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Customizing Care to Enhance Fracture Healing

Medscape interviewed William M. Ricci, MD, chief of Orthopedic Trauma at HSS, about customizing the care of patients with simple and complex fractures to enhance healing and minimize complications.

Dr. Ricci discussed the latest techniques and science in fracture healing. “In orthopedic trauma, we treat all different types of fractures, and we customize the treatment method to the particular fracture type and the particular patient. One thing that's relatively new is customizing the treatment to a particular subtype of fracture. Every fracture that we treat involves, to some degree, a race between the fracture healing and our implants failing,” said Dr. Ricci.

To enhance the healing process, Dr. Ricci underscored the importance of proper nourishment, and explained his practice for pain management, and weight bearing. “Good nourishment is needed to heal a fracture. We're particularly interested in making sure that patients have normal vitamin D levels. Vitamin D deficiency has been associated with healing problems and nonunion,” noted Dr. Ricci. He cited, “There is some controversy about treating patients with nonsteroidal anti-inflammatory drugs (NSAIDs) after a fracture. Some data indicate that NSAIDs can slow down fracture healing, and other, conflicting data indicate that they may not. In my practice, in patients with fractures that are at high risk for nonunion, I like to avoid NSAIDs and use other methods for controlling pain. Inflammation is a necessary and important part of the healing process.” Dr. Ricci concluded, “For certain fractures, weight bearing is absolutely safe and can augment the fracture healing process; but for other fractures, weight bearing is detrimental. That's why it's so important that we customize the postoperative protocol per patient per fracture.”

Read the article at Medscape.com.