Refracture

Refracture

The doctor then speaks of a refracture when a broken bone has been diagnosed that was localized in the immediate area of ​​a former fracture line. Refractures mainly occur when the fracture healing is poor or not completed.

What is a refracture?

In the context of a refracture, a repeated fracture of a bone at or near the fracture site of a previous fracture, several factors must be considered. Thus, the physicians must determine whether the refracture occurred because the fracture did not heal completely or whether an inadequate trauma was sometimes the reason for a refracture. For meanings of circular hair loss, please visit bestitude.com.

If the patient has not completed the last phase of healing (modeling or remodeling phase) so that sufficient callus or bone replacement tissue has not yet formed in the fracture site, there is an automatically increased risk of a refracture. Therefore, if the patient puts pressure on the previously injured region too early, the fracture line can break again or the fracture can occur above or below the fracture line.

If the fracture healing is not complete, however, new fractures of the not yet fully healed fracture line are common. The doctor speaks of an inadequate trauma when the bone would not have withstood the previous load and the force.

Causes

Typical causes that sometimes trigger a refracture are loading too early after a fracture. Above all, if the last healing processes (sufficient callus formation) are not fully awaited and the injured region is loaded too early, the fracture site can break again. However, the premature removal of osteosynthesis materials can also lead to the bone not “holding” due to the lack of support.

This often results in re-fractures at or near the fracture line. Sometimes a disrupted fracture healing (e.g. in osteoporosis or osteogenesis imperfecta) can lead to refractures occurring, since the healing process is very slow or does not occur at all, so that subsequent surgical measures (osteosynthesis materials) have to be taken. Sometimes, however, the physician can also misjudge the healing of the fracture, so that a refracture occurs.

Symptoms, Ailments & Signs

As with all other fractures, the patient complains of increasing pain and restricted movement ; Swelling and bruising can be seen or can form as the disease progresses. Depending on the location, refractures cause the same symptoms and symptoms as corresponding fractures.

Diagnosis & course of disease

The doctor will first perform a clinical examination and then have an X-ray taken. The imaging procedure makes it possible to determine whether the fracture line has actually broken again or whether a fracture has occurred above or below the fracture line.

Especially when the X-rays of the old fracture are superimposed on the new ones, the doctor can immediately see whether there is a refracture or not. The course of the disease and prognosis vary and are also related to the cause of the refracture. If too early or too much stress was responsible for breaking the fracture line again, care must be taken after the refracture that the healing process is actually endured patiently.

However, if the doctor diagnoses any causes that could impair the fracture (e.g. osteoporosis, osteogenesis imperfecta, etc.) or if the fracture is so serious that “normal healing” does not bring the desired success, bone-supporting materials must be used. These ensure that the bone is supported and stabilized.

As a rule, the materials are removed over time; However, if they were used surgically to support bones in the course of fracture healing disorders, they usually remain in the bone – provided they do not cause any problems – and are not surgically removed again.

Complications

The symptoms and complications of a refracture are usually very similar to the symptoms of an ordinary fracture. Those affected primarily suffer from very severe pain. The pain often spreads to neighboring areas of the body and can lead to insomnia and irritability, especially at night.

Depression or psychological complaints can also set in as a result of the refracture. Furthermore, many suffer from swelling or bruising. As a rule, a broken bone also significantly restricts the patient’s movement, resulting in various restrictions and complaints in everyday life. If the refracture is not treated, in the worst case the bones can grow together incorrectly or become inflamed.

In the worst case, the patient can die of blood poisoning. In most cases, the refracture is treated without complications by resting the affected region. The broken bone usually heals after a few weeks. In some cases, however, patients are dependent on various therapies to restore the movement of the joints. The life expectancy of the patient is usually not negatively affected by the refracture.

When should you go to the doctor?

A refracture must always be treated by a doctor. Self-healing is not possible with this disease, so that the affected person is always dependent on medical treatment. Only medical treatment can completely heal the refracture. A doctor should be consulted if the affected person still suffers from severe pain or restricted movement after the fracture has healed.

This can also lead to effusions or severe swelling in the respective area, so that the patient also suffers from a significantly reduced quality of life. Movements are significantly restricted and the affected person is usually dependent on the help of other people in their everyday life. If these symptoms occur and persist for a longer period of time, a doctor must be consulted in any case. As a rule, the refracture is treated by an orthopedist or a trauma surgeon.

Treatment & Therapy

The treatment of a refracture is based on the fracture that has already occurred. If, for example, the cause was a load that was too early, the fracture site is immobilized again or a plaster cast is applied. However, the doctor must subsequently inform the patient again before the healing process begins, so that any refractures can be prevented.

However, if the doctor finds that there was a healing disorder, which is sometimes due to the fact that the patient is suffering from a bone disease, other methods than those used for the first fracture must be chosen so that the healing brings the desired success. In this way, bone-stabilizing materials can be surgically incorporated into the bone.

The bone can be supported in its healing process by means of marrow nails or plates and, on the other hand, stabilized in such a way that refractures can be virtually ruled out. Since the treatment of refractures is usually based on the first fracture line that has already occurred, there are individual therapies and treatment options.

It is important that – so that the muscles are strengthened again after the rest phase – the patient takes physiotherapeutic measures. Physiotherapy can also prevent refractures, since the muscles are subsequently strengthened.

Prevention

If there are no fracture healing disorders caused by underlying diseases, refractures should usually be prevented. Since many refractures occur as a result of loading too early, re-fracture can be prevented if the patient has enough patience and allows the patient to fully heal. Sometimes physiotherapeutic measures can also help; the muscles are strengthened by the exercises, so that further fractures near the fracture line can be almost completely ruled out.

Aftercare

Follow-up care for a refracture can be longer-term than follow-up care for a normal fracture. The cause of the refracture is particularly important here. A differentiation must be made as to whether the refracture is caused by loading the bone too early or insufficient stabilization, or whether the refracture may be due to other diseases that also need to be treated here in order to achieve complete healing of the bone fracture.

In many cases, this can be osteoporosis, for example, which would have to be treated with appropriate medication by a specialist doctor. Depending on the cause, practical aftercare is primarily designed to control and ensure the healing process of the refracture. An orthopedist checks the condition of the refracture at appropriate time intervals using X-rays.

Overall, a longer healing and aftercare phase can be assumed than in the case of a single fracture, even if the forms of therapy do not differ. In some cases, however, surgical intervention may have been necessary in the acute treatment of the refracture; the healing of the surgical wound must also be taken into account in the follow-up care. It is also important for the patient to be informed and instructed on how to behave in order to avoid further complications during the healing of the fracture, such as loading too early.

You can do that yourself

If a new fracture occurs in the area of ​​an older fracture, there can be several reasons. It is important for patients to know these reasons in order to avoid complications or even another fracture.

For example, if too early loading of the old fracture was the reason for the new fracture, it is important that the patient allows this new fracture to heal more carefully. It is also possible that the doctor misjudged the healing of the fracture or the osteosynthesis material was removed too early. In these cases, it might be advisable to change doctors or get a second opinion.

If the refracture is due to impaired wound healing, undetected diseases could be behind it. In this case, a discussion with your family doctor is recommended. Osteoporosis or other bone diseases can also be to blame for the refracture. These diseases must be recognized and treated. For the refracture, they usually mean that materials are introduced that are intended to permanently support the bone in the future.

Cooling helps against the pain and swelling commonly associated with broken bones. The patients provide the relevant areas with either cooling pads (cold/warm compresses) or make cold wraps, for example with quark. If the cooling pads have been stored in the freezer, they must not be placed directly on the skin, otherwise cold burns may occur.

Refracture