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What to Expect From a Complicated Fracture Injury

X-ray Lt.leg AP.Fracture fibula and mid shaft tibia with Oost ORIF with plates and screws.

Fractures are among the most common injuries cyclists encounter in a bike crash, but it’s a common misconception that they heal faster than other bone-related injuries. In fact, cyclists are prone to experiencing complicated fractures, which can require surgeries, physical therapy and lots of patience throughout the healing process.

Because a cyclist exposes more of their body, they’re more vulnerable to impact injuries that can easily result in fractures. Fractures in wrists, hands, fingers and collarbones result from extending arms out to break a fall, while a motor vehicle impact can cause fractures in the pelvis, hips and femur. Skull fractures are also common injuries that often accompany a traumatic brain injury. 

These fractures can vary, from relatively minor to complicated fractures, which require much more care, time and recovery.

What is a complicated fracture? 

Like its name explains, a complicated — or “complex” — fracture is more involved than just a typical crack in the bone. Yale physicians describe complicated fracture as being “when the bone breaks into bits and pieces, when the soft tissue surrounding the bone is severely damaged, or when the patient has other illnesses or injuries that complicate treatment and healing.”

This means that it’s not only the bone that’s affected. Tissue, blood vessels, muscles and other parts of the body may also be injured. When a bicycle accident happens it might not be immediately obvious that a fracture is complicated, which is why it’s important to quickly seek out medical attention. Clavicle fractures, for example, might not require an immediate bone reset, but doctors will want to examine whether blood vessels near the injury are impacted and need more medical attention. 

Fractures “that result from a motor vehicle accident or a fall from a high place are of a different magnitude,” Yale doctors explain. “Such accidents can cause serious injuries all over the body, shattering and/or breaking multiple bones, often in several places.” Bicycle accidents most often involve speed, which is why they can often result in complicated fractures. 

E-bikes, which are powered by a motor, increase the bike’s speed, also meaning impacts during a crash may be more severe. Studies show that injuries from e-bike are becoming more prevalent as popularity soars.

Do complicated fractures require surgery? 

Each accident is different and so is every injury. Complicated fractures can differ greatly, and because more than just the bone is impacted, it’s possible that surgery is required. 

Treatment of complicated fractures may include: 

  • Fracture fixation: This is a stabilizing surgery that can also prepare for reconstruction. 
  • Debridement: Dead tissue is removed to allow for proper healing. 
  • Soft tissue coverage: Tissue is taken from other parts of the patient’s body to cover the injury. 
  • Fracture reconstruction: Fixing a fracture may require using metal screws, rods or plates to hold the bone in place while it heals.

It’s important to remember that fractures are as unique as the crash. Several different variables will determine whether surgery is necessary, and even in the case that it’s not, you may be in for a long recovery period.

Recovery time differs

You should be prepared for a long recovery time if you’re dealing with a complicated fracture. Not only does impacted bone need to heal, which can take months depending on severity, you may have muscles and tissue that also need to heal. Our bicycle lawyers at Bay Area Bicycle Law often see clients who’ve encountered an accident and months later are still recovering. This means that they require extended medical care, even after the initial crash.

A complicated fracture most likely means that your injury requires physical therapy to regain mobility. In some cases, such as simple fractures, the bone can heal completely. Complicated fractures, however, may leave you with mobility more limited than before the accident. This could delay your return to cycling and require extensive work, which can also be costly. Working with an experienced personal injury attorney on your case may ensure that you pay less for the health care you need to get better, and get compensated for any permanent disability.

The 2016 study found that clavicle fractures, for example, make up about 10% of all sports-related injuries and have the third longest return time to the sport, “with as many as 20% of athletes with such injuries failing to return to sport.” The factor is an average across various sports, but highlights how serious a common injury can be. 

“The management of clavicle fractures depends on the location (mid-shaft, lateral, medial) and the nature (displaced, undisplaced, comminuted) of the fracture,” the study says. “The commonest fracture locations in sporting populations are mid-shaft (70%) and lateral (25%).  Around 45% of sport-related clavicle fractures are undisplaced.”

Long-term effects

Given the complex nature of complicated fractures, it may take longer than expected to recover. Researchers have found that specifically can weigh on a person after an accident. The time of recovery, cost, loss of work and stress caused by a complicated fracture can easily compound, weighing on a person’s mental health, too. 

“Long bone fractures are common injuries caused by trauma and are a common cause for referral to hospitals,” one 2019 study says. “Little consideration has been given to the impact of long bone fractures in adults despite the World Health Organization’s statement that such injuries cause substantial morbidity in low- and middle-income countries.”

Even in high-earning countries, such as the United States, an injury like a complicated fracture can take a toll. 

“In some cases, the fracture prevents patients from working and meeting financial obligations,” the study says. “The injury limited previously normal social interactions and pre-injury functioning.”