New Options Can Fix Broken Bones

When it comes to mending broken bones, doctors may not be ready to cast out tradition. But new materials and high-tech designs can make recovery a lot easier than it was when injured limbs were routinely encased in plaster and stabilized with pulleys and weights. In some cases, doctors can even skip casts.

"Plaster still remains the mainstay, but over the past 20 to 30 years fiberglass has become available," says Steven Morgan, M.D., a spokesman for the American Academy of Orthopaedic Surgeons. "It's lighter, more durable and can stand getting wet. And there are also water-resistant cast liners to protect the skin."

Broken bones can also be held in place with metal pins, rods, screws or locking plates, often made of titanium alloys or stainless steel.

Plates more common

Locking plates have grown more common in the past 10 years. "They do offer some advantages in fractures close to joints and in patients with weak bones," Dr. Morgan says. "They provide more stability than traditional screws, and can be maintained in the body permanently or removed if they become uncomfortable."

Also new: custom-fitted, thermoplastic splints. Unlike casts, splints can be removed for bathing, loosened to deal with swelling or tightened to offset the loss of muscle mass in a limb you can't use.

A study of 87 boys and girls compared removable splints with short arm casts for treating wrist buckle fractures. This common, partial break on one side of the bone (which is still soft in a child) results from a fall on an outstretched hand. The study found kids with splints had "better physical functioning and less difficulty with activities" than those with casts. They also went back to sports sooner. Both groups had similar pain. No one in either group reported breaking the wrist again in the next six months.

Wrist fractures

Dr. Morgan says wrist splinting may work only rarely for adults. Their broken wrists tend to involve a complete fracture of a bone at the wrist. "It commonly requires a cast or surgery, depending on the fracture pattern," he says.

What will work best if you break a bone? "The thing I would stress is that there certainly are options, but not every option is appropriate for every fracture," he says. "That's a decision that should be made in consultation with a trained surgeon with experience in the injury involved."