Open and Closed Fracture Treatment | Surgery, Symptoms, Healing Time, Recovery for Open or Closed Fractures
Fractures can either be closed or open. Previously, these types of fractures are called simple (open) fractures and compound (open) fractures. Although they are both characteristic of bone fractures, they have their own identifications when it comes to physical manifestations. Closed fractures are fractures that have completely unharmed skin but because the fractures happen inside the skin, there is a hematoma or blood accumulation surrounding the fractured bone. This makes the fracture a little complicated. Keep reading to learn the difference between open and closed fractures.
However, an open fracture is more complicated than the closed fracture because the fractured bone due to the impact and breakage of bone fragments has penetrated through the skin and now exposed to the external environment. Because the wound has a protruded bone, blood may also trickle to the outside environment which can attract bacteria and infect the wound as well as the bone itself.
Types of Open and Closed Fractures
• Open or compound fractures are usually caused by traumas such as vehicular accidents or falls from heights. It is characterized by the tearing of the muscles and the epidermis because of the protrusion of fractured bones. These types of fractures are seen as serious form of bone fractures because bone and wound infections is most likely while there is also a chance of blood loss in severe cases. There are also sub-types of this category, namely:
• Type 1. Small wound with clean edge that is usually around 1 centimeter.
• Type 2. There is a laceration of the skin where the wound is bigger than 1 centimeter but the skin has still smooth edges.
• Type 3. There is a severe laceration and trauma to the skin due to the protrusion of bone fractures.
• Closed or simple fractures. This is the type of broken bone that was inside the muscles but did not pierce the skin. The types of these fractures are:
• Displaced fractures. A closed fracture with displaced bones
• Hairline or stress fractures. The bones have minute cracks in them due to overuse.
• Pathological fractures. Could be caused by bone diseases or mineral deficiencies.
When diagnosing a closed fracture, the doctor would usually ask the patient when and how the injury happened. This is to rule out other possible injuries that may have result when the injury happened. Physical examination will also be conducted such as the search for swelling, bruises, bleeding, discoloration of the skin and other symptoms. X-rays will follow so that the real status of the bone can be confirmed. With open fractures, there is no need for much diagnosis for this because obviously, the fracture is there and it is serious. Probably, blood samples could be taken for analysis if there is the probable cause of infection then the patient need to be rushed to the emergency room for bone surgery. Rehabilitation or rehab is required.
Because open fractures seemed to be the severe forms of bone fractures, the causes of these are also extreme. The common causes are direct blows, vehicular accidents, sports related accidents and falling from certain heights. It can also be caused by indirect blows such as the person hitting his limbs hard on a solid surface. For closed fractures, the same thing can happen but the severity of the blows or impacts is lesser. On the other hand, the overuse of legs, limbs, or fingers can also cause closed fractures on the bones.
Open and Closed Fractures Symptoms
Closed fractures symptoms can range from minor pain to severe physical manifestations but always included any of the following:
• Swelling or deformity of the injured body part
• Bruising or discoloration of the skin from redness to bluish skin
• Tingling sensations to numbness
• Soreness and feeling of weakness such as with stress or hairline fracture
• Extreme pain for severely displaced fracture
• Fever after few hours of uncontrolled swelling
For open fractures, the symptoms are pretty obvious.
• A piece of bone is piercing through the skin
• Lacerations of the skin
• Minor to extreme bleeding depending on the size of the wound.
Open and Closed Bone Fracture Treatment
Treatment for close fractures usually involved splint for minor fractures but for incomplete fracture where the bone is still in placed without fragments, the bone could be placed in a cast to immobilize it. Severed and splintered bones are set back into place through surgery and metal wires are used to reattach them. Two methods can be used in this process. The first method is internal fixation wherein wires, pins, rods, or plates could be used internally to reattach the bones. The second method is external fixation and it is the setting of the bones with metal wires but there would also be the use of rings and bars on the outside of the skin so that bones could be adjusted properly while healing. Physical therapy with muscle conditioning will be part of the treatment.
For open fractures, the wound would be cleaned and disinfected first then followed by surgery to clean away dead tissues and small bone fragments. Bigger bones will be reattached again using screws, rods, metal plates, and pins. Internal and external fixation could also be applied depending on the severity of the fracture. The fractured limb could be placed on a cast or sling to immobilize it after the operation. It would take 7 to 8 weeks before the cast can be removed. Physical therapy will follow to strengthen the muscles again.
Healing of Closed and Open Fracture: Healing Time Or Recovery Time
It takes more than 8 weeks.
Prevention of Open and Closed Bone Injury
Open and closed bone injuries are usually the result of any trauma that has direct or indirect effect on the bone. For causes of closed fractures such as falls from heights, vehicular accidents, and sports related activities, when the impact can be most severe these can also cause open fractures. The best prevention however is to avoid doing dangerous activities that can harm your body. However, we can never tell people what not to do or do so the best option is to remind them to protect their bodies by wearing protective gears which include padding, helmet, braces and anything that can soften any hard impact to their bones.
When to Call A Doctor
We need to call medical help immediately for cases of open fractures because infection and shock can set in quickly. For closed fractures, when symptoms are clearly seen, call medical help as well, because we can never tell whether the fracture inside could be severe or not.