Comminuted fracture is a type of fracture which includes the presence of three or more bone fragments. This is a serious type of fracture and the treatment may be rather challenging. Due to multiple bone fragments there is an increased risk of complications. Comminuted fractures can be classified into open and closed fractures. In open fractures the bone fragments protrude through the skin and this carries increased risk of serious complications such as infections. In case of close fractures the bone fragments do not cause the tear to the skin. The skin is practically intact and the damage may only affect the underlying tissues.
Causes and Symptoms of Comminuted Fractures
Comminuted fracture is associated with crush injuries. It is rather common in elderly people. They are particularly predisposed to fractures due to process of aging which causes structural changes in skeletal system making it more susceptible to fractures and other injuries. Furthermore, comminuted fracture may occur in people suffering from primary or secondary bone cancer, osteogenesis imperfecta, osteoporosis etc. This particular type of fracture results from enormous force which typically occurs in car accidents and a fall from a height.
Patients who have experienced comminuted fracture complain about intensive pain at the very site of injury. Soon after the injury the particular area becomes swollen, tender and warm to touch. In open fractures the bone fragments protrude through the skin and there may be bleeding.
Diagnosis and Treatment for Comminute Fracture
Once the patient has been admitted the doctor performs physical examination. The diagnosis is definitive once the injured bone is exposed to X-ray examination. Additional laboratory tests and CT scan of the injured area are usually required. After these examinations patients are administered pain relieving medications.
The treatment for comminuted fracture includes surgical repair and fixing of the broken bone. It is essential to reconnect the broken bone fragments and then fix them with suitable material such as surgical nails, screws, plates or wires. Once the injured area is cut open the surgeon has insight in all surrounding structures. This way he/ she may look for possible damage to nearby tissue and perform suitable repair. Bone fragments are aligned with a technique called reduction. After the surgery the injured part is immobilized with a plaster, splint or fiberglass splint. The fracture usually takes long to heal completely. After the surgery all patients are engaged in physical therapy. The goal of physical therapy is to restore the lost function of the broken bone and to strengthen the surrounding muscles. Complications such as infection at the site of fracture may only prolong the recovery time and require aggressive treatment with antibiotics.