Patient education: Surgery to fix a broken bone – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

How are broken bones fixed with surgery? — This can be done with something called "open reduction and internal fixation" surgery. For this surgery, the doctor moves the broken pieces of bone into the correct place. This is called "reduction." They also use some type of hardware to hold the bone in place while it heals. This is called "internal fixation." The hardware can include metal plates, rods or nails, pins, wires, or screws (figure 1).

Usually, the hardware used to hold the bone in place goes inside of the body. It can stay in place after the bone heals or, in some cases, the doctor will remove it. For some kinds of broken bones, the doctor uses pins or screws that go through the skin and into the bone. They are attached to a metal bar that is outside of the body. This is called an "external fixator." It is removed when the bone is healed.

How long it takes for you to recover, and what you need to do, depends on what kind of fracture you had. Most fractures take weeks to months to heal. Fractures in children usually heal faster than fractures in adults.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

For the first 24 hours after surgery:

●Do not drive or operate heavy or dangerous machinery.

●Do not make any important decisions or sign any important papers.

●Do not drink alcohol of any kind.

You should also:

●Prop your injured body part on pillows, keeping it above the level of your heart. This can help lessen pain and swelling.

●Take medicine like ibuprofen (sample brand names: Advil, Motrin) or naproxen (sample brand names: Aleve, Naprosyn) for swelling and pain, if needed. These are nonsteroidal antiinflammatory drugs ("NSAIDS"). You might also have gotten a prescription for stronger pain medicines to take for a short time. If so, follow the instructions for taking them.

●Take a stool softener to help with constipation, if needed. Opioid pain medicines can cause constipation.

●Ice to help ease pain and swelling – Place an ice pack or a bag of frozen vegetables wrapped in a towel over the painful part. Never put ice right on the skin. Do not leave the ice on for more than 10 to 15 minutes at a time. Use for the first 24 to 48 hours after an injury.

●If you smoke, try to quit. Broken bones take longer to heal if you smoke.

●Take care of your incision – You might have stitches, skin staples, surgical glue, or a special skin tape on your incision. If you had laparoscopic surgery, you might have more than 1 incision.

•If you do not have a cast or splint over your incision:

-Keep your incision dry and covered with a bandage for the first 1 to 2 days after surgery. Your doctor or nurse will tell you exactly how long to keep your incision dry.

-Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not put your incision underwater, such as in a bath, pool, or lake. This can slow healing and raise your chance of getting an infection.

-After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on the incision. They will also tell you if you need to cover your incision with a bandage or gauze.

-Always wash your hands before and after you touch your incision or bandage.

•If you have a cast or splint that covers your incision:

-Keep your cast or splint dry. The doctor will tell you when this needs to be changed.

•If you have an external fixator:

-The staff will teach you how to take care of the pins in your skin.

●Increase your activity slowly – Start with short walks around your home, and walk a little more each day.

•Use your sling, crutches, walker, or wheelchair as instructed. If your surgery was on your pelvis, leg, ankle, or foot, you might not be able to put weight on it as you walk.

•Avoid heavy lifting, sports, and swimming until for at least a week or 2. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)

•Your doctor might refer you to a physical therapist (exercise expert). If you were given specific exercises, be sure to do them. This will help build strength once your bone has healed.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

If you have stitches or staples, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

If you have a cast or splint, the doctor will want to remove or change it at a certain time. Do not try to remove it yourself.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You start to have trouble breathing.

●You are becoming pale and very weak or pass out.

Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●There is a bad smell or drainage coming from your cast, splint, or incision.

●You have worsening redness or swelling around the cuts from your surgery.

●You have severe pain that is not relieved by pain medicine.

●Your cast or splint becomes too tight and uncomfortable.

●Your fingers or toes are blue, gray, or cold.

●Your cast or splint feels too loose, or your cast has a crack or becomes soft.

●You are not able to move your fingers or toes.

●The skin becomes red or irritated around the cast.

More on this topic

Patient education: Surgery to fix a broken bone (The Basics)
Patient education: Fractures (The Basics)
Patient education: How to care for your cast (The Basics)
Patient education: How to care for your child's cast (The Basics)
Patient education: How to care for a splint (The Basics)
Patient education: Managing pain after surgery (The Basics)

Patient education: Cast and splint care (Beyond the Basics)