Breaking a bone is a serious and scary situation that can happen to anyone in a number of different ways. The most common way a bone breaks is through a traumatic event like a car accident, a fall, or a sports-related injury; however, a broken bone can even occur through improper overuse. Those diagnosed with Osteoporosis are much more likely to find themselves with a fracture because the ailment itself leads to weakened bones, making them more likely to break.

Bone breaks are categorized into different types of fractures. The most common types are stable fractures, open compound fractures, transverse fractures, oblique fractures, and comminuted fractures. These types of fractures range in severity from a simple bone displacement to a fracture involving the bone breaking through the skin.

Once a doctor diagnoses what kind of fracture you have, they can develop a treatment plan. For some breaks, your doctor might elect to treat it with a cast, sling, or boot; for a more severe break, the patient may require surgery. Treatment options depend on where the fracture is located, the patient's age and health, and the break's severity. 

Dr. Michael Hawks, a board-certified orthopedic surgeon specializing in Orthopaedic Trauma and Fracture Care, held an open Q&A segment with our followers on Instagram to answer some of the most common questions about fractures. Keep reading to get a first-hand account of treatment options, their differences, recovery success rates, and more.

What is the most painful fracture?

Dr Hawks: I might not be an expert on this topic since —fun fact — I’ve never broken a bone myself! But after treating tens of thousands of injured patients over the years, I’d probably guess that the top three would be fractures of the ribs, hips, and spine.

That said, any broken bone hurts, and not a week goes by that I don't hear, “Doc, this is the worst pain I’ve ever felt, and I’ve had ‘insert any other painful condition here!’”

What are some signs of a definite fracture vs. a bruise or sprain?

Dr. Hawks: Sometimes, it’s very difficult to distinguish between a soft tissue injury, bruise or sprain, and a true fracture without taking x-rays and/or other imaging. Both types of injuries occur after similar mechanisms, like twisting your ankle or bracing a fall with your hand. If you suspect you have had a serious enough injury to possibly have caused a broken bone, an x-ray of the area will help lead to the proper diagnosis and guide treatment.

If a bone breaks, do I have to get surgery?

Dr. Hawks: Great question! Actually, many broken bones can heal properly without surgery. How a break is treated depends on the location of the break -involvement of a moving joint usually requires surgery- the distance it’s moved, and the age of the patient - most fractures in kids can be treated with casts/splints- and other factors.

If a bone heals in a cast, will it break again more easily? Would surgery prevent this?

Dr. Hawks: Whether an injury is treated with casting or surgery, the goal is for complete healing and return to full function. Sometimes your doctor may need to perform surgery to realign fractures that would be unstable with casting alone or are too displaced to imagine casting would work. But to answer your question, we would not expect a bone to break more easily if treated to complete healing in a cast.

Is a boot the same as a cast?

Dr. Hawks: If your doctor has recommended a cast, he or she believes that completely immobilizing the break will lead to better results. A boot is used when less protection is needed and when some time out of the boot to work on your flexibility is desired.

Knee pain can be all-consuming and a detriment to your day-to-day life. Whether it’s soreness at the end of the day, difficulty performing everyday tasks, or pain when exercising, no one should have to constantly battle knee pain. 

If you’re suffering from consistent knee pain, and non-operative methods have been ineffective, a partial knee replacement could help get you moving comfortably again. In order to better understand if a partial knee replacement is right for you, we must first understand what a partial knee replacement is, as well as the symptoms that might cause someone to need a partial knee replacement.

What is a partial knee replacement? 

A partial knee replacement is a surgical procedure for individuals with damage to their knees that cause them to suffer from pain and a loss of mobility. During a partial knee replacement, the surgeon will remove the damaged parts of the joint, usually localized to one of the three compartments of the joint.  It will then be replaced with a plastic, ceramic, or metal piece. These implants will work together with the original healthy parts of the joint to provide pain-free joint use and increase mobility. 

A successful partial knee replacement will be mostly healed in 4-12 weeks, though getting the full benefit from the surgery can take up to one year. After 4-12 weeks, the patient can get back to the regular activities and sports they enjoyed prior to the surgery. Perhaps more importantly, over 90% of partial knee replacements provide full mobility and comfort for more than a decade. 

Partial knee replacement vs. total knee replacement 

The decision between a partial knee replacement or a total knee replacement is a big choice. You should consult with your surgeon and see which procedure is the best option for you, but first let’s get a better understanding of the differences and similarities between the two. 

As we discussed above, in a partial knee replacement, the surgeon will remove the most damaged sections of the joint and replace them with artificial parts. The new artificial parts will work in combination with the healthy section of the original joint.

In contrast, a total knee replacement involves the surgeon removing the entire joint and replacing it with a metal, plastic, or ceramic joint. A total knee replacement has a longer recovery time since it is more invasive than a partial knee replacement. 

Signs you might need a partial or total knee replacement

You might be a candidate for a partial knee replacement if you’ve been experiencing any of these symptoms, or suffer from pain associated with knee arthritis:

• Consistent pain in the knee
• Stiffness and swelling around the joint
• Decrease in mobility
• Difficulty completing everyday tasks because of pain
• Trouble sleeping due to pain
• Non-operative treatment methods are or are becoming ineffective 

If you have been diagnosed with knee arthritis, such as osteoarthritis, rheumatoid arthritis, or psoriasis, you are more likely to wear down healthy cartilage in the knees, which leads to rapid deterioration of the joint. Because of the nature of these ailments, people with knee arthritis are more likely to need some sort of operative knee surgery during the course of their lives.

How long does a partial knee replacement last?

Partial knee replacements have a lifetime similar to the rates of those who undergo total knee replacements. 92.9% of partial knee replacements still function well after ten years, and 87.8% of replacements last 15 years, according to a study done in 2020. The lifespan of these artificial joints is dependent on the type of usage, age, and health of the patient. An artificial joint in someone who frequently participates in high-impact sports might have a shorter lifetime than someone who doesn’t. 97% of patients said they were pleased with their partial knee replacement outcome. 

What happens during partial knee replacement surgery?

Before a partial knee replacement, the surgeon and their team will review your medical history and most recent X-rays to determine an appropriate plan and decide which types of artificial pieces they will use. Once in the operating room, the surgical team will locate the damaged cartilage and bone, remove it, and replace it with the artificial pieces. The procedure usually takes between 45 minutes to an hour to complete. Afterward, you can expect to be leave the facility the same day or the next day. The staff will check your progress and develop a post-operative plan, including physical therapy.

Aches and pains may become a prevalent part of your daily life as you get older, but it doesn’t always mean it’s normal. Athletes may also shake off injuries that they attribute to typical training aches and pains when they require attention. The truth is it can be difficult to know for sure if you’re okay or if you’re in need of a doctor. 

Athletes or those who suffer from chronic injuries may be more familiar with when an injury is worthy of a visit to an orthopaedic doctor, or if your family practice will suffice. An orthopaedic doctor specializes in the health of your bones and joints, and the doctor you are used to visiting for a cold may not be as qualified to diagnose your condition. 

The primary care physician is likely your first stop, but if you want to bypass that step and save yourself a copay, there are some signs that signal a trip to the orthopaedic doctor will be necessary. 

Persistent Soft Tissue Injury 

A soft tissue injury, such as a sprained ankle, twisted knee or sore wrist should be treated immediately using the RICE method - rest, ice, compression and elevation. If after 48 hours, pain persists and swelling is still visible, set up an appointment with an orthopaedic doctor. 

Chronic Joint Pain

Consistent pain in the joints or bones, specifically the neck, back, elbows or knees, can mean a serious orthopaedic issue. You may be suffering from osteoarthritis or an inflammatory disorder. An orthopaedic doctor will be able to understand your symptoms and provide an accurate diagnosis so you can be on your way to relief. 

Decreased Range of Motion

Your joints allow you to move your limbs freely and with ease, so when these motions become difficult, it’s a sign something is wrong. Decreased range of motion can signify arthritis, another joint disease or a joint injury. If it continues to persist, it’s likely it won’t go away on its own and you’ll need to see a doctor. Left untreated, this type of injury can get worse or cause other issues. 

Everyday Tasks Are Affected 

Common run-of-the-mill joint pain can be normal, but not so normal that it’s affecting your daily tasks. Regular activities such as walking short distances, climbing stairs, getting in and out of bed, brushing your teeth - these should all be done without any pain. The same lingering pain sticking around while you perform a certain task can mean a more serious injury than you may have thought. 

Tingling in Hands or Fingers 

A numbness in your hands or your thumb, pointer or middle fingers, or a tingling sensation, can mean you’re dealing with carpal tunnel syndrome. Dropping things often can also be a telling sign. Carpal tunnel syndrome affects the nerve that runs through your wrist to your forearm and allows your four fingers to feel, except for your pinky. There are many factors that can result in this condition, but mostly include flexing the wrist repeatedly over longer periods of time.

Your Orthopaedic Doctor Visit

You’ll discuss your pain and discomfort with your orthopaedic doctor and they will proceed to examine whatever is ailing you. They will be looking at your range of motion, strength and that everything is functioning normally. If more information is needed, the doctor may order more tests to further diagnose your condition or injury, like an x-ray or MRI.

After your doctor has learned more about your injury or condition, and has evaluated the findings of any tests, they will work with you to determine the best course of action when it comes to a treatment program. Often, you'll be able to treat your injury with nonoperative methods such as rest, medication, injections or a physical therapy and rehabilitation program. Your doctor will work with you to optimize your strength and flexibility, and put together a program that may combine several treatment methods to have you feeling back to normal.

Orthopaedic Care in Urgent Care Centers Walk-In Clinics

When you’re dealing with pain, you may not find it severe enough to visit the emergency room, but relief still can’t come soon enough. Rothman Orthopaedics Center City Walk-In Clinic offers medical care specifically for patients ages 16 years and older with non-life threatening orthopaedic injuries. Unlike emergency rooms or urgent cares that treat a broad range of urgent health problems, Rothman Orthopaedics walk-in clinic will focus on treating acute orthopaedic issues including sprains, strains, fractures and tears.