What are Complex Fractures?

Complex fractures occur when bones break into several small pieces and the surrounding tissue is severely damaged. They are characterized by intense pain, trauma and possible displacement of bones and adjacent tissues. Complex fractures can occur due to many reasons such as fall from a height and motor vehicle accidents. When a person is suffering from other diseases or injury, it further complicates the fracture and can make treatment and recovery more difficult.

What are the Different Types of Complex Fractures?

The different types of complex fractures include:

  • Open fractures- fractures with complicated wounds
  • Closed fractures- internal fractures with numerous breaks in the bone
  • Pelvic/acetabular fractures- breaks in the acetabulum, strong bony connection between the base of your spine and hips
  • Ankle fractures

What are the Symptoms of Complex Fractures?

The signs and symptoms of complex fractures may include:

  • Intense pain
  • Injury to surrounding tissues
  • Loss of sensation in or near the fractured bone
  • Loss of movement
  • Bleeding
  • Dislocation/displacement of the broken bones or tissues

Diagnosis of Complex Fractures

You will need to be seen at the emergency department for a complex fracture. Your doctor will diagnose you based on your symptoms and order imaging tests such as X-ray and computerized tomography (CT) scans to determine the severity of the fracture and to develop a suitable treatment plan for you.

Treatment of Complex Fractures

Treatment of complex fractures depend on the person’s age, health conditions and the severity of trauma.The primary purpose of complex fracture treatment is to stabilize the fracture and provide pain relief. Treatment may be surgical or non-surgical.

Non-surgical treatment of complex fractures includes:

  • Application of ice packs
  • Promoting blood flow to the arms and legs by positioning the patient appropriately
  • Providing support through slings, braces and pelvic binders

A pelvic binder is a wrap that is placed around the top of your thighs and buttocks to prevent internal bleeding during a pelvic fracture. It should be removed within 24 hours after application to prevent development of pressure sores.

Surgical Treatment of Complex Fractures

An orthopedic surgeon performs fracture surgery to treat the fracture and associated wounds.

  • You will lie on your side or back during the procedure and administered a general or local anesthesia.
  • Your doctor makes a small incision at the site of the injury and removes the damaged tissue around the fractured bone. 
  • The broken bones may be fixed through any of the following approaches:
    • External fixation with the help of an external frame
    • Internal fixation with the help of screws, wires, rods or plates
  • Upon completion, your surgeon will close the incision.
  • Your wound will be covered using a temporary dressing to minimize infection and promote healing.

Usually a single operation is sufficient for repairing a complex fracture. However, rarely cases may require another operation, and your surgeon typically performs it within 72 hours.

Post-Operative Care for Complex Fractures

After your surgery, your doctor will recommend physical therapy to help with exercises to improve your joint movement and flexibility. You will also be given pain medication to provide pain relief and minimize inflammation. You should always follow your doctor’s instructions for the best outcome.