Most broken bones in an arm, leg, hand, or foot require a cast or splint. However, bone fracture surgical repair may be necessary to fix a broken bone by using plates, nails, screws, or pins. Surgical repair is recommended for complicated fractures that cannot be realigned (reduced) by nonsurgical methods. This is especially true of fractures that involve joints.
Using general or local anesthesia, a surgical cut is made over the fractured bone. The bone is placed in proper position. Screws, pins, or plates are attached to or placed in the bone temporarily or permanently. Any disrupted blood vessels are tied off or burned (cauterized). If a lot of bone has been lost due to the fracture (especially if there is a gap between the broken bone ends), the surgeon may decide to do a bone graft. Bone grafting may be performed using the patient's own bone (usually taken from the hip), a donor's bone, or a synthetic substitute. Or, the bone may be taken from a donor. Bone grafts may also be used to allow for proper healing or to speed the healing process.