An impacted fracture is a fracture in which the bone breaks into multiple fragments that drive into each other. This type of fracture can present some challenges in setting the fracture and waiting for it to heal. Impacted fractures are usually treated by orthopedic surgeons and a support team that includes operating room staff who keep the patient safe during the surgery used to set the bone.
This type of fracture is usually caused by something like a fall, especially if someone breaks a fall with their arms or legs. The impact of the fall is such that not only do the bones break, but the pieces of bone push against each other with the force of the fall. Impacted fractures are usually very painful and also very noticeable; the fracture will not be mistaken for a minor sprain.
X-ray images are used to visualize fractures to determine the location and nature of the break. In an impacted fracture, the x-ray will show small pieces of bone around the fracture site, and will also show compression and compaction. Fracture correction requires decompressing the fracture, making sure all pieces are accounted for, and shaping so the bone has a chance to heal. In some cases, pins, rods, and other devices may be used to hold the bone in place during healing because the bone cannot hold.
The hip is a common impacted fracture site, especially in older adults. When someone falls and breaks the femoral neck, it can lead to an impacted hip fracture. Because the hip is a large and critical bone, such fractures usually need to be pinned and there may be cases where a hip replacement is required because the bone is too damaged. This can usually be determined by looking at x-rays of the impacted fracture, but sometimes the surgeon must view the fracture in the operating room to get a clear idea of what is going on.
Surgeons generally recommend operating as quickly as possible if surgery is needed to correct an impacted fracture. This will reduce the risk of complications for the patient. When emergency surgery is required, it is helpful for the surgical team to know when someone last ate or drank, what medications the person is taking, if they have any allergies, and if the patient has a history of major surgery or other medical events.