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Treating The Complex Comminuted Foot Fracture

When you picture a broken bone, you likely imagine it snapping in one spot, which leaves a fracture between two bone segments. This makes sense, because this standard fracture is the most common type of break pattern, but it’s not the only way that a bone can break. During instances of intense trauma, you may actually suffer what’s known as a comminuted fracture, where the bone breaks into more than two segments. In today’s blog, we take a closer look at comminuted fractures, and we explain how Dr. McDonald can help you heal after the injury.

Understanding Comminuted Fractures

A comminuted fracture describes a bone that has broken in at least two different places. If we think of a standard fracture as a tree branch snapping in half, we can think of a comminuted fracture as what might happen if you drop a plate on the ground. The plate will likely break in in multiple locations, and as you can imagine, these types of fractures are much more complex in nature. They can occur in any bone, but they tend to be more common in your feet or in major bones like the femur, tibia and fibula.

It takes intense trauma for a bone to break in more than one location, which is why there are two main causes of comminuted fractures – car accidents and falls from a great height. Both of these causes involve high-energy trauma to a specific area of your body. You may not know that you are specifically dealing with a comminuted fracture, but you will be in obvious pain following a high-energy collision, so it will be clear that medical care is necessary.

Diagnosing And Treating Comminuted Fractures

If you suspect that you are dealing with a broken bone or other internal injuries, you’ll want to head to the emergency room or seek similar medical care as soon as possible. While your doctor may ask you about your symptoms and conduct a short physical exam, comminuted fractures and other internal damage will be assessed with an imaging exam. An x-ray can help the doctor see what type of fracture pattern you are dealing with, but an MRI or CT scan will show how the surrounding soft tissues have been affected by the trauma, so your specific imaging test may vary.

When assessing the fracture pattern, your doctor will also review the images to see if you are dealing with a displaced or nondisplaced comminuted fracture. A non-displaced fracture is one where the broken bones have not shifted too far away from one another, meaning they will likely be able to fuse back together on their own over time. A displaced fracture means that a gap now exists between the bone segments, and it’s unlikely that they will fuse back together without surgical intervention. Given the fact that comminuted fractures involve multiple breaks, these fractures are more likely to be displaced, although it’s not a guarantee.

In most instances, a comminuted fracture will require surgery to address. During the operation, your surgeon will work to reposition the bones so that they can fuse back together on their own. They will likely need to use internal fixation hardware to help secure the bones in the right location, meaning rods, screws and plates may need to be temporarily or permanently inserted. Depending on your situation, a bone graft may also be used to ensure that the broken bones are more likely to fuse back together correctly. The bone graft may be taken from another area of your body, like your hip, it may be harvested from another source, or an artificial bone graft may be used.

Following your operation, you will need to keep the area immobilized to ensure that healing can run its course. Your foot, ankle or leg will likely be placed in a hard cast to protect it and limit stress on the area, which you’ll wear for a number of weeks. Eventually you will transition to a soft cast or a walking boot before pursuing limited weight bearing and physical therapy exercises to strengthen the muscles that have weakened as a result of limited function during recovery. Full recovery can take anywhere from 6-12 months depending on the specific nature of your fracture.

Hopefully you never have to experience one of these complex foot fractures, but know that Dr. McDonald and his team are here to help in the event that you need care. For more information about comminuted fractures or treating more common foot and ankle injuries, reach out to Dr. McDonald’s office today at (860) 244-8889.

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