the Connection Between Edema and Bone Displacement

Bone and edema?

Recently, I was sent to Linkou Chang Gung Memorial Hospital for a diagnosis after a car accident.
I have a closed fibular fracture on the outer side of my right leg, which is a clean oblique break.
Although the fracture was detected on the day of the accident, the overall shape was intact, and surgery was not performed immediately.
Instead, I returned for a follow-up appointment a week later, at which point the doctor informed me that there was slight displacement and recommended surgery.
Later, my mother suggested that I seek opinions from different doctors, so I went to Tri-Service General Hospital.
The doctor explained that there was only a slight displacement and suggested waiting to see if the swelling subsides before making a decision.
Is there a close relationship between swelling and bone displacement?

Lian Xiansheng, 10~19 year old female. Ask Date: 2018/01/15

Dr. Shi Guozheng reply Orthopedics

After the edema subsides, the surgery becomes simpler and easier, and it is unrelated to the displacement.
Additionally, another X-ray will be taken to determine the degree of displacement before deciding whether surgery is necessary.

Reply Date: 2018/01/15

More Info

Edema, or swelling, is a common response to injury, including fractures. When a bone is fractured, the body initiates a healing process that involves inflammation, which can lead to the accumulation of fluid in the surrounding tissues, resulting in edema. This swelling can have a significant impact on the alignment and stability of the fractured bone, particularly in cases of displaced fractures.

In your case, the diagnosis of a fibular fracture with slight displacement suggests that the bone has not completely lost its alignment but may be at risk of further displacement due to the surrounding edema. The relationship between edema and bone displacement can be understood through several mechanisms:
1. Increased Pressure: Edema increases the pressure within the soft tissues surrounding the fracture site. This pressure can affect the position of the fractured bone fragments, potentially leading to further displacement. If the swelling is significant, it can push against the bone, causing it to shift from its original position.

2. Soft Tissue Involvement: The soft tissues around the fracture, including muscles, ligaments, and tendons, can also be affected by edema. If these tissues are swollen, they may exert additional forces on the bone fragments, which can contribute to displacement. For example, if the muscles are tense and swollen, they may pull on the bone fragments, exacerbating any existing displacement.

3. Healing Process: The inflammatory response that causes edema is part of the body's natural healing process. While inflammation is necessary for healing, excessive swelling can hinder the healing process by limiting blood flow and nutrient delivery to the area. This can lead to complications, including delayed healing or malunion (improper healing of the fracture).

4. Assessment and Treatment Decisions: The presence of edema can complicate the assessment of a fracture. In your case, the initial evaluation may have indicated a clean break without significant displacement. However, as swelling developed, it became more challenging to assess the alignment of the bone accurately. This is why some physicians may recommend waiting for the edema to subside before making definitive treatment decisions, such as whether to proceed with surgery.

In summary, there is indeed a close relationship between edema and bone displacement. The swelling can influence the alignment of the fractured bone and complicate the healing process. It is essential to monitor the swelling and assess the fracture's stability over time. If the edema decreases and the fracture remains stable, conservative management may be sufficient. However, if the displacement worsens or if there are concerns about the fracture's healing, surgical intervention may be necessary.

It is crucial to maintain open communication with your healthcare providers and to seek multiple opinions if you have concerns about your treatment plan. Each case is unique, and the best course of action will depend on various factors, including the degree of displacement, the presence of edema, and your overall health. Always follow your physician's recommendations and report any changes in your symptoms or concerns you may have during your recovery process.

Similar Q&A

Understanding Bone Edema After Surgery: Causes and Treatment Options

Dear Dr. Chen, My son underwent surgery in July 2006 due to unexplained bone necrosis around the growth plate of his ankle. The necrotic tissue was excised, and a bone graft was taken from his hip to fill the defect. After nearly two years of follow-up, his bone growth was satis...

Dr. Chen Xingyuan reply Orthopedics
Dear Reader: Bone marrow edema is a manifestation of changes in signal intensity observed during magnetic resonance imaging (MRI). It appears as decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images, which is a non-specific finding....

Post-Surgery Complications After Hip Fracture in Elderly Patients

My grandfather is 82 years old. He fell before the Lunar New Year and had a large bruise on his buttocks. An X-ray taken at a clinic showed no bone injury, but as the pain became more pronounced, he was unable to bear weight while walking. Later, he went to a larger hospital for ...

Dr. Shi Guozheng reply Orthopedics
After surgery for fractures near the hip joint, there is often poor blood circulation, so it is necessary to elevate the lower leg. Additionally, rehabilitation exercises for the knee and ankle joints should be performed. If there is redness, swelling, heat, or pain, one should s...

Understanding Bone Tumors: Symptoms, Concerns, and Next Steps

Hello Doctor: Thank you for taking the time to patiently answer my questions. Thirty years ago, I suffered an open fracture of the tibia in my right leg, which required four surgeries over four years, including the insertion and removal of a metal plate. During rehabilitation, I ...

Dr. Shi Guozheng reply Orthopedics
1. Go to the hospital for a check-up when you have time. 2. It may be unrelated. 3. If the tumor is growing, there is usually a phenomenon of pain. 4. Temporarily avoid vigorous exercise.

Concerns About Possible Displacement After Ankle Surgery: A Patient's Inquiry

Hello, on June 23, I underwent surgery for fractures in both legs, specifically the lower legs and the inner and outer malleoli in Thailand (the right inner malleolus was not operated on but is slightly displaced). When I compare the left inner malleolus with the right ankle, I n...

Dr. Chen Yongxue reply Orthopedics
Hello, the possibility of displacement after a fracture is not negligible. It is essential to rely on pre-operative and post-operative X-rays. Rehabilitation should generally wait for at least two months or until there are signs of healing at the fracture site visible on X-rays b...