Breaking a bone can be a very traumatic incident. However, fractures are extremely common resulting in millions of emergent visits to orthopedic physicians annually for care. Perhaps you were active in the past and incurred multiple fractures from either participating in sports, climbing the monkey bars on a school playground, bike riding, skateboarding, or roller skating. On the other hand, you may be one of the fortunate adults who never had a fracture. Even if the latter is the case, there is a high probability you know someone who has broken a bone.
Despite the number of fractures we regularly address with patients of all ages; surprisingly, bones are relatively resilient. They do give way, to some extent, much like a wooden ruler will bend to a certain point before breaking. However, if force is applied for an extended period of time or if there is a tremendous initial impact, the bone will fracture.
There are several types of fractures. Some of the most common ones are:
Hairline: A very thin line or crack from a slight injury on one side of the bone.
Simple fracture: There is a break but it has not traveled transversely through the bone and a portion of the bone is intact.
Comminuted fracture: The bone is broken in such a way that it is segmented into three or more pieces.
Compound fracture: Bone is split completely in two pieces. This type of fracture can result in the bone puncturing through the skin which would be referred to as an “open” fracture.
Fractures are diagnosed through a series of x-rays. Northwest Broward Orthopedics has a fully staffed, onsite, radiology department with technologically advanced equipment providing high quality images for our orthopedic physicians to assess patients for any signs of infractions to the skeletal system. If a fracture is diagnosed it is important to stabilize the bone allowing regeneration of new bone and healing. In order to immobilize the bone a cast may need to be applied.
If you are above the age of 40, most certainly you remember the bulky, itchy, heavy plaster casts that would become sticky and dirty as the weeks passed. We use a lightweight, pliable fiberglass casting tape in our office that will not deteriorate if it becomes wet. The tape also comes in an array of colors allowing you to customize the color to suit your tastes; from neutral black to a standout purple, we have a color to fit any lifestyle.
We activate the hardening of the fiberglass material initially with the application of water. The affected extremity is positioned in the appropriate manner to facilitate new bone growth. After positioning, a protective barrier or liner is applied on the skin. Over the barrier the fiberglass casting material is wrapped and molded further to ensure proper alignment. We then allow the cast to dry and harden which usually takes anywhere from 10 to 15 minutes. Now, you may wonder if water makes the fiberglass become pliable to apply to the fracture, what happens if it gets wet again. Well, through a process called an exothermic reaction, the initial water application creates a reaction in the fiberglass that generates a slight warming sensation and causes the material to mature and harden. Once this process is completed, additional water will not cause the material to reactivate again.
The casting material can also be lined with a waterproof substance called Gore-Tex. This liner allows patients to shower, bathe, swim, etc., without affecting the integrity of the cast; unlike its plaster cast counterpart. Plaster casts are heavy, absolutely cannot be allowed to get wet, and come only in the concrete white color which becomes dull and dirty over time. The removal of the fiberglass cast is a breeze as well. We use a long, flexible, plastic “ruler” type of tool referred to as a zip stick. This stick is inserted between the cast and the skin to provide a barrier. A cast saw is then used to cut through the cast. The fact that the saw only vibrates combined with the proper placement of the zip stick reduces the risk of a skin abrasion when removing the cast. Once the cast is removed, it is common for the affected extremity to be somewhat atrophied, due to the lack of muscle use. Also, there may be a sensation as if the extremity has “fallen asleep.” Both of these symptoms are common and rectify themselves spontaneously.
Suffering an injury that results in a broken bone is often a very stressful event; however, once diagnosed we strive to make the casting and healing process as comfortable as possible. From the onset of the injury we take the patient through the initial diagnosis to application of a tailored cast which allows the continuation of routine activities of daily living and hygiene. Afterwards, we evaluate the healing process through follow up visits and on to the final removal of the cast. Depending upon the type of fracture and age of the patient, aftercare may include splint placement or physical therapy in our onsite department. We hope you will choose to contact our facility if you are in need of orthopedic related care.