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Surgery for a broken bone
Expert reviewer, Mr Roger Tillman, Orthopaedic Surgeon
Next review due January 2023
If you break a bone, it will need to be held in place while it heals. This can be done using a splint, sling, brace or cast. But sometimes a broken bone will need to be fixed with surgery, using metal plates, rods, wires, screws or pins.
How a wrist fracture is treated
A fracture is a broken or cracked bone.
How a wrist fracture is treated
A fracture is a broken or cracked bone.
About surgery for broken bones
Broken bones are sometimes called fractures. There are several different types of fracture and treatment usually depends on which bone has been broken and the type of break it is.
Bone is a living tissue so if it breaks, it can heal itself. But broken bones need be held in place (immobilised) long enough to make sure that they heal in the right position. To do this, the break has to be reduced. This means the broken ends have to be lined up together.
Depending on the break, you may need to have an operation to move your bones into the correct position and fix them there. Your body will then produce new bone to join the broken parts together.
You might need an operation to fix a broken bone if:
- the broken bone or bones are unstable (this means the broken bone has moved or is likely to move, whereas with stable fractures, the damaged bone is still in alignment and not likely to move)
- your doctor has tried to get the bones lined up with each other but it hasn’t worked
- you have a break that won’t heal well without an operation, such as a broken top of your thigh bone (neck of femur)
- you have more than one break in the same area, such as a broken pelvis and thigh bone
- you have a large broken bone which affects the muscles and tendons around it, such as a broken knee
- the fracture is open, which means the broken bone has pierced the skin
You will meet the surgeon carrying out your procedure to discuss your care. It might be different to what we've described here because it will be designed to meet your individual needs.
Preparing for surgery for a broken bone
If you’re having an operation on a broken bone, you’ll need an anaesthetic of some kind. The type you have will depend on your general health and which bone you’ve broken. For example, for a broken thigh bone you may have a general anaesthetic or a regional anaesthetic. A general anaesthetic will mean you’re asleep during the operation. A regional anaesthetic is where part of your body is made numb so you can’t feel any pain.
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. These will help to prevent deep vein thrombosis (DVT).
Your surgeon may give you antibiotics before your operation to help reduce the risk of 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 which can help to ease your pain and keep the bones in the right place. You might need to have traction before you have surgery.
Your nurse or surgeon will discuss with you what will happen, including any pain you might have. Ask questions if you’re unsure about anything. 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 will depend on several things, such as the type of fracture you have and where it is. Ask your surgeon if these treatments are an option for you.
- A sling can be used if you’ve broken your collar bone or for some breaks in the upper arm.
- A splint is a long, narrow piece of plaster or fibreglass. It can be used to treat stable fractures and those that heal quickly, as well as giving time for swelling to go down before a cast is put on. Broken fingers, hands and wrists can all be treated using a splint.
- A cast is a hard and rigid protective covering that relieves pain, holds your bone in place and helps it to heal. Casts are custom-made to fit you and can be made of plaster of Paris or fibreglass.
- A brace is similar to a cast. These are 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 that has airbags inside it and a Velcro fastening may be used for foot and ankle fractures.
What happens during surgery for a broken bone?
Open surgery
Your surgeon will make a cut to open the area where the break is. Before they can fix your bones in place, your surgeon will need to move them back into their normal position. This is called reducing the fracture.
Your surgeon will 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. Wires are usually used alongside screws and plates. These metal parts are 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, pins are put in through your skin and into your bone, above and below where the break is. The pins are joined with a metal bar and sometimes a frame that’s on the outside of your body. This stabilises your bone and make sure it heals in the right position.
External fixation is usually for fractures that are severe and unstable or where the bone has broken into more than one piece, such as a broken pelvis. It’s also used as a treatment for open fractures where the bone has pierced the skin and there is an open wound.
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.
Depending on the type of surgery you’ve had and which bone has been repaired, you may have a splint or cast on after the operation. If you’ve broken your leg, your surgeon will tell you whether you can put weight on it or not, and if you’ll need to use crutches or a walking frame.
How long you need to stay in hospital will depend on the type of break you have and if 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.
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.
Looking for physiotherapy? You can access a range of treatments on a pay as you go basis, including physiotherapy. Find out more >
Looking for physiotherapy?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 was broken and the type of break. It can take from a few weeks to 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. Keep in mind that the pain from a fracture may go before your bone has fully healed.
The plates, screws and other metal parts may stay in place for the rest of your life, or they may be taken out after the bone has fully healed. Ask your surgeon if you’ll need another operation.
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.
Side-effects of surgery for a broken bone
Side-effects are the unwanted but mostly temporary effects you may get after having your operation. You might have some pain as well as swelling and bruising, both before and after surgery for a broken bone.
All medical procedures come with some risk. How these risks apply to you will be different from how they apply to others. Be sure to ask for more information if you have any concerns.
Complications of surgery for a broken bone
Complications are when problems happen during or after the operation. We explain some of the main general complications of surgery for a broken bone here. There are some specific complications for each type of operation, depending on the bones that are being repaired. Ask your surgeon to explain the possible risks of your surgery.
- You may get an infection in your wound or bone. Antibiotics can usually treat this.
- Your bone may take a long time to heal or it may heal in the wrong position. If your bone doesn’t heal properly, you might need to have another operation.
- Surgery for a broken bone can lead to compartment syndrome. This is when there is swelling and bleeding inside a closed space where there are muscles. It’s more likely to develop if you’ve had surgery for a broken bone in your lower arm or leg. The pressure increases and blood can’t flow properly. This is extremely painful and it needs treatment quickly. You may need to have an operation called a fasciotomy to release the pressure.
- 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 to prevent this.
- Fractures that happen inside a joint, such as inside your knee, can sometimes lead to pain and arthritis after surgery.
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Why is physiotherapy important after surgery?
Physiotherapy and exercise can build up strength in your bones and muscles and help to prevent stiffness. This can help you to get the full range of movement back.
Not everyone with a fracture will need physiotherapy. But for some fractures, such as a broken thigh bone, physiotherapy after surgery is an important part of your treatment. A physiotherapist will see you the day after your operation and on the days following it.
They will give you exercises to follow and a rehabilitation plan. These will help you to improve how well you move, build strength in your muscles and improve your balance. Your physiotherapist can show you how to move safely from bed to chair, to stand up and to begin walking after your operation.
A physiotherapist or an occupational therapist can also give you help and advice about how to use crutches or a walking frame safely. It’s particularly important to learn how to go up and down stairs on crutches.
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Will the plate in my leg set off a metal detector?
It’s possible but unlikely.
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 (in theory) set off detectors like those used for security at airports. But such detectors don’t usually pick up the metal used in this way.
Some airports now have full body scans which will show metal implants. After the scan, only you and the security officer will see a diagram on a small screen. If you would rather not be scanned, you can ask for a private search instead.
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Related information
Over-the-counter painkillers
Over-the-counter painkillers are painkillers that you can buy from a pharmacy or shop, without needing a prescription from your GP.
Physiotherapy
Physiotherapy is a treatment that aims to improve the way your joints and muscles work.
Fractures
A fracture is a broken or cracked bone.
Bupa Knee Clinic
If you've injured your knee or have a long-term problem, our Bupa Knee Clinic can help you find the information and support you need.
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Other helpful websites
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Sources
- Overview of fractures. The MSD Manuals. www.msdmanuals.com, last full review July 2019
- Orthopaedic surgery. Oxford handbook of clinical surgery. Oxford Medicine Online. oxfordmedicine.com, published online 2013
- General principles of fracture care. Medscape. emedicine.medscape.com, updated April 2018
- Fractures (non-complex): Assessment and management. National Institute for Health and Care Excellence (NICE), 2016. www.nice.org.uk
- Guay J, Parker MJ, Gajendragadkar PR, et al. Anaesthesia for hip fracture surgery in adults. Cochrane Database of Systematic Reviews 2016. doi:10.1002/14651858.CD000521.pub3.
- Traction: principles and application. Royal College of Nursing, 2015. www.rcn.org.uk
- Splinting technique. Medscape. emedicine.medscape.com, updated October 2017
- Care of casts and splints. American Academy of Orthopaedic Surgeons. www.orthoinfo.org, last reviewed August 2015
- Internal fixation for fractures. American Academy of Orthopaedic Surgeons. www.orthoinfo.org, last reviewed April 2019
- Fracture external fixation – an overview. Science Direct. www.sciencedirect.com, accessed December 2019
- Orthopaedics. Oxford handbook of operative surgery. Oxford Medicine Online. oxfordmedicine.com, published online 2017
- Compartment syndrome. Patient. patient.info, last edited January 2015
- Compartment syndrome of extremities. BMJ Best Practice. bestpractice.bmj.com, last reviewed November 2019
- Hip fracture rehabilitation in physiotherapy practice. Chartered Society of Physiotherapists. 2018 www.csp.org.uk
- Ismail A, Dancey A, Titley OG. Prosthetic metal implants and airport metal detectors. Ann R Coll Surg Engl. 2013; 95(3):211–14. doi:10.1308/003588413X13511609955977
- Your rights at the airport. GOV UK www.gov.uk, accessed December 2019
- Walker boot / shoe advice. NHS Wales. www.wales.nhs.uk, published April 2019
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Author information
Reviewed by Sarah Smith, Freelance Health Editor and Natalie Heaton, Specialist Health Editor, Bupa Health Content Team, January 2020
Expert reviewer, Mr Roger Tillman, Orthopaedic Surgeon
Next review due January 2023
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