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Surgery for a broken bone


Your health expert: Henry Maxwell, Consultant Orthopaedic Surgeon
Content editor review by Pippa Coulter, May 2022
Next review due, May 2025

Surgery for broken bones involves fixing your broken bone into place using metal plates, rods, wires, screws or pins. The type of surgery you have will depend on which bone you’ve broken.

About surgery for broken bones

Bone is a living tissue so if it breaks, it can heal itself. But broken bones need to be lined up and held in place long enough to make sure that they heal in the right position. If a broken bone isn’t treated properly, it may not heal properly or it might not heal in the right position. A fracture in a joint (such as your knee or shoulder) may lead to stiffness and reduced movement.

Fractures can sometimes be treated without an operation by using things like casts, braces or splints (see Alternatives section for more information). But sometimes you may need to have an operation to move your bones into position and fix them there. This is more likely if:

  • the broken bone or bones won’t stay lined up in position
  • you have a break known to heal better with surgery, such as in your thigh bone (femur)
  • you have more than one break in the same area, such as in your pelvis or thigh bone
  • the broken bone affects the muscles and tendons around a joint, such as your knee
  • the fracture is open, which means the broken bone has pierced the skin
  • your broken bone hasn’t healed without surgery

Your doctor will discuss with you whether surgery is the most suitable option for you.

Preparing for surgery for a broken bone

Initial care

If you have any other injuries or medical conditions, your doctor will aim to get these under control first. You might need to have some tests, including blood tests, X-rays and an electrocardiogram (ECG). Sometimes, your broken bone may be held in place with pins (external fixation) while you wait for further surgery. You can read more about this technique in the section below.

Your healthcare team will discuss with you exactly what to expect before, during and after surgery. This will include the potential risks and benefits involved. If you’re unsure about anything, don’t be afraid to ask any questions. You’ll need to sign a consent form before the surgery can go ahead, so it’s important to make sure you feel fully informed.

Anaesthesia

The type of anaesthetic you’ll have for your operation will depend on your general health and which bone you’ve broken. It might be a local, regional, spinal or general anaesthetic.

  • A local anaesthetic involves having an injection to numb a small area of your body – such as a finger or toe.
  • A regional anaesthetic involves having an injection to numb a larger, or deeper part of your body. This can be into your back to numb the lower part of your body (a ‘spinal’).
  • A general anaesthetic will mean you’re asleep and won’t feel anything during the operation.

If you’re having a general or spinal anaesthetic, you’ll need to stop eating and drinking for a period of time beforehand. Your hospital will tell you exactly when. It’s important to follow their instructions.

Preventing DVT and infection

You may need to wear compression stockings or have an injection of an anticlotting medicine before your surgery. These will help to prevent deep vein thrombosis (DVT). See our complications for more information on DVT. You may also have antibiotics before your operation to help reduce the risk of an infection.

What happens during surgery for a broken bone

There are two main types of fracture surgery, which we describe below.

Open reduction and internal fixation (ORIF)

In this type of surgery, your surgeon will make a cut in your skin to access the area where the break is. They’ll move the broken pieces of bone 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. 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 fits pins through your skin and into your bone, above and below where the break is. These are joined with a metal bar or sometimes a frame, on the outside of your body. This makes sure your bone stays in place and heals in the right position. External fixation is usually for more severe or complex fractures. It’s also used as a treatment for open fractures (if your bone has pierced the skin and you have an open wound).

What to expect after surgery for a broken bone

You’ll 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. How long you need to stay in hospital will depend on the type of break you have and if you have any other injuries.

You may need to wear a splint or cast after the operation, to support your bone while it heals. If you’ve had surgery for a broken leg, your surgeon will tell you whether or not you can put weight on it straightaway. Sometimes your healthcare team may give you crutches or a walking frame to help you walk.

After a general anaesthetic, 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. If you’re going home the same day as you’ve had a general anaesthetic or sedative, you should organise for someone to take you home. They should also stay with you for the first 24 hours.

Recovery from surgery for a broken bone

How long it takes for a fracture to heal depends on which bone was broken and the type of break. It can be anywhere from a few weeks for a bone in a joint, to several months for broken leg surgery. This is usually quicker in children. Your surgeon should be able to give you a timeframe for how long they’d expect it to take. They’ll be able to tell you when you can start moving the affected area or putting weight on it too. If you continue to need pain relief after surgery, you can take over-the-counter painkillers, such as paracetamol or ibuprofen.

You may also see a physiotherapist to help with your recovery and rehabilitation. A physiotherapist can help you to build up strength in your bones and muscles and ease any stiffness. They may give you an exercise programme to follow, which will help you get the full range of movement back. Your physiotherapist can show you how to move around safely while you recover. They may give you advice about using crutches or a walking frame properly.

Plates, screws and other metal implants used in your surgery don’t usually need to be removed. But if they’re causing irritation or other problems, your surgeon may recommend that they’re taken out. You’ll need another operation if so.

Complications of surgery for a broken bone

Complications are when problems happen during or after your operation. Many of the complications associated with surgery for broken bones can also happen as a result of the fracture itself. They include the following.

  • Infection in your wound or bone. Antibiotics can usually treat this.
  • Damage to nerves or blood vessels during your operation.
  • Your bone may take longer than usual to heal or it may heal in the wrong position. If your bone doesn’t heal properly, you might need to have another operation.
  • Compartment syndrome. This is when pressure builds up in the tissues around your broken bone, so blood can’t flow into the area properly. It can happen as a result of the fracture itself, or after surgery. It’s extremely painful and often needs urgent treatment with an operation to release the pressure.
  • Deep vein thrombosis (DVT). This is when blood clots develop in the deep veins in your legs. It can be dangerous if it moves to your lungs. You might need to wear compression stockings and have an injection of an anticlotting medicine to prevent this.
  • Fat embolism syndrome. This is when a piece of fat gets stuck in a blood vessel, causing a blockage. It can happen as a result of the fracture, or the surgery.
  • There will also be complications specific to different types of broken bone. Your surgeon will explain the possible risks of your surgery and how these may affect you.

Alternatives to surgery for a broken bone

Other treatments for a broken bone are listed below. Your surgeon can explain if these are an option for you. This will depend on several things, such as the type of fracture you have and where it is.

  • A sling. This can be an option if you’ve broken your collar bone or for some breaks in the upper arm.
  • A cast. This is a hard and rigid protective covering that goes all the way around the affected arm or leg. These are usually used for broken bones that need to be held in place for several weeks to heal.
  • A splint. This is a hard device that supports your broken bone while it heals. Unlike a cast, it doesn’t tend to go all the way around the affected area. They’re usually used if it’s a broken bone that only needs a few days to heal. Broken fingers, hands and wrists can all be treated using a splint.
  • A brace. This is similar to a cast. They’re used for fractures across a joint, such as your knee, where a hinge in the brace means you can bend your knee.
  • A special type of boot. These are padded, supportive boots you can wear that may be used for foot and ankle fractures.

Looking for physiotherapy?

You can access a range of treatments on a pay as you go basis, including physiotherapy.

To book or to make an enquiry, call us on 0370 218 6528

It may take up to several months for a broken leg to completely heal. But this depends on which bone is broken and how bad the break is. It takes less time for bones to heal in children. See our Recovery section for more information.

You don’t always need surgery for a broken bone. It depends on which bone you have broken and how bad a break it is. Sometimes you may just need a cast, brace or splint while your broken bone heals. See our About and Alternatives sections to find out more.

If you don’t get appropriate treatment for a broken bone, it might not heal in the right position. If it’s in a joint (such as your knee or shoulder), it may become stiff. Your doctor can tell you whether surgery or other treatments are the best option for you. Read more in our About section.

Yes, you can still fly if you have metal from surgery – like plates or rods – in your leg. It’s possible that it’ll set off a metal detector as you go through security, but this doesn’t always happen. You may find it helpful to carry a letter from your doctor to confirm you have metal implants in your leg.

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