Optimal Timing for Surgery After a Fracture: What You Need to Know

How long after a fracture should surgery ideally be performed?

Hello Doctor, my mother recently went abroad for a trip and unfortunately slipped and fell.
After a quick assessment and X-ray examination, it was confirmed that she has a fracture and dislocation near her ankle.
Emergency surgery was not required, and she managed to continue her trip for over ten days, thinking it would be best to rest, monitor the situation, and wait for the swelling to subside.
However, when she recently visited the outpatient clinic, the doctor informed her that it was too late for surgery.
Typically, fractures are operated on the day after they are discovered.
Our family is very concerned about this situation and is unsure whether she should rush into surgery.
We are also confused about whether it is feasible to perform surgery quickly when the injury is still bruised and swollen (although most of the swelling has subsided now).
I would like to ask, under normal circumstances, how long after a fracture is it typical to perform surgery? What are the differences between early and late surgery? I hope to clarify these medical concepts.
Thank you!

Jane, 20~29 year old female. Ask Date: 2015/08/06

Dr. Shi Guozheng reply Orthopedics

Ankle fractures typically do not affect outcomes if surgery is performed within two weeks.
However, if surgery can be done sooner, it is certainly better, as it reduces the duration of pain and allows for quicker recovery.
Once the swelling subsides, the surgery becomes easier.
However, delaying the surgery for too long is not advisable; for example, if it exceeds one month, the surgery can become significantly more complicated.

Reply Date: 2015/08/06

More Info

When it comes to the optimal timing for surgery after a fracture, several factors must be considered, including the type and severity of the fracture, the patient's overall health, and the presence of any complications such as swelling or bruising. In general, the sooner a fracture is treated, the better the outcome tends to be. However, there are nuances to this approach that are important to understand.

Timing of Surgery
1. Immediate vs. Delayed Surgery: In many cases, especially with open fractures or fractures that are displaced (misaligned), surgery is performed as soon as possible, often within 24 hours. This is to reduce the risk of complications such as infection and to restore proper alignment, which is crucial for healing. However, in cases where there is significant swelling or bruising, surgeons may opt to delay surgery until the swelling has subsided to minimize the risk of complications during the procedure.

2. Swelling and Bruising: If a fracture is accompanied by significant swelling, it may be advisable to wait until the swelling decreases before proceeding with surgery. This is because excessive swelling can complicate the surgical procedure and increase the risk of complications, such as delayed healing or infection. Surgeons often assess the swelling and may use imaging studies to determine the best timing for surgery.

3. Type of Fracture: The nature of the fracture also plays a critical role in determining the timing of surgery. For example, fractures that are stable and not significantly displaced may be treated conservatively with immobilization and may not require immediate surgical intervention. Conversely, fractures that are unstable or involve joint surfaces often require prompt surgical fixation.

Consequences of Delayed Surgery
1. Healing Complications: Delaying surgery can lead to complications such as malunion (healing in an incorrect position) or nonunion (failure of the bone to heal). These complications can result in chronic pain, functional impairment, and the need for additional surgeries.

2. Increased Pain and Disability: Prolonged immobilization due to delayed surgery can lead to stiffness and loss of function in the affected limb. Early surgical intervention often allows for earlier mobilization and rehabilitation, which can improve overall outcomes.

3. Psychological Impact: Delayed treatment can also have psychological effects, leading to increased anxiety and concern about the injury and recovery process. Patients may feel frustrated or worried about their ability to return to normal activities.

Conclusion
In your mother's case, it is essential to follow the advice of the orthopedic surgeon regarding the timing of surgery. If the doctor has indicated that surgery is necessary, it is likely because they believe that the benefits of surgical intervention outweigh the risks associated with waiting. While it may seem counterintuitive to operate on a swollen area, surgeons are trained to assess the risks and benefits carefully.

In summary, the optimal timing for surgery after a fracture typically depends on the specific circumstances surrounding the injury. While immediate surgery is often preferred, factors such as swelling and the type of fracture can necessitate a delay. It is crucial to communicate openly with the healthcare team to understand the rationale behind their recommendations and to ensure the best possible outcome for your mother's recovery.

Similar Q&A

Post-Surgery Recovery: Insights on Plate and Screw Removal in Orthopedics

Dear Deputy Director Shih, I have a situation where I fractured my tibia in two places, resulting in an open fracture. After the injury, I had two plates and nine screws inserted for stabilization. I used crutches for eight months, and it has now been 17 months. On May 4th, I un...

Dr. Shi Qiming reply Orthopedics
Hello: 1. The decision to remove screws and plates after fracture surgery is still based on the healing status of the fracture. If 5-6 doctors agree that the surgery and healing are satisfactory, you can feel reassured. 2. Generally speaking, as long as there is not too much pain...

Understanding Closed Fractures of the Right Tibia and Fibula: Recovery and Care

I apologize, but I would like to ask about my brother's injuries. He was in a car accident yesterday, resulting in an open fracture of the right tibia and fibula. However, he won't be able to have surgery until Wednesday. How long will it take for this type of injury to...

Dr. Wang Shouji reply Orthopedics
Hello: Bone healing takes at least three months, and full functional recovery may require an additional one to three months. If the fracture has healed, there should be minimal sequelae. However, if the fracture is not healed, caution is needed when bearing weight to avoid the ri...

Clavicle Fracture: To Operate or Not? Recovery Times Explained

In January 2017, I was involved in a motorcycle accident where I was hit by a car, resulting in a fractured left clavicle. I visited two hospitals and underwent X-rays. One doctor recommended surgery, while the other said surgery was not necessary and prescribed a 28-day course o...

Dr. Shi Guozheng reply Orthopedics
Both surgical and non-surgical options are available, and if the physician determines that surgery is not necessary, conservative treatment can be adopted. Typically, healing occurs within approximately three months, and recovery to previous work capacity is generally achievable.

Understanding Comminuted Humerus Fractures: Surgery, Recovery, and Options

Dr. Lee: Hello, my younger brother's mother suffered a humeral fracture in a car accident a week ago, resulting in a comminuted fracture at the junction of the proximal humerus and the long bone with slight displacement. The physician believes that surgery is an option. (1) ...

Dr. Li Wenlin reply Orthopedics
Hello: In response to your question, based on your description, your mother likely has a neck of the humerus fracture. Generally, the decision to operate depends on factors such as age, gender, side of the body, and overall health condition. For instance, for individuals over 65 ...