Principles of Fracture Treatment

Written by Cheng Bin
Orthopedics
Updated on March 12, 2025
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Usually, the treatment principles for patients after a fracture are mainly reflected in the following aspects:

First, it is necessary to actively reposition displaced fractures, as continuously misplaced fractures can easily lead to nonunion or malunion later on. It is crucial to actively perform manual repositioning or consider open reduction and internal fixation surgery.

Second, strict rest and immobilization must be adhered to, as these provide the best conditions for fracture healing. During the treatment period, patients can take non-steroidal anti-inflammatory analgesics and medications that promote fracture healing.

Third, once callus formation begins in the later stages, diligent functional exercises are necessary.

(Please use medications under the guidance of a doctor)

Other Voices

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Written by Guan Yu Hua
Orthopedic Surgery
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How long should one stay in bed with a rib fracture?

Rib fractures are mostly caused by trauma, such as direct or indirect force. Radiographic examination can basically confirm the diagnosis. A single rib fracture generally requires no intervention or special treatment, just immobilization is sufficient. However, strict bed rest is necessary. Typically, immobilization for about four weeks is needed until callus formation occurs. During this period, you should avoid deep breathing, heavy breathing, or coughing, and stay away from cooking fumes and smokers. Such irritative coughing might cause pain. A rib fracture will likely also result in intercostal neuralgia, which can be very troublesome and prolong the pain. However, fractures generally fully heal within eight to ten months. They can gradually heal without issues, but it is best to rest in bed for a month.

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Written by Na Hong Wei
Orthopedics
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Fractures are categorized into several types.

In short, fractures can be classified into the following types: First, based on the integrity of the skin and mucous membrane at the fracture site, it can be classified into closed fractures and open fractures. Second, based on the shape and degree of the fracture. It can be categorized into oblique fractures, transverse fractures, spiral fractures, comminuted fractures, greenstick fractures, impacted fractures, compression fractures, and bone injuries. Third, based on the stability of the fracture ends, it can be classified into stable fractures and unstable fractures. Among unstable fractures, these include oblique fractures, spiral fractures, and comminuted fractures. Thus, fracture classification fundamentally falls into these major categories.

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Written by Li Jie
Orthopedics
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Does a fracture hurt?

A fracture is an interruption in the continuity of a bone. After a fracture, there is significant bleeding at the site, along with bruising of the soft tissues nearby, including bleeding from blood vessels and bruising of muscles and tendons. Because these soft tissues are rich in nerves, the pain at the site of the fracture can be very severe. Pain is a primary symptom for patients with fractures. Other symptoms may include swelling, limitation of joint movement, potential deformities, and changes in the local shape. Pain, deformity, and limited function are the three common signs seen in patients with fractures.

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Written by Li Jie
Orthopedics
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How is a fracture treated?

The treatment of fractures involves three main principles: reduction, fixation, and functional exercise. First and foremost, a perfect reduction is required after a fracture. If the alignment of the fracture is not satisfactory, the fracture may require either closed or open reduction. After a successful closed reduction, if the fracture position is stable, fixation should be considered. Generally, following a successful closed reduction, a local application of a cast or splint can be done for external fixation. If the results of closed reduction are not satisfactory, surgical open reduction may be needed. In such cases, internal fixation, possibly with steel plates, steel pins, or intramedullary nails among other methods, is necessary. These first two points cover the need for reduction and effective fixation—including both external and internal fixation. After proper fixation, the fracture can gradually heal. During the healing process, active functional exercises are needed to prevent muscle atrophy and joint adhesion. To avoid disuse of the limb, muscle atrophy after removing the cast, whether it be a leg or an arm, functional exercises are imperative. Thus, the three principles of fracture treatment are reduction, fixation, and functional exercise, requiring professional care by medical experts in accredited hospitals.

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Written by Zhang Ying Peng
Orthopedics
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How to exercise for fracture recovery

After the fracture heals, rehabilitation exercises can reduce pain and shorten the healing time of the fracture. The main rehabilitation training methods include physiotherapy such as hot compresses, massage of the fracture site, acupuncture, electrotherapy, and exercises like muscle training of the fracture site, isometric contraction, isotonic contraction, etc. Once the fracture reaches relative stability, further activities like getting out of bed and non-weight bearing exercises at the fracture site can also help accelerate the healing time.