What Do We Mean By Closed Fracture & What is its Treatment, Recovery Period?

A fracture or break in the bone can also occur due to a high impact injury resulting in the bone to break. The sheer impact of force weakens the bone to the extent that it breaks. There are basically two types of fracture one is a closed fracture and the other is an open fracture. In open fractures, the broken bone penetrates through the skin and come out, being visible and requires immediate treatment for fear of infection and other debris contaminating the injured area. Let us look at closed fractures, their causes, symptoms and treatment in detail.

A closed fracture occurs when a bone which is broken does not penetrate the skin and does not come out, but may have soft tissue injury of the surrounding structures. A closed fracture usually presents with immediate swelling and pain with difficulty moving the injured area but will not have any open wound which is not the case with open fractures. A closed fracture does not always require surgical treatment and the bone is allowed to heal with just immobilization of the injured area.

Some of the commonest causes of a closed fracture are:

• Unexpected falls
• Direct blow to the bone
• High impact automobile accidents
• Gunshot wounds to the bone
• Sporting injuries, especially while playing contact sports like football or rugby

A closed fracture can occur in any person but individual bone health also determines the susceptibility or risk factor for fractures. If the overall health of a person or the bone health is not good the risk of a closed fractures is higher. This is more common in the elderly, people with bone disorders or aging women.

Some of the medical conditions that may predispose an individual to frequent Closed Fractures are:

• Osteoporosis
• Advancing age
• Disorders of the endocrine and gastrointestinal systems
• Prolonged use of steroids
• Prolonged inactivity, which may be due to any illness or during the time recuperating from any other injury
• Smoking and alcohol use also make the bones weak

The classic symptoms of a closed fracture are intense pain and immediate swelling around the injured site. Severe pain that worsens with touch and inability to move the injured part are the immediate symptoms of a closed fracture. In some cases, the pain is so intense that a person may even lose consciousness.

Some of the other symptoms of a closed fracture are:

• A snapping sound at the time of the injury
• Swelling, erythema, and bruising around the injured area
• Visible deformity around the affected area

A closed fracture can be diagnosed with a routine physical examination and the symptoms of the person. Immediately after the injury when the individual presents to the emergency room, the treating physician will begin by taking a history about how the injury occurred and try to gauge the impact of the injury. It helps to make a diagnosis of a closed fracture.

The physician will inspect the injured area and look for any signs of visible deformity, erythema, and swelling. The physician will try to move the area to see if the patient experiences any pain. If a closed fracture is suspected, the physician will order radiological studies like an x-ray of the injured area to confirm the diagnosis of a closed fracture. An X-ray normally clearly shows a break in bone or a closed fracture. In cases if a closed fracture is not visible on X-ray then more advanced studies like CT scan or an MRI may be performed to pinpoint the area for diagnosis of closed fracture.

Treatment of a closed fracture is aimed at putting the bone back into its normal place, aligning it correctly, and allowing it to heal. It is extremely vital in treatment of closed fractures that the affected area be immobilized, to allow the fracture to heal and avoid any displacement of the bone from its normal position which may complicate the situation further. During the healing phase, new bone is formed around the edges of the broken pieces and connects them. It is a crucial part of the treatment of a closed fracture and can be done through a cast, sling, brace, or traction up till the time the bone is fully healed. During the healing phase, the patient is often given pain medications to control pain after a closed fracture.

The recovery time for a closed fracture depends on the severity and location of the fracture. Normally, it takes four to six weeks for a closed fracture to heal but in some cases the healing may be delayed and it may take even a few months to completely recover from a closed fracture.

Presence of other underlying medical condition also affects the healing rate of a closed fracture. If a person is a smoker and does not stop smoking after the fracture it may affect healing and the recovery time for a closed fracture may be longer in such cases. It should also be noted that once a fracture has healed, due to prolonged immobilization the muscles become stiff and hence physical therapy is necessary to get the muscles back into shape so that the individual can return to activities post a closed fracture. Apart from the individual health, physical therapy and rehabilitation influences the recovery from a closed fracture. The physical therapy may begin with slight stretching exercises followed by strengthening and range of motion exercises. Once the person is able to do all the exercises pain free and fairly recovered from the closed fracture then they are gradually allowed to go back to normal activities, while some exercises may continue for strengthening.

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