Occasionally people have fractures (bone breaks) that require surgery. Breaks like this include those that cannot be controlled by a cast, or immobilization, those that have the bone fragments in a position that does not give good function, or those that break the skin.
When Dr. Goodman performs surgery on this, he spends time before mapping out the best way to put together the bone fragments and fix them. This often requires ORIF – Open Reduction and Internal Fixation, namely opening up the skin to get the bones in good alignment and fixing them inside, usually with a plate and screws or with a nail on the inside (hollow part) of the bone with screws. Dr. Goodman has experience in these techniques and will choose the one most suited to you and your fracture.
Before surgery, you will have a medical evaluation by your family doctor. You will also be seen by an anesthesiologist at the hospital, who will decide the best form of anesthesia for you. A nerve block is often used – a technique that make all of the sensation in your arm go away for 12-24 hours, without general anesthesia. After surgery, your pain will be controlled by intravenous as well as oral medications. As the fracture is in your leg, walking will be more difficult. You may need a cast, crutches or a walker after surgery. Your stay in the hospital will most likely be 1-3 days and will involve physical therapy, a pain management team, and a social worker visit to evaluate whether you need to go to rehabilitation after discharge.
You will see Dr. Goodman two weeks after surgery and then have regularly scheduled appointments to follow up with examinations and X-rays. You will also need physical therapy, often over the course of months, in order to increase your motion and your strength. Recovery is very personalized based on the type of fractures, but most patients return to normal within 3-6 months
Any surgery does pose some risk, and fracture surgery is no exception. The risks of this surgery include bleeding (often requiring transfusion), infection (possibly even requiring multiple surgeries to replace the metal), deep vein thrombosis (blood clots), incomplete relief of pain, need for further surgery, less motion (stiffness). Special risks for fracture surgery include malunion – improper alignment, and nonunion – the bones not healing together. Preoperative sickness (such as diabetes, kidney disease or decreased blood flow) raises the chances of complications. Smoking is one of the biggest reasons for problems after surgery, and increases the possibility of bone and tissues not healing appropriately.
Your decision for surgery is based on many factors, and by putting the bones in the right place and fixing them as they heal, you have the best chance of getting rid of the pain and restoring function. Dr. Goodman is committed to getting you the best result possible, and looks forward to partnering with you to achieve these goals.
For more information on broken bones: Patient Information about Broken Bones