different types of fractures.
Sometimes, what happens is that the application of cast may be feasible but, our body reacts differently, and hence, healing either does not take place or improper healing occurs. So, some other ways to manage the fracture are required to be tried.
The goal of the fracture treatment is to bring back the broken bone pieces into their true positions and allow a natural healing process to work. This could either be done via closed reduction or open reduction. Closed reduction is often followed by the application of a cast or a splint but, when it cannot be done, open reduction is recommended.
Open surgery, known as reduction and internal fixation, is used to repair broken bones with orthopedic implants. This is the first choice of the surgeons to manage the fracture when a cast fails.
In some cases, traction or external fixation is required as soon as possible after the diagnosis.
Traction
This is the process that requires the use of weights and pulleys to gently pull the bones in place.
External Fixation
This is a surgical procedure that is generally recommended for open fractures where a special metal frame is applied to stabilize broken bones along with special metal plates and screws. The frame remains outside the body.
The type of alternative chosen to fix the fracture when a cast is not enough will completely depend upon the cause, location, and severity of the fracture.
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