Treatment, Surgery And Rehabilitation Of Complex Fractures

Complex fractures are breaks to the bones that are more severe than the majority of injuries normally treated by an orthopedic surgeon. Complex fractures most often occur in aging adults and athletes. Due to the challenging and intense treatment normally required for these patients, complex fractures of any kind should only be treated by an orthopedic surgeon who is highly experienced in this area of orthopedic.

Complex fractures frequently occur in the wrist, spine, ankle, leg, pelvis or hip. Of these, the majority of fractures occur to the wrist with women aged 60 and older being at the greatest risk of receiving a complex fracture to this area. The degree of injury is usually proportional to the impact that caused the fracture, regardless of the area that sustains the fracture. However, the elderly are at a greater risk because of an increase in the number of falls they take and osteoporosis which makes bones more fragile. Due to the irregularity of complex fractures, individual assessment and treatment should be provided on a case by case basis. There are a variety of types of complex fractures as well as a number of methods used to treat them. The different ways that complex breaks occur are:

• The bones are broken into multiple pieces

• Damage to the surrounding soft tissue is severe

• Trauma results in the loss of bone

• Severe injury to the cartilage in a joint

• Multiple fractures in different levels of one bone

• An associated joint is dislocated

Common Causes of Complex Fractures

While athletes and aging adults are at the highest risk for complex fractures, they can occur to individuals of any age. Automobile accidents, falls and sports-related injuries result in severe injuries that require immediate intense treatment. In addition to the treatment of an experienced orthopedic surgeon, the individual may also be treated by other specialists for comprehensive treatment to the affected area.


For complex open fractures in which the skin is broken from the bone, diagnosis is usually easy. The surgeon will typically perform a physical examination, take a medical history and use X-rays or MRI to evaluate the type and severity of the fracture.


An orthopedic surgeon may use casting or pinning to treat a complex fracture or open surgery with plates and screws to secure the bone may be required. Sometimes fusion is used to secure two bones together. Both internal and external devices may be used to secure the broken bone in place. Since fractures occur in a number of patterns, choosing the best method of treatment is done according to the individual injury. The goal of the surgeon is to promote healing, restore anatomic alignment and prevent complications from occurring later on. For athletes, their future careers will depend on the ability of the orthopedic surgeon to repair the bone and related damage to the surrounding area.


The period of rehabilitation depends on the injury and the type of treatment used. Following surgery, the patient can expect to be restricted from putting weight on the broken bone for up to 8 weeks. The orthopedic surgeon will determine the rate at which the patient should add weight to the affected area, what type of therapy may be required, and when normal activities can be resumed.