Closed Fracture: Treatment, Recovery Time, Causes, Symptoms

A fracture is a break of part of a bone anywhere in the body due to excessive stress being put on the bone.¹ A fracture 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.

A Closed Fracture occurs when a bone which is broken does not penetrate the skin and does not protrude out.² An individual with a closed fracture will have 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.

In open fractures, the broken bone penetrates through the skin and protrudes out and is visible which requires immediate treatment for fear of infection and other debris contaminating the injured area.

A closed fracture does not necessarily require surgical treatment and the bone is allowed to heal with just immobilization of the injured area. In some cases of closed fracture, surgery may be needed but it is never an emergency as is the case with open fractures and the procedure is performed some days after the injury. Closed Fracture may not penetrate the skin, but still they can inflict significant damage to the surrounding soft tissues and if such soft tissue injuries are significant then a surgical intervention may be needed.

Some of the 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.

Fracture can occur in any individual, but the bone health of an individual also determines the susceptibility of that individual for fractures. If the overall bone health of an individual is not good then the chances of that individual incurring a fracture even with a small event is more. This is more common in the elderly population or people with bone disorders. Some of the medical conditions that may predispose an individual to frequent closed fractures are:

• Osteoporosis.
• Advanced 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 presenting feature of a closed fracture is intense pain and immediate swelling around the injured site. The pain becomes worse with any touching of the area. The individual will not be able to move the injured area. In some cases of closed fracture, the pain is so intense that an individual 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 just by a routine physical examination and the symptoms that the patient experiences. Immediately after the injury when the individual presents to the emergency room, the treating physician will begin by taking a history as to how the injury occurred and try to gauge the impact of the injury. An inspection of the affected area will then be carried out to look for any signs of visible deformity, erythema, or swelling. A range of motion may also be performed to see if the patient can move the injured area and if so to what extent and whether there is any pain with doing it. Once a closed fracture is suspected, then radiological studies will be done in the form of an x-ray, which will clearly show a break in bone or a closed fracture. In cases if a Closed Fracture is not visible on x-ray then more advanced studies in the form of a CT scan or an MRI may be performed to pinpoint the area of the closed fracture.

Treatment of a closed fracture is aimed at putting the bone back into its normal place, align 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. The patient may be immobilized through a cast, sling, brace, or traction up till the time the bone is fully healed. During the healing phase, the patient will be 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 for the patient to completely recover from Closed Fractures. Presence of other underlying medical condition also affects the healing rate of a Closed Fracture. If the patient is a smoker and does not stop smoking after the fracture then that individual may have a prolonged recovery time post a Closed Fracture.

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. The physical therapy may begin with slight stretching exercises followed by strengthening and range of motion exercises and once the patient is able to do all the exercises pain free then he or she is gradually allowed to go back to normal activities after sustaining a Closed Fracture.

References:  

Also Read:

• Calcaneus Fracture or Broken Heel
• Closed Fracture of Toe Bones
• Closed Fracture of Finger Bones or Phalanges