Signs and Symptoms
Signs of a fracture include:
- Pain at a specific spot that gets worse with movement or pressure
- Swelling and bruising
- Trouble bearing weight or using the arm or hand
- A limb that looks bent, shortened or out of place
- A grinding or snapping feeling at the time of injury
Some fractures, such as stress fractures and small breaks in the wrist or foot, cause milder pain and can be mistaken for a sprain.
What Causes It?
Fractures happen when more force is placed on a bone than it can handle. Common causes include falls, sports injuries, car crashes and work injuries. Stress fractures come from repeated impact over time, such as running. In people with osteoporosis, bones can break from a simple fall from standing height, which is called a fragility fracture.
How We Diagnose It at POPB
Your physician examines the injured area, checks circulation and nerve function, and orders X-rays, which are available in our office. If a fracture is suspected but not seen on X-ray, or more detail is needed, MRI or diagnostic ultrasound can be done on site. Fractures of the hand and wrist, such as distal radius (wrist) and scaphoid fractures, are usually seen by Dr. Tucker.
If a fragility fracture is found, we also look at bone health and fall risk to help prevent the next one.
Dr. Adelman also evaluates and treats many sports-related fractures without surgery.
Non-Surgical Treatment Options
Many fractures heal without surgery when the bone pieces are well aligned and stable. Treatment may include:
- A cast, splint, walking boot or brace to hold the bone still while it heals
- Closed reduction, where the physician gently moves the bone back into position without an incision
- Pain control, elevation and ice in the first days
- Follow-up X-rays to confirm the bone stays in position
- Physical therapy or hand therapy in our office once healing allows, to restore motion and strength
Surgical Options
Surgery may be recommended when a fracture is displaced (pieces out of line), unstable, involves a joint surface, or does not heal as expected. Surgeons use plates, screws, pins or rods to hold the bone in place (open reduction and internal fixation). Our surgeons operate at hospitals and surgery centers across Palm Beach County, and your therapy after surgery continues in our office with therapists who share your chart.
Recovery
Most bones take about six to twelve weeks to heal, depending on the bone, the type of break, your age and your health. Smoking and diabetes can slow healing. Getting back full strength and motion often takes longer than bone healing itself, which is where therapy helps. Your physician will guide when you can return to work, driving and sports. Timelines vary.
Insurance and Cost
Fracture care, including X-rays, casting, surgery and therapy, is generally covered by Medicare and most commercial PPO plans. If your fracture happened at work, we accept workers' compensation and coordinate evaluation, treatment, return-to-work planning and documentation with your employer and carrier. HMO and managed-care plans require a referral before your visit. Our staff verify benefits when you call.
When to Be Seen
Call our office promptly if you have pain, swelling or bruising after an injury that is not improving, or if you suspect a broken bone in your hand, wrist, arm or leg.
Go to the emergency room or call 911 if a limb looks deformed, bone is visible through the skin, you cannot bear weight, the hand or foot beyond the injury is cold, pale or numb, or the injury involves the head, neck or back.
