Complications Of Fracture

Complications of a fracture can be due to injury per se, problems of healing or as an unwanted effect of treatment. Sometimes complications of the fracture injury become much more important than fracture itself because of life threatening or limb threatening nature.

Most of the complications though are of not this nature. A physician must take into account the potential complications and patient should be monitored regularly since the time of arrival for early signs pointing to fracture.

The complications can be listed as local or pertaining to the injured region and systemic or involving other systems of body.

They can also be divided into early and late. Early complications are those which occur at time of injury or within a short period after injury due to factors related to injury.

Late complications are those which occur after a substantial time has passed and are as a result of defective healing process or because of the treatment itself.

Here is the list of most common complications after fracture injury

Early Complications

Local

  • Vascular injury. This can cause external or internal haemorrhage
  • Visceral injury. This can cause damage to vital organs kidneys, intenstine or bladder
  • Veural Damage
  • Injury to surrounding tissue
  • Haemarthrosis. this means blood in the joint
  • Compartment syndrome. Due to bleeding the blood gets accumulated in the compartments formed by fascia and bone. When this becomes too much in a compartment which does not expand, pressure on the surrounding tissues causes ischaemia or lack of oxygen following poor blood supply.
  • Wound contamination that could lead to infection

Systemic:

  • Fat embolism.
  • Shock
  • Thromboembolism
  • Acute Respiratory Distress

Late Complications

Local:

  • Delayed Union. The bone takes more time to heal than what it normally takes. Union occurs eventually with or without augmentation procedure.
  • Non-union. There occurs complete cessation of bone healing and bone would not heal without an augmentation procedure like bone grafting.
  • Malunion. the fracture unites in with fragments in unacceptable position leading to deformity and other potential problems of malalignment
  • Joint stiffness
  • Contractures of soft tissue. this may include tendon, ligaments, joint capsule and skin
  • Myositis ossificans. This is a term used for abnormal ossification of soft tissues. if arounfd joint, it may limit the range of motion.
  • Avascular necrosis
  • Algodystrophy or Sudeck’s atrophy. It is neurovascular disturbance following abonormal behavior of sympathetic nervous system.
  • Osteomyelitis. it is infection of bone and medulla
  • Growth disturbance or deformity leading to limb length discrepancy.
  • Pressure ulcers following cast
  • Pin tract infection

Systemic

  • Gangrene. It may occur due to vascular injury, failed vascular repair or as complication of pplaster cast
  • Tetanus. This is as a result of contamination by tetanus spores at time of injury
  • Septicaemia

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