An incision is made over or near the fracture site. The broken bone fragments are carefully realigned (reduced) and held in position with metal implants. The type of fixation depends on the fracture location and pattern: plates and screws for joint fractures, intramedullary nails for long bone shaft fractures, or wires and pins for smaller bones. The wound is closed and a splint, cast, or dressing is applied. The operation duration varies depending on the fracture complexity.
Surgery is recommended when a fracture is displaced, unstable, involves a joint surface, or cannot be managed satisfactorily with a plaster cast. The goal is to restore the bone to its normal alignment and allow earlier, safer rehabilitation.
Many fractures heal well with plaster casts, splints, or functional bracing. Your surgeon will advise whether surgery is necessary based on the fracture type, displacement, stability, and your individual circumstances.
Fracture fixation may be performed as an emergency or planned within days of the injury, depending on the urgency. Standard pre-operative fasting and assessment are required.
The aim is to restore bone alignment, promote healing, reduce pain, and allow earlier movement and rehabilitation. Most fractures heal within six to twelve weeks after fixation. The metalwork may be left permanently or removed once the fracture has healed.
StiffnessCommon
Joints near the fracture may become stiff. Early movement and physiotherapy help.
Pain and swellingExpected
Expected around the fracture site for several weeks.
Prominent metalworkCommon
Plates and screws may be felt under the skin, particularly in areas with little soft tissue cover.
InfectionUncommon
Wound or deep infection around the metalwork. Risk varies by fracture location and severity.
Non-unionUncommon
The fracture may fail to heal. Smoking significantly increases this risk.
MalunionUncommon
The fracture may heal in a suboptimal position.
Hardware failureUncommon
Plates or screws may break, particularly if the bone is slow to heal.
Nerve or vessel injuryRare
Structures near the fracture may be damaged during surgery.
Compartment syndromeRare
A rare but serious condition where pressure builds within the muscles. Requires emergency surgery.
Blood clotsUncommon
DVT or pulmonary embolism, particularly with lower limb fractures.
General or regional anaesthesia depending on the fracture location and patient factors.
Recovery depends on the fracture type and location. Physiotherapy is usually essential. Your surgeon will advise on weight-bearing restrictions, return to activities, and the timeline for healing.
Regular follow-up with X-rays to monitor fracture healing. Timing depends on the fracture type.
Will the metalwork need to be removed?
Not always. Metalwork is only removed if it causes problems such as pain, prominence, or infection. In some locations (such as the ankle), removal is more commonly needed.
How long does a fracture take to heal?
Most fractures heal within six to twelve weeks. Factors affecting healing include fracture severity, location, blood supply, smoking, and overall health.
Why is smoking so harmful to fracture healing?
Nicotine reduces blood flow to bone and impairs the healing process. Smokers have significantly higher rates of non-union and delayed healing.