There are many situations causing fractures, falling down, traffic accident, fighting conflict, even arm wrestling. As a result, caring fractured patients takes a large proportion in an orthopedic surgeon’s daily life. In this article, we concluded “Top 5 questions asked pre-operatively by the patients”, such as(1) Who needs surgery and who doesn’t? (2) What’s the difference between general and spinal anesthesia? (3) What is the timing of surgery? (4) How long does it take to stay in the hospital? (5) Which implant is best for me?

Is the surgery really necessary for me?

Different bone and different traumatic mechanism lead to various fracture patterns. Generally, fracture without severe displacement and fracture over upper extremities are indicated for conservative treatment. Splint, cast, arm sling and brace are used according to the location of fracture.

Surgery is indicated for displaced fracture and fracture which tends to be displaced in the future. We do the surgery to reduce the fractures and fix the bone with implants.

Orthopedic surgeon will discuss with the patient and family and conclude a best treating plan for the patient according to each patient’s age, underlying disease, work style and possible surgical risk.

What about the anesthesia? Could you please make me fall asleep?

General anesthesia, spinal anesthesia and local anesthesia are the methods used more frequently.

Local anesthesia is injected around the surgical field, like fingers, toes and superficial wound.

Spinal anesthesia is injected via the lumbar region, which led to pain-free over the lower extremities such as hip, thigh, knee, leg and foot. Sometimes the anesthesiologist would use some sedative medication simultaneously to relieve patient’s anxiety.

General anesthesia is induced with medication thought IV and then the patient is intubated before the surgery over shoulder, arm, hand and spine.

There are other anesthetic methods like TIVA (total intra-venous anesthesia), laryngeal mask airway, regional block…, etc. The anesthesiologist and the surgeon will discuss with the patient and family and make a best anesthetic decision.

The fracture really hurts! Can I undergo the surgery right away?

To prevent pneumonia caused by vomiting and choking, patient usually needs fasting before the surgery, unless it’s an emergent surgery. Sometimes the operation would be postponed if there is another emergent condition such as cardiac and brain surgery.

How long do I need to stay in the hospital?

The patient needs to stay admission to ensure recovering well physically, pain controlled, wound healing well and good rehabilitation. The length of stay differs in each patient due to different variables like age, underlying disease, fracture site, surgical procedure, wound condition and vitality. The patient should prevent the wound from getting wet and stitches will be removed 10-14 days after surgery

Which implant should I choose?

Different form the old implant, the newly developed one is titanium, which is light and more flexible and fit the bone contour. The locking mechanism increases the strength of bone fixation. The minimal invasive tools shorten the wound and surgical time. Patient can discuss with the surgeon about the appropriate implant corresponding to the fracture pattern.

These are the “Top 5 FAQ about fracture surgery-pre-operatively.” We really hope the article helps!

Where is Orthopedic & Spine surgeon Dr. Yen KoLun?