Bone Fractures Specialist

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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

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What are Fractures?

Fractures are a medical condition where there is a disruption in the structural integrity of bones. This disruption typically involves the breaking or cracking of bone tissues.

Fractures are not uniform and can be classified into different types, such as simple or closed fractures, where the bone remains beneath the skin, and compound or open fractures, which involve an open wound at the fracture site.

Causes of Fractures

Fractures result from a variety of causes, each linked to different mechanisms of injury.

  • Trauma
    This includes incidents such as car crashes, falls from heights, sports-related injuries, and physical altercations. The force exerted in these situations often exceeds the bone’s capacity to withstand stress, resulting in a break.
  • Osteoporosis
    This medical condition, characterised by weakened bones, heightens the risk of fractures. It is particularly notable in older adults. In severe cases, even minor falls or stresses can cause fractures.
  • Repetitive Stress
    Continuous or repetitive stress on a bone, often seen in athletes or individuals involved in high-impact activities, can lead to stress fractures. These are common in areas subjected to repeated strain, like the shins in runners.
  • Certain Pathological Conditions
    Underlying medical conditions such as bone tumours or infections can weaken bone structures, leading to a higher risk of fractures. These are termed pathological fractures.
  • Age-Related Degeneration
    As people age, their bones naturally lose density and strength. This makes them more susceptible to getting a fracture, even from minor incidents.

Symptoms and Signs

Fractures manifest through a range of symptoms, varying based on factors like the fracture’s type, location, and severity.


  • Pain: Often the most immediate indicator, pain at the fracture site can vary from mild to severe and typically worsens with movement or pressure.
  • Swelling: This is a natural response to injury, resulting from inflammation and the body’s healing processes. The extent of swelling can differ based on the severity of the fracture.
  • Bruising: Accompanying fractures, bruising or discolouration is a common sign.
  • Deformity: Visible misalignments or deformities of the affected bone can be observed, indicating a fracture.
  • Limited Range of Motion: Fractures can restrict normal movement in the affected joint or limb, primarily due to pain, swelling, or misalignment.
  • Tenderness and Numbness: The area around the fracture site might be tender to touch, and in severe cases, numbness or tingling sensations can occur.
  • Inability to Bear Weight: In weight-bearing bones like the leg or ankle, fractures might render the individual unable to put weight on the injured limb.
  • Crepitus: A grinding or crackling sensation, known as crepitus, may be felt when the ends of the broken bone rub against each other.

Diagnosis

The process of diagnosing a fracture involves a combination of clinical assessment and medical imaging.

  • Physical Examination: Diagnosis starts with a thorough examination of the affected area, assessing for signs such as deformity, tenderness, swelling, bruising, and functional loss.
  • Medical History and Injury Detail Review: Understanding the patient’s medical history and the circumstances surrounding the injury aids in evaluating the likelihood of a fracture.
  • Imaging Tests: X-rays can effectively depict the location and extent of the break, and are the primary imaging technique used to visualise fractures. In complex cases or where deeper structures may be affected, CT scans or MRI scans may be used for a more comprehensive view.

Non-Surgical Treatment Options

Non-surgical methods play a role in treating many fractures, focusing on stabilisation and pain management to facilitate healing.

Immobilisation

For a majority of fractures, the broken bone is immobilised to enable healing. This is achieved using casts, splints, or braces, depending on the fracture type and need for swelling accommodation.

Weight-Bearing Restrictions

Depending on the fracture type, patients may be guided to limit weight-bearing on the affected limb and use assistive devices like crutches or walkers.

Closed Reduction

For displaced fractures, where the bone ends are misaligned, closed reduction is performed. This non-surgical procedure realigns the bone manually without the need for surgery.

Orthopaedic Devices

In certain cases, devices such as external fixators or traction may be employed to stabilise fractures or correct deformities.

Pain Medication

Pain relief is an aspect of fracture treatment. Over-the-counter or prescription pain relievers are often recommended to manage discomfort.

Physical Therapy

Physical therapy can help regain strength, flexibility, and range of motion. Tailored exercises and rehabilitation programs aid in recovery.

Surgical Treatment Options

Surgical intervention is often required for complex, open, or particularly severe fractures. The surgical methods employed aim to realign, stabilise, and promote the healing of the broken bone.

Internal Fixation

Utilised for repositioning and securing fractured bones, this technique involves the insertion of metal screws, plates, rods, or pins to hold the bone fragments in place, facilitating proper healing.

External Fixation

In this method, surgeons insert screws into the bone on either side of the fracture and connect them to a brace or frame outside the body. This stabilises the fracture, allowing initial healing before potential further surgery.

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Prevention Strategies

Preventing fractures involves a combination of lifestyle adjustments, safety measures, and proactive health management.

  • Modifications at Home to Prevent Falls - Identifying and mitigating hazards in the home, especially for older adults, can reduce the risk of falls. Ensuring adequate lighting, securing loose rugs, and installing support handles in areas like bathrooms are practical steps.
  • Wearing Supportive Footwear - Choosing shoes with good support, broad heels, and non-slip soles can greatly reduce the risk of slips and falls.
  • Regular Bone Density Scans - Regular bone density screenings, such as DEXA scans, can aid in the early detection of osteoporosis and monitoring bone health, particularly for women above 65 and men over 70.
  • Managing Osteoporosis - Those with osteoporosis should engage in regular discussions on treatment options. Treatment classes like antiresorptive and anabolic treatments help maintain and stimulate bone formation.
  • Weight-Bearing Exercise - Engaging in weight-bearing exercises like walking or resistance training helps maintain bone density and reduces the risk of osteoporosis-related fractures. Exercise also improves balance and agility, further decreasing the likelihood of falls.
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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.

  • Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
  • Member, Royal College of Surgeons of Edinburgh (MRCSEd)
  • Master of Medicine (Orthopaedic Surgery), National University of Singapore
  • Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
  • Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany

 

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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
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Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed

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    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road, #08-62/63
    Singapore 329563

    Frequently Asked Questions (FAQ)

    Can I Walk on a Fractured Leg or Foot?

    The ability to walk on a fractured leg or foot depends on the nature of the fracture. In cases of stable and well-aligned fractures, limited weight-bearing with the aid of crutches or a walker might be permissible. For fractures that are displaced or have required surgical intervention, complete avoidance of weight-bearing can help prevent further damage.

    Can Fractures Lead to Long-Term Complications?

    If not managed properly, fractures can potentially lead to complications including arthritis in affected joints, chronic pain, and limitations in movement. Additionally, improperly healed fractures can result in malunion or nonunion. Adhering to treatment plans and engaging in prescribed rehabilitation can help minimise these risks.

    How Long Does It Take for a Fracture to Heal?

    The healing duration for a fracture varies, depending on factors such as the type and location of the fracture, the individual’s age and general health, and the treatment method. Simple fractures might heal within 4-6 weeks, while complex fractures, especially those involving large bones or joints, may take several months.

    Can I Return to Sports After a Fracture?

    Returning to sports after a fracture is possible, but it depends on the fracture’s severity, the healing process, and the specific sport. Rehabilitation plays a role in restoring strength and mobility. A thorough assessment by a fracture specialist is necessary before resuming sports activities. They can guide the appropriate timing and provide any necessary precautions to reduce the risk of re-injury.