Closed Fracture Treatments

A closed fracture is a broken bone that does not penetrate the skin. This is an important distinction because when a broken bone penetrates the skin (an open fracture) there is a need for urgent treatment, and an operation is often required to clean the area of the fracture. Furthermore, because of the risk of infection, there are more often problems associated with healing when a fracture is open to the skin.

Closed fractures may still require surgery for proper treatment, but most often this surgery is not as urgent and can be performed in the days or weeks following the injury. While a closed fracture does not penetrate the skin, there can still be severe soft-tissue injury associated with some closed fractures. The condition of soft-tissues can still alter treatment recommendations, as closed fractures with severe soft-tissue injury may indicate a need for surgical intervention.

x-ray of a closed fracture
Matt Meadows / Getty Images

Examples

Examples of the most common closed fractures include:

  • Broken Wrist: A wrist fracture is one of the most common type of fracture that requires medical treatment. Often closed wrist fractures can be treated with a cast to hold the healing bones in proper position. More severe wrist fractures may require surgery, even when the injury is closed. In these cases, pins, plates, and screws are commonly used for treatment.
  • Hip Fractures: A broken hip is a type of closed fracture that can be common in the elderly population. Almost always these are closed fractures, as open hip fractures are exceedingly rare injuries. Despite being a closed fracture, broken hips almost always require surgical treatment.
  • Ankle Fractures: A broken ankle can occur when the ankle joint is severely twisted in the bone is injured. Depending on the type and severity of the injury, surgery may be needed.
  • Spinal Compression Fracture: The spinal column is made of vertebrae stacked up upon each other. These vertebrae can be injured if the bones become thin from osteoporosis. Spinal compression fractures are most common in older individuals and often occur with relatively minor injuries or even no known injury at all. 

Closed fractures can occur from a variety of different problems. Most often, fractures occur is a result of an injury such as a fall, motor vehicle collision, or sports injury. However, fractures can also occur as a result of overuse. These types of fractures are called stress fractures and occur as a result of excessive, repetitive use of the bone. Lastly, fractures can also occur as a result of the weakening of the bone. These types of injuries are called pathologic fractures and typically result in a closed fracture pattern. Pathologic fractures occur when there is a weakening of the bone as a result of infection, tumors, or other medical conditions that can weaken the structure of the bone. Pathologic fractures sometimes occur with very low energy injuries.

Treatment

Fracture treatment is highly dependent on a number of different factors. Even in two situations of seemingly identical fracture patterns, treatment may differ based on factors such as patient age, patient preference, or surgeon preference. Treatments are not always the same, and often your orthopedic doctor will give you options about how to best manage your fracture. Some of the treatments used for closed fractures include:

No Immobilization: Not every fracture requires intervention. Some broken bones are stable injuries that can be managed without immobilization or other intervention. Sometimes a sling or walking boot may be enough, and other times some simple reassurance that healing will occur is fine.

Cast Immobilization: Casts are often used for the treatment of many types of fractures. Casts help to hold bones in proper alignment and protect the healing bone.

Internal Fixation: Internal fixation is used to realign broken bones, and then hold the healing bones in position with metal plates, pins, rods, or screws.

External Fixation: External fixation is a type of treatment that can hold bones securely without having to operate on the surrounding soft tissue. This treatment is often used when a soft-tissue injury makes surgery at the site of fracture unsafe.

A Word From Verywell

Many closed fractures can be treated with simple, nonsurgical treatments. However, when the bones are not sufficiently aligned, or if the fracture cannot be supported, a surgical procedure may be necessary to reposition and hold the bones in proper alignment. While a closed fracture may require urgent treatment in order to restore proper alignment and prevent further damage, it is uncommon to need for an emergency surgery as a result of a closed fracture, unlike with open fractures. Only in rare situations would emergency surgery be required for treatment of a closed fracture.

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