Basic principles of Management of Fractures

The goal of management of fracture is to restore function and structure of the affected part without any cosmetic problems. Management of fractures is carried out according to 3 major basic principles. 

1. reduction (R)
2. Immobilization (I)
3. Rehabilitation (R)

Reduction

Reduction of a fracture restores the distal part of the fracture segment to its normal position. The fractured segment can be displaced or angulated. To achieve this traction is applied along the long axis of the bone and the mechanism of fracture is reversed to put the fractured segment beck in to its normal position. Reduction be achieved either by open method or closed method.The patient is anaesthetised before the procedure because it can be very painful.

Immobilization

Immobilization is achieved by several methods. The appropriate method for a particular person is decided according to the nature of the fracture he or she is having. The following methods are used to immobilize the affected part. They are,

1. Splinting
2. Casting
3. Traction
4. Internal fixation
5. External fixation 

Splinting and casting are applied by using plaster of paris (POP). Splints are also called back slabs. All 5 methods help to keep the fractured segments approximated so they can heal fast. Even though, internal fixation allows early mobility, it does not accelerate the rate of healing process. 

External fixation is applied for compound fractures where internal fixation can not be achieved due to high risk of infection. In such situations the soft tissues should first be healed.