It's going to depend on which bone is broken, how many pieces and if there are other injuries. Unless it's a fairly clean compound fracture, the displacement is going to be severe enough to require internal fixation - meaning the orthopedic surgeons get involved, take ya to the OR and possibly put a nail in to hold the bone in place while it heals (this is also very true and necessary if the bone is broken into more than one piece and displaced).
If it is really a very simple compound fracture and can be reduced back through the skin and set in the ER, then we would do that, but several X-rays would be involved to ensure that the bone makes it back to the right place, and that the break
isn't worse than originally thought.
Then, as far as covering the skin break and medications goes...during the operation scenario, the wound can be cleaned pretty well, and then closed. In the ER, if reduced and set, we would put in stitches to close the wound (numbing it first and cleaning it pretty well). Then it would get casted - hairlines and smaller fractures can sometimes get away with aircasts or slings, but compounds are going to need a cast. But the cast would not get put on in the ER...we put on a splint (hard plaster) in the ER and then they follow up in Ortho clinic in a week to get the actual cast. There's going to ge a lot of swelling involved over the next several days, and if you put a cast on in the ER it's going to get too tight when the significant swelling starts.
And yes, the person will get put on antibiotics and pain medication (narcotics). I can give you names of meds if you want, but how specific do you want to get? After OR, person would be admitted for a while (few days) and on a morphine drip, then switched to oral pain meds. Also on IV antibiotics, then switched to oral antibiotics. From the ER, they may be sent home if it's easily reduced, on both oral pain meds and antibiotics - we'd usually do like Percocet and Augmentin or something...
Most likely time frame would be ending up going to OR and getting admitted for 2-3 days. Then there'd be 4-6 weeks for healing in the cast (again, gonna depend on the bone).
I think that covers most stuff, let me know if you need anything else or anthing more specific.
Jill
