Suffering a fracture can be unsettling—especially when surgery is recommended. As an orthopaedic surgeon, I’ve cared for countless patients facing this crossroads. Understanding the procedure, recovery and rehabilitation can ease anxiety and set you up for success. Below, I break down the journey from pre-op planning to full recovery.
1. Why Surgery Is Sometimes Needed
Not all fractures need an operation. Many can heal perfectly well with casts or splints. However, surgery becomes necessary when:
- Bones are severely displaced—where ends don’t align on their own
- Fracture fragments penetrate the skin (open fractures)
- Joints are involved and misaligned (like in distal radius/wrist or ankle fractures)
- There are multiple breaks or additional injuries
The goals of surgical repair are simple: restore bone alignment, stabilise fragments, and allow for early motion where possible—especially crucial around joints like the wrist and ankle.
2. Common Fracture Surgeries
Wrist Fractures
- The distal radius is the most commonly fractured part of the wrist.
- In surgery, I often use a volar locking plate, which sits on the palm side and holds bones firmly in place.
- This usually entails a small 4–6 cm incision and takes around an hour.
Hip Fractures
- Two main types: femoral neck (just below the ball of the hip) or intertrochanteric (a little lower).
- Femoral neck fractures in older adults are often treated with hip replacements (hemi or total).
- Intertrochanteric fractures are typically stabilised with a sliding hip screw or intramedullary nail.
- Surgery usually lasts between 60–90 minutes, often on the same or next day after admission.
Ankle Fractures
- Often unstable, involving the malleoli (bony prominences around the ankle).
- Surgical repair includes open reduction and internal fixation (ORIF) with plates and screws.
- Commonly a 2–3 hour procedure, depending on complexity.
3. What to Expect Before, During & After
Pre-Operative
- Assessment: You'll undergo blood tests, ECG and possibly X‑rays or CT scans.
- Fasting: No food or drink usually from midnight before the surgery.
- Consent: A thorough chat about risks, benefits and alternative options (as per AHPRA guidelines).
In the Operating Room
- You’ll be under general anaesthesia—completely asleep.
- Sometimes, we use regional blocks (like a nerve block for wrist surgery) to ease pain afterwards.
- Surgical time ranges from 60 minutes (for straightforward wrist fractures) to 3 hours (for complex ankle or hip fractures).
Post-Operative
- You’ll wake up in recovery and can often go home same day for wrist fractures or after a brief hospital stay.
- Hip or ankle fractures usually require 2–5 days in hospital for monitoring, pain management, and walking assessments.
- Pain is managed with paracetamol, NSAIDs and, if needed, short-term opioids—all within AHPRA-compliant limits.
4. Recovery Expectations
Wrist Surgery
- A light splint may be used for 1–2 weeks.
- Gentle range-of-motion exercises begin early.
- Return to daily activities: 4–6 weeks; full sports: 2–3 months.
Hip Fracture Repair
- Mobilisation with a walking frame or crutches starts within 24 hours of surgery.
- Average hospital stay is around a week, depending on fitness and support.
- Indoor walking: 4–6 weeks; outdoor/long distances: 8–12 weeks.
Ankle Surgery
- You will likely have a back slab or boot for 2–4 weeks.
- Non-weight‑bearing initially, progressing to partial by 6 weeks, and full by 8–12 weeks.
- Swelling can take 6 months to 1 year to fully settle.
5. Rehab Tips for Faster, Safer Recovery
Consistency in rehabilitation is key:
- Early movement: Avoid stiffness—move joints gently as soon as allowed.
- Strengthening exercises: Focus on building back endurance, not just muscles.
- Balance training: Crucial after ankle or hip surgery to reduce fall risk.
- Activity grading: Start slow and gradually increase the intensity.
- Follow-up visits: Critical for monitoring bone healing with X-rays and modifying rehab.
I often work with physiotherapists to tailor rehab plans and offer real-world examples, such as helping a 70‑year‑old patient walk to the letterbox just two weeks post-op.
6. When to Call Your Surgeon
Contact your orthopaedic surgeon if you experience:
- Redness, warmth, increasing pain at the surgical site
- Fever above 38 °C or chills
- Numbness or tingling suggesting nerve irritation
- Severe swelling that worsens
- Signs of deep vein thrombosis—pain, redness, or swelling in the calf
Early detection is key to prevent complications.
7. Overall Outlook
Most patients achieve excellent outcomes with surgical fracture repairs. In many cases, you’ll regain full function—though deeper joints (like the hip or ankle) may need extra support through regular exercise, weight maintenance, and activity modifications.
Frequently Asked Questions
How long will it hurt after surgery?
Moderate pain is normal for 1–2 weeks, manageable with pain relief. After that, it transitions to mild soreness.
Will I regain full function?
Many do—especially if rehabilitation is consistent. It may take 3–6 months for full strength return.
Can I avoid surgery?
If bones are aligned and stable, non-surgical treatment might work. But misaligned or joint-involving fractures almost always need fixation to avoid long-term problems.
When can I drive again?
Usually 6–8 weeks post-surgery—but only once you're off narcotic pain meds and can safely operate pedals.
