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Surgery for a broken bone


Expert reviewer, by Mr Roger Tillman, Orthopaedic Surgeon
Next review due August 2020

If you break a bone, you may just need to wear a splint, cast or brace to hold it in place while it heals. But sometimes a broken bone will need to be fixed with surgery, using metal plates, rods or pins.

About surgery for broken bones

You may hear your surgeon talk about your broken bone as a fracture, which is the medical term. We have a separate topic on fractures that explains exactly what happens when you break a bone.

Bone is a living tissue so if it breaks (fractures), it can heal itself. But broken bones have to be held in place (immobilised) long enough to make sure that they heal in the right position. Depending on the break, you may need to have an operation to move your bones into the correct place and fix them there. Your body will then produce new bone to join the broken parts together. This new bone is called fracture callus.

Because everyone’s injury will be different, your care may not be quite as we describe here because it’ll be adapted to suit you.

Preparing for surgery for a broken bone

You may be given an anaesthetic to help with the pain of an operation for a broken bone. The type of anaesthetic you have will depend on which bone you’ve broken. You may have local or regional anaesthesia, which will completely block pain from the area but you’ll stay awake during the operation. Or you may have general anaesthesia and be asleep during the operation.

A general anaesthetic can make you sick so it’s important that you don’t eat or drink anything for six hours before your operation. Follow your anaesthetist’s advice and if you have any questions, just ask.

You may need to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may also need to have an injection of an anticlotting medicine such as tinzaparin or dalteparin as well as, or instead of, wearing compression stockings. These will help to prevent deep vein thrombosis (DVT).

Your doctor or surgeon may give you antibiotics before your operation to help reduce the risk of you getting an infection.

Traction

Traction is a treatment that’s sometimes used in hospital. It brings your bones into line with each other using a gentle but steady pulling action. This is done by attaching weights to your skin using tape, or to your bone using metal pins. These pull your bones into line. You might need to have traction before further surgery.

Your nurse or surgeon will discuss with you what will happen, including any pain you might have. If you’re unsure about anything, just ask. Understanding what’s going to happen can help you feel more at ease and comfortable. You may be asked to give your consent by signing a form.

What are the alternatives to surgery for a broken bone?

Other treatments for a broken bone are listed below. Whether or not these are an option for you will depend on a number of things, such as how severe your fracture is. Ask your surgeon if these treatments are an option for you.

  • A sling can support your arm if you’ve broken your upper arm, elbow or shoulder.
  • A splint, which is a long, narrow piece of plaster or fibreglass or aluminium, can hold broken bones in place, particularly just after an injury.

Your doctor will secure the splint in place using tape, velcro or a bandage. It doesn’t go all the way around your limb, so it may be more comfortable than a cast if you have a lot of swelling. You might then need to have a cast or brace when the swelling has gone down.

  • A cast is a hard and rigid protective covering that holds your bone in place and helps it to heal. Casts can be made of plaster of Paris or fibreglass.
  • A brace is similar to a cast but you’ll still be able to move the broken area a little.

For information about the types of breaks that usually do need surgery, see our FAQ: Do I need an operation rather than just a cast? 

What happens during surgery for a broken bone?

Open surgery

After the anaesthetic has taken effect, your surgeon will make a cut to open up the area where the break is. Before they can fix your bones in place, they’ll need to move them back into their normal position. This is called reducing the fracture.

Your surgeon will then use a combination of metal wires, pins, screws, rods and plates to securely fix your bones in place. These are made of stainless steel or titanium. Metal rods or nails sit inside your bone, while screws and metal plates attach onto the surface of it. They’re designed to work with your body so you shouldn’t get any allergic reaction to them.

Your surgeon will close your skin using stitches or staples. They may put a cast or splint on to protect your bone as it heals.

External fixation

In this type of operation, your surgeon will drill pins through your skin and into your bone above and below where the break is. They’ll then join these together with a metal bar that’s placed on the outside of your body. This will stabilise your bone and make sure it heals in the right position.

Keyhole surgery

It may be possible to have keyhole surgery to mend a broken bone. One type of keyhole surgery is an operation called knee arthroscopy. In this type of operation, your surgeon will make small cuts in your skin and insert supporting plates to fix the break. You usually recover from this type of surgery faster than with open surgery but it isn’t suitable for all broken bones. Ask your surgeon if it’s an option for you.

What to expect afterwards

You may need to rest until the effects of the anaesthetic have passed. You might have some discomfort as the anaesthetic wears off but you’ll be offered pain relief if you need it.

If you’ve had surgery for a broken arm, you may be given a splint for support while it heals. If you’ve broken your leg, you might be given crutches or a walking frame to stop you from putting weight on your leg while it heals.

How long you need to stay in hospital will depend on the type of break you have and whether you have any other injuries. When you do leave hospital, make sure someone can take you home. And it’s a good idea to ask someone to stay with you for a day or so while the anaesthetic wears off.

Having a general anaesthetic can really take it out of you. You might find that you're not as coordinated or that it's difficult to think clearly. This should pass within 24 hours. In the meantime, don't drive, drink alcohol, operate machinery or sign anything important.

How long does it take to recover from surgery?

How long it takes for a fracture to heal and for you to recover depends on which bone you broke and the type of break. It may take several months to completely get back to normal but ask your surgeon to give you a more exact timeframe.

If you need pain relief, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and, if you have any questions, ask your pharmacist for advice.

You’ll probably have questions after your operation, for example about when you can use your arm or put weight on your leg. Talk to your surgeon about this so you feel clear about what you can and can’t do. It’s important to keep in mind that the pain from a fracture may go before your bone has fully healed. Even though it may feel better, remember not to put too much stress on it too soon.

You may need to have some of the screws, pins and metal plates removed when your bones have healed. This will depend on the type of fracture you have and where it is. Sometimes the metal parts stay in place for the rest of your life.

You may need to see a physiotherapist to help you to build up strength in your bones and muscles and ease any stiffness. Your physiotherapist may give you an exercise programme to follow, which will help you get the full range of movement back. For more information see our FAQ: Why is physiotherapy important after surgery? 

Side-effects of surgery for a broken bone

Side-effects are the unwanted but mostly temporary effects you may get after having your operation. After surgery for a broken bone, you might have some pain, as well as swelling and bruising.

As with every procedure, there are some risks associated with surgery for a broken bone. We haven’t included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Complications of surgery for a broken bone

Complications are when problems occur during or after the operation. We’ve explained some of the main complications of surgery for a broken bone here.

  • You may get an infection in your wound or in your bone, but this can be treated with antibiotics.
  • Your bone may not completely heal, or it may heal in the wrong position. This can happen if your bone is infected or if you use your injured arm or leg too much before it has healed properly. If your bone doesn’t heal properly, you might need to have another operation.
  • Your nerves or blood vessels (arteries and veins) may be damaged when you break your bone, or there’s a chance this could happen during your operation. Damaged nerves may cause some loss of movement or feeling. Any damage to your blood vessels may affect the blood supply to your arms or legs.
  • A broken bone can lead to compartment syndrome. This can happen if your muscles swell. Your muscles sit inside a capsule of tissue called fascia, so they don’t have much room to expand. When your muscles swell, the pressure increases and blood can’t flow into your muscle properly. This is extremely painful and you may need to have an operation called a fasciotomy to release the pressure on your muscle.
  • You may develop deep vein thrombosis (DVT), particularly if you can’t move around for a while. You might need to wear compression stockings and have an injection of an anticlotting medicine during your operation to prevent this.

Frequently asked questions

  • Physiotherapy and exercise can build up strength in your bones and muscles. This can help you to get the full range of movement back.

    If you break your arm or leg, for example, the bone will need to be held in place to help it heal properly. You may have a cast or a sling on after your operation. Because your muscles can’t move and work as they normally would, they can become weak. If you break a bone near a joint, this can also cause stiffness. Without treatment, you’ll have some discomfort and difficultly moving after your bone has healed.

    After your operation, your surgeon may refer you to a see a physiotherapist. They’ll develop an exercise programme for you, which will help you to exercise your arm or leg, for example, while your bone heals. This will help to maintain or build up strength in your muscles and bones to make sure you recover as fully as possible. Exercises can also help to ease any stiffness.

    A physiotherapist, or an occupational therapist, can also give you help and advice about how to use crutches or a walking frame safely.

  • Whether you need surgery to treat a broken bone or have a cast depends on the type of fracture you have and where it is. Some breaks don’t heal well if they’re treated with a cast.

    Some breaks need to be fixed in an operation, rather than held in a cast, to help them heal properly. The main types of breaks that you’ll need to have an operation to fix are described below.

    • Open fracture. This is when a broken bone breaks through your skin. This kind of break needs to be cleaned well and any dirt or other materials removed before the bone can be put back in place. This helps to prevent infection.
    • A broken bone that can’t be lined up properly or kept in place will need an operation to fix it securely.
    • Sometimes a piece of bone or a tendon gets trapped in the bone ends and this also needs to be repaired using surgery.
    • Comminuted fracture. This is when your bone has broken into three or more pieces which need to be lined up and fixed in place using surgery.
    • A broken bone across a joint will need to be fixed in place to stop you developing osteoarthritis in later life.
    • A fracture of your thigh bone (femur). You’ll usually need to have surgery for this type of break.

  • It’s possible, but this doesn’t happen often.

    The metal parts that are used to fix broken bones are made of stainless steel or titanium. If they’re left in place for your bone to heal, they may set off detectors, for example when you go through security at airports. But usually, such detectors don’t pick up the metal used in this way.

    If the metal in your leg has previously set off a metal detector, tell the security officer before you go through screening. Metal plates, screws and joint replacements are now so common that security officers are very used to seeing them so it shouldn’t be a problem.


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  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, August 2017
    Expert reviewer, by Mr Roger Tillman, Orthopaedic Surgeon
    Next review due August 2020



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