A man sitting with a plastered leg

Learning About The Fracture Complications

Up to 10% of all fractures can lead to fracture complications.1 These complications can result in pain and a decrease in movement. The incidence and form of bone complications or bone defects may vary depending on the fracture site.2 Let’s look at some of the common fracture complications. 

Complications of fracture healing can be divided into early and delayed complications.

Early Complications Occur Due To The Initial Trauma And Include:3

Hypovolemic Shock

Hypovolemic Shock

It is an emergency condition caused by blood or extracellular fluid loss. Trauma is one of the major causes of hypovolemic shock.4

Fat Embolism

Fat Embolism

An embolism refers to a sudden blockage in the artery. During a fracture, fat molecules may move into the bloodstream and obstruct the blood supply to vital organs.3

Pulmonary Embolism (Blood clots In lungs)

Pulmonary Embolism (Blood clots In lungs)

In case of hip or leg fracture, the blood clots from the veins can travel to the arteries present in the lungs.5,6

Disseminated Intravascular Coagulopathy (DIC)

Disseminated Intravascular Coagulopathy (DIC)

It is a blood clotting disorder caused by major tissue trauma. DIC can lead to bleeding from the mucosal membrane, gastrointestinal and urinary tract.3 
(Mucosal membrane is the moist, inner lining of many organs and structures of the body.)

Infections

Infections

Open fractures may become infected as the bacteria can enter the wound and travel to the fractured bone, resulting in an infection.7

Nerve Damage

Nerve Damage

A closed fracture may lead to nerve injury.8 The early signs of nerve injury include tingling sensation and numbness. Inability to move or paralysis may be caused due to nerve damage.3 

Delayed Complications May Develop Over The Course Of Time3

Osteonecrosis or Avascular Necrosis

Osteonecrosis or Avascular Necrosis

Osteonecrosis is the death of bone tissue. It results from the disruption of blood supply to the bone.3

Delayed Union

Delayed Union

It occurs when the broken bone doesn’t heal within the estimated time.3

Non-union

Non-Union

It occurs when the ends of the fractured bones fail to unite.3

Malunion

Malunion

It occurs when the fractured bone does not heal in a correct or optimal position.9

Complex Regional Pain Syndrome

Complex Regional Pain Syndrome

This condition results in redness, unexplained pain, swelling, and reduced function at the affected site.10

Signs And Symptoms Of Fracture Complications11,12

You may consider visiting a doctor, if you are experiencing any signs or symptoms of fracture complications, seek immediate medical assistance. 

Look out for the following warning signs:

Severe pain

Swelling and tenderness

Fever

References

1. Gajdobranski D, Zivković D. Poremećaji zarastanja preloma [Disorders in fracture healing]. Med Pregl. 2003;56(3-4):146-51. Croatian. DOI:10.2298/mpns0304146g. 
2. Hernandez RK, Do TP, Critchlow CW, Dent RE, Jick SS. Patient-related risk factors for fracture-healing complications in the United Kingdom General Practice Research Database. Acta Orthop. 2012;83(6):653-60. 
3. Brunner LS, Smeltzer SC, Suddarth DS. Brunner & Suddarth's textbook of medical-surgical nursing; Vol. 1. Language. 2010; 27:1114-2240p. Available at: www.brainkart.com (accessed 22 Feb 2022)
4. Taghavi S, Askari R. Hypovolemic Shock. [Updated 2021 Jul 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022-. Available from: www.ncbi.nlm.nih.gov
5. Barrett JA, Baron JA, Beach ML. Mortality and pulmonary embolism after fracture in the elderly. Osteoporos Int. 2003;14(11):889-94. 
6. Mayo Clinic. Pulmonary Embolism. [Internet] [Cited 28 April 2022] Available from: www.mayoclinic.org
7. AAOS. Orthoinfo. Infections after a fracture. [Internet] [Cited 28 April 2022] Available from: orthoinfo.aaos.org
8. Mohler LR, Hanel DP. Closed fractures complicated by peripheral nerve injury. J Am Acad Orthop Surg. 2006;14(1):32-7. 
9. Cleveland Clinic. Foot & Ankle Fractures Malunion. [Internet] [Cited 28 April 2022]. Available from: my.clevelandclinic.org
10. Giannotti S, Bottai V, Dell'Osso G, et al. Algodystrophy: complex regional pain syndrome and incomplete forms. Clin Cases Miner Bone Metab. 2016;13(1):11-4.
11. AAOS. Orthoinfo. Nonunions. [Internet] [Cited 03 May 2022] Available from: orthoinfo.aaos.org
12. AAOS. Orthoinfo. Infections after fracture. [Internet] [Cited 03 May 2022] Available from: orthoinfo.aaos.org

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