Many bony fractures (breaks) can be treated with a period of immobilization. However, when necessary, fractures may require surgery. Regardless if non-operative or operative treatment is chosen, bones may take anywhere from 10-16 weeks or more to heal depending on the location and severity of the break. This is performed at the hospital or surgery center and can often be done as an outpatient. A peripheral nerve block may at times be used for post-operative pain control. This is done by the anesthesiologist in the pre-operative holding area. Post-operatively the extremity may be immobilized in a splint or a sling depending on the location of the fracture.
Dr. Lenarz usually performs fracture repair through an open incision. The bony fragments are then aligned into position and are secured in one of two methods. A metal plate may be placed against the bone and in turn secured to the bone with screws that go through the plate and into the bone. This provides stability and fixation of the fragments in the aligned position while they heal. Occasionally a “nail” is used to stabilize the bone. This is a metal rod that is placed inside the canal of the bone. Screws are then placed through the bone, into the nail and out the other side of the bone to stabilize the fracture fragments in the aligned position.
The most difficult part of the repair for the patient is the period of recovery, the initial immobilization and eventual progression of range of motion and strengthening. Failure to follow these recommendation and their timeline increases the risk of the bone being pulled apart so it is unable to heal.
After the surgery, the patient will wake in the recovery room in a sling. If a “nerve block” was performed by the anesthesia doctor before the operation the arm will remain numb for 12-24 hours. This is usually done for post-operative pain control. Icing the shoulder should be done liberally. This can be through the use of ice in a bag, ice packs or a circulating ice water cooler. The dressing should not be removed.