Evaluation

How will your doctor diagnose your fracture?

The first task of the medical team managing your injury is to make sure none of your injuries are dangerous to your life. Diagnosing and treating your fractures comes right after that. The emergency doctor and later the orthopaedic surgeon will ask questions about the injury and your general health (history), will undertake an examination of the injured part and a general physical examination and then will order tests, including x-rays.

History

The doctors will ask about the forces that acted to cause the injury, the timing, and treatment to date. They will question you about the pain, its location, and what affects it. They will also ask about numbness or paralysis of the limbs. They need to know about your general health and whether there may be any special risks to surgical treatment. Your lifestyle, employment, sports activity, and expectations after recovery all may have an important bearing on the way your injury is managed.

Examination

The examination of the injured part will pay special attention to the location of the pain and any wounds. Swelling, bruising, tenderness, and any deformity will be noted. The nerve and blood supply to the whole limb will be examined. Usually it is not necessary to move or stress the limb because this is likely to increase the pain but sometimes provoking pain with certain movements is an important clue.

Radiology

X-ray examination of the bones suspected of being broken is done for several reasons. It confirms the clinical suspicion that the bone is broken. It reveals the nature of the fracture and shows features such as displacement, angulation, rotation and overlap. It may reveal unexpected injuries and it is used in the planning of treatment. A common precaution is to x-ray the joints above and below the fracture to make sure there are no injuries there.

Orthopaedic surgeons use the x-ray features of fractures to classify the injury, the first step in forming a treatment plan. More rarely, other radiology tests are needed. CT scans are specially helpful in the planning of treatment for complex fractures near joints and in the spine.