A fracture is a complete or partial break in a bone, typically resulting from a force stronger than the bone structure can withstand. Fractures are broadly categorized by the integrity of the skin and the alignment of the bone fragments. Among the various types, a displaced fracture is a significant injury involving a major shift in the normal anatomical position of the bone pieces. This misalignment means the bone cannot heal correctly on its own and requires intervention to restore its proper length and orientation.
What Defines a Displaced Fracture
A displaced fracture is defined as a break where the bone fragments have moved significantly and are no longer in their correct, natural alignment. The fractured ends may be separated by a gap, overlap each other, or be sharply angled away from the body’s normal axis. This misalignment distinguishes it from a non-displaced fracture, where the pieces retain their proper alignment and remain stable.
A displaced fracture has a visible shift that disrupts the bone’s structural integrity. This loss of anatomical positioning is medically significant because if the fragments heal in this position, it can result in a permanent deformity or loss of function, known as a malunion. Restoring the bone’s original shape is the primary goal in treating this injury.
How Displaced Fractures Are Classified
Displaced fractures are categorized based on the pattern of the break and whether the overlying skin has been compromised. The pattern describes the geometry of the fracture line, which often indicates the mechanism of injury.
Fracture Patterns
A transverse fracture runs straight across the bone, perpendicular to its long axis. An oblique fracture has a diagonal break, typically caused by a compressive force. A spiral fracture occurs due to a twisting force, resulting in a line that winds around the bone shaft. A comminuted fracture is a severe break where the bone shatters into three or more separate fragments, often requiring complex surgical techniques.
Skin Integrity
Fractures are also classified by the integrity of the surrounding soft tissue and skin. A closed fracture means the bone is broken but has not pierced the skin. Conversely, an open fracture, sometimes called a compound fracture, involves the broken bone penetrating the skin or a wound leading down to the fracture site. Open fractures carry a much higher risk of deep bone infection because the fracture site is exposed to the external environment.
Necessary Steps for Treatment and Healing
Treating a displaced fracture almost always requires a procedure called reduction to realign the pieces. The goal of reduction is to restore the bone to its correct anatomical position, which is a necessary first step for proper healing. This is accomplished through either a closed or open method, depending on the severity and stability of the injury.
Closed Reduction
Closed reduction is a non-surgical technique where the doctor manually manipulates the bone externally through the skin to bring the fragments back into alignment. This is typically performed under anesthesia or sedation. Once aligned, the bone is immobilized with a cast or splint to hold the fragments in place while they heal.
Open Reduction and Internal Fixation (ORIF)
If the fracture is too unstable, complex, or cannot be successfully realigned non-surgically, an open reduction procedure is necessary. Open reduction involves a surgical incision to directly access the fracture site and physically align the bone fragments under direct visualization. This procedure is followed by internal fixation to permanently stabilize the bone.
Internal fixation uses specialized hardware, such as metal plates and screws placed on the bone surface, or rods inserted down the center of the bone, to hold the fragments securely. This stabilization allows the bone to bear stress while the natural healing process occurs over several weeks to months. Following treatment, physical therapy is prescribed to restore joint mobility, muscle strength, and the full function of the injured limb.