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Part VII: Injuries and Damages

Broken Bones

If you were injured in an automobile collision or other type of accident caused by another person that resulted in broken bones, you have the right to recover monetary compensation for all of your injuries and associated costs. Common causes of bone fractures include motor vehicle accidents, falls from a height, a direct blow to the bone, child abuse, and repetitive forces, such as those produced by running, causing stress fractures of the foot, ankle, tibia, or hip.

One source says that the most commonly fractured bone is the collar bone (“clavicle”), usually as the result of an automobile accident. Another source lists breaks of the wrist, hip, and ankle as the most common fractures. A break or a crack in a bone is known as a fracture and can affect any bone in the body. A simple (or “closed”) fracture is a clean break to the bone that does not damage any surrounding tissue or break through the skin. The only way of certainty in diagnosing a closed fracture is with an X-ray, CT scan, or MRI.

A compound (or “open”) fracture occurs when the surrounding soft tissue and skin is damaged, such as where the broken bone penetrates through the skin. The attending emergency room physician will order X-rays or other imaging studies performed so she can find out exactly the extent of injury. This kind of fracture is more serious in large part because there is a high risk of infection since it is an open wound.

Additionally, a “simple” fracture is one that occurs along one line, splitting the bone into two pieces, while “multi-fragmentary” fractures, known as “comminuted fractures,” involve the bone splitting into multiple pieces. A simple closed fracture is much easier to treat and has a much better prognosis for full recovery than an open comminuted fracture. Another type of bone fracture is a “compression fracture,” which usually occurs in the vertebrae (the bones that make up the spinal column). There are approximately 14 different types of fractures.

Fractures are most frequently a result of an accident such as a bad fall or motor vehicle collision. The time it takes for a bone to heal depends on the type of fracture, where it is, and if it is an open or closed fracture. Healing of a broken bone is a gradual process, and it can take anywhere from a few weeks to several months. The healing process may, in fact, take even longer in some cases, such as in the presence of chronic diseases like osteoporosis and diabetes. As a person gets older, their bones become weaker making the individual more prone to fractures if they fall. Young children get different types of fractures because their bones are more elastic. They also have growth plates at the ends of the bones that can be damaged.

In order for a fracture to heal as well as possible, a good placement (“reduction”) of the bones must be attained. When doctors talk about “reduction” of a fracture, or “reducing” the broken bone, they are talking about improving the alignment of the broken ends of the bone. In most cases reducing a fracture may involve a little pulling and tugging of the bones to attain optimal alignment. Once the bones are properly aligned, a plaster or fiberglass cast will be applied to hold the bones in the proper position while they heal.

A plaster cast molds to the skin better and is preferred if the broken bone needs to be held in a specific place. If the fracture is not unstable, or if some healing has already taken place, a fiberglass cast may be used. In many cases, physical therapy is required after the fracture has healed and the cast is taken off to strengthen the muscles and restore mobility in the affected area. Fractures near or through joints may result in the joint becoming permanently stiff or being unable to bend properly. In such a case, the lawyer will argue that the patient/client is entitled to recover a higher monetary award to compensate the injured person for the added pain and suffering, lack of enjoyment of life, and work prohibitions that the victim will experience.

If the bones cannot be properly aligned or are not sufficiently stable, and reduction cannot be satisfactorily achieved, then surgery is often necessary. In one type of surgery, “internal fixation,” an orthopedic surgeon aligns the fractured bones with pins, plates, screws, or rods. A second type is “external fixation.” Here, the pins or screws are placed into the broken bone above and below the fracture site. The orthopedic surgeon then repositions the bone fragments, and the pins or screws are connected to a metal bar or bars outside the skin. The external fixation devices hold the bones in the proper position so they can heal. After an appropriate amount of time, the external fixation devices are removed.

Occasionally the orthopedic surgeon uses “bone grafting” to treat a fracture. A bone graft is surgery to place new bone into spaces around a broken bone or bone defects. The new bone can be taken from the patient’s own healthy bone (an “autograft”), from frozen, donated bone (“allograft”), or an artificial, synthetic, or natural substitute for bone. Bone grafting is used to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. The new bone is held in place with pins, plates, or screws. Stitches are used to close the wound, and a splint or cast is usually used to prevent injury or movement while the bone is healing.

Bone grafts are used to fuse joints to prevent movement, repair broken bones (fractures) that have bone loss, and to repair bone that has not healed. Surgeons use bone grafts to repair and rebuild diseased bones in the hips, knees, spines, and sometimes other bones and joints. Most bone grafts help the bone defect to heal with little risk of graft rejection, and recovery time generally varies from two weeks to two months, depending on the injury or defect being treated. Vigorous exercise is usually prohibited for up to six months.

If you have suffered a broken bone due to another person’s carelessness (“negligence”), you are entitled to recover your medical expenses, lost wages, pain and suffering, and loss of enjoyment of life you endured from the party that negligently injured you, as well as the lost wages for the time you are off work for surgery, recovery, and physical therapy. Recoverable medical expenses include visits to the emergency room, your primary care provider, an orthopedic specialist, and the costs of having a cast made for you. If the break results in a deformity or limp that you will have to live with for the rest of your life, you are entitled to receive damages for that as well.