The Ponseti Method: A Step-by-Step Guide to Clubfoot Correction and Long-Term Management
March 24, 2025What is Non-Operative Fracture Management?
What Is Non-Operative Fracture Management?
Key Indications for Non-Operative Treatment
Undisplaced or Minimally Displaced Fractures
Fractures where bone alignment remains intact are prime candidates. For example, a wrist fracture with minimal displacement often heals effectively with a cast.
Calcaneal Body Fractures
These heel fractures require strict non-weight-bearing protocols. Patients use crutches for six weeks, transitioning to full weight-bearing only after radiographic confirmation.
Proximal Humeral Fractures in Elderly Patients
Surgery in frail seniors poses high risks. Instead, non-operative fracture management combines sling immobilization with early shoulder exercises to prevent stiffness.
Clavicle, Wrist, and Foot Injuries
Non-surgical methods excel in areas with high vascularity. For instance, 85% of clavicle fractures heal without surgery when properly immobilized.
Phases of Recovery in Non-Operative Care
Immediate Care (0–6 Weeks)
This phase stabilizes the injury and manages acute symptoms.
Immobilization Techniques
Fiberglass casts or braces are custom-fitted by Orthotrauma Technologists. For ankle injuries, posterior splints allow limited motion to reduce stiffness.
Pain Management Strategies
Elevation: Reduces swelling in extremities.
NSAIDs: Prescribed judiciously to avoid interfering with bone healing.
Monitoring and Follow-Up
Weekly X-rays ensure bones remain aligned. Adjustments to casts are made if swelling subsides.
Early Rehabilitation (Weeks 2–6)
Controlled motion begins once initial healing is evident.
Controlled Motion Exercises
For proximal humeral fractures, passive shoulder rotations start within a week. This prevents adhesive capsulitis (“frozen shoulder”).
Weight-Bearing Protocols
Patients with calcaneal fractures practice toe-touch weight-bearing (10–20% body weight) to stimulate bone remodeling without compromising alignment.
Long-Term Rehabilitation (6+ Weeks)
Focus shifts to restoring strength and function.
Progressive Loading Techniques
Full weight-bearing begins after X-ray confirmation. Gait training helps patients rebuild confidence in walking.
Strength Training and Functional Recovery
Resistance bands and weightlifting reverse muscle atrophy. For example, calf raises aid recovery after tibial fractures
Evidence-Based Best Practices in Non-Operative Care
Pediatric Fracture Management
Children’s bones have high remodeling potential, resolving 90% of fractures without surgery. The Kenya Society of Orthotrauma Technologists advocates casting over surgery for most pediatric cases.
Care for Elderly Patients
Studies show frail seniors with proximal femoral fractures report similar quality-of-life outcomes with non-operative care versus surgery, minus surgical risks.
Cost-Effectiveness of Non-Surgical Treatments
Hospitals save 30% on average by avoiding OR fees, implants, and prolonged stays. This makes non-surgical treatments vital in resource-limited settings.
