Bone fracture is a common injury [1]. There are many ways to repair bone fractures, including immobilization using a cast or a splint, and closed reduction wherein a medical professional non-surgically realigns the patient’s bones [1]. Unfortunately, in some cases, those treatments may not be enough to heal the bone, justifying surgery [2]. The need for surgery to treat bone fractures depends on factors like the type of fracture, the bone that was fractured, the cause of the fracture, and the prior health of the fractured bone [3]. This article will explore some of those factors in more detail to highlight key considerations that medical professionals should take into account when deciding whether to there is a need for surgery to repair bone fractures rather than non-invasive treatment.
One factor that providers should consider in assessing the need for surgery is the type of fracture. For instance, displaced fractures —meaning ones where pieces of bone have moved such that an open space has formed around the initial fracture— are more likely to need surgery than non-displaced fractures, where the bone pieces are not out of alignment [1]. Complex fractures are also more likely to call for surgery, such as when a bone breaks at several locations or when a fracture reaches a joint [3, 4]. Such is also the case with fractures that endanger the bone’s future structural integrity; in those situations, surgery may be the most prudent path forward [3].
Besides the nature of the fracture, another crucial inquiry is which bone was fractured. Some bones, when broken, are more likely to require surgery to repair than others [5]. This is true for the femur, the body’s largest bone [5]. Most instances of femur fracture occur due to a traumatic occurrence involving a considerable amount of force, like a car accident [5]. Consequently, a significant proportion of femur fracture patients undergo intramedullary nailing (also known as intramedullary fixation) [5].
Similarly, humerus fracture also tends to require surgical intervention. Unlike most other shoulder fractures, breakage to the humeral head is more likely to require surgery [5]. This is because, as with femoral fractures, breaking the humerus often necessitates the application of extreme pressure [5]. However, this is not true in all cases: Many fractures of the humerus also occur among elderly patients who, due to osteoporosis, have weak bones [5]. Irrespective of the cause of the fracture, humerus fracture often requires open reduction internal fixation to adequately repair [5].
One last consideration is the possibility of future complications. When a bone fracture does not properly heal, a patient may experience complications such as infection, formation of blood clots, and damage to the tissues, muscles, or skin [6]. Such complications can be life-threatening. For instance, untreated long bone fractures can result in potentially fatal fat embolism [6]. Therefore, when gauging the need for surgery for bone fractures, medical professionals should also evaluate the likelihood and danger of complications.
In conclusion, taking all of these factors into account is crucial to making an informed decision about whether a patient needs surgery and, thus, ensuring recovery to the greatest extent possible after a bone fracture.
References
[1] “Bone Fractures,” Cleveland Clinic, Updated September 1, 2022. [Online]. Available: https://my.clevelandclinic.org/health/diseases/15241-bone-fractures.
[2] “Bone Fracture Repair,” Healthline, Updated September 17, 2018. [Online]. Available: https://www.healthline.com/health/bone-fracture-repair.
[3] E. Ko and E. M. Glazier, “Severity of broken bone determines if surgery is needed,” UCLA Health, Updated March 6, 2023. [Online]. Available: https://www.uclahealth.org/news/severity-broken-bone-determines-if-surgery-needed.
[4] “Broken Leg,” Mayo Clinic. [Online]. Available: https://www.mayoclinic.org/diseases-conditions/broken-leg/diagnosis-treatment/drc-20370416.
[5] A. Hess, “When Does a Broken Bone Require Surgery?,” Bone & Joint Clinic of Baton Rouge, Updated October 28, 2021. [Online]. Available: https://www.boneandjointclinicbr.com/blog/when-does-a-broken-bone-require-surgery.
[6] J. Cavaco Silva, “What to know about bone fracture repair,” Medical News Today, Updated July 11, 2018. [Online]. Available: https://www.medicalnewstoday.com/articles/322419.