Fracture & Trauma Surgery at OSI
A broken bone is one of the most common reasons people need orthopedic surgery, and not every fracture needs an operation. Many heal well in a cast or boot. Surgery comes in when the bone is out of place, unstable, involves a joint surface, or will not heal reliably on its own. The goal is the same in every case: put the bone back where it belongs and hold it there steadily enough that you can start moving and healing.
OSI surgeons treat fractures across the whole skeleton, and the surgeon who sees you in clinic or the emergency department is the one who fixes the fracture and follows your recovery. Fracture surgery is done at our partner hospitals, with follow-up at any of our six clinic locations. For the injuries themselves and how they are diagnosed and treated without surgery, see Fracture & Trauma Care and the full list of injuries we treat.
How Fracture Surgery Works
The most common fracture operation is open reduction and internal fixation. "Reduction" means putting the broken pieces back into alignment. "Internal fixation" means holding them there with hardware: plates and screws, a rod down the center of the bone, or pins and wires, depending on which bone broke and how. The hardware holds while your body heals, and in most cases it stays in for good.
Some breaks of a long bone are better treated with a rod placed down its hollow center, which shares the load while the bone knits. Fractures that run into a joint need the joint surface rebuilt precisely, so the cartilage lines up and arthritis is less likely later. Which approach fits your injury depends on the bone, the fracture pattern, your age, and your activity, and your surgeon will walk you through the reasoning.
Upper Extremity Fractures
Breaks of the arm and hand range from a collarbone or shoulder fracture after a fall to wrist fractures, the single most common broken bone in adults. Around the elbow, the bony tip (olecranon), the radial head, and the end of the humerus each have their own repair. In the hand, metacarpal and finger fractures are fixed when they are unstable or rotated.
Lower Extremity & Pelvic Fractures
Hip fractures are common after a fall in older adults and are usually fixed promptly so a patient can get back on their feet, with the repair tailored to the pattern: femoral neck, intertrochanteric, or subtrochanteric. Further down, the thigh bone, upper shin, shin shaft, lower shin, and ankle are all frequently repaired. In the foot, the heel bone and talus are high-stakes repairs because of the joints they carry. Pelvic ring and hip-socket injuries (pelvic ring, acetabular) are among the most complex.
Open Fractures and Healing Problems
When a fracture breaks through the skin it is an open fracture and an emergency: it needs prompt irrigation and debridement to clean the wound and lower the risk of infection, often before or alongside the bone repair. Sometimes a fracture does not heal on schedule, and a nonunion repair revisits a break that has failed to knit, often adding bone graft and stronger fixation. Once a fracture is healed, hardware occasionally causes irritation and can be taken out with a hardware removal. In rare, severe injuries where a limb cannot be saved, amputation is part of orthopedic trauma care.
All Trauma Procedures We Perform
Upper extremity
Lower extremity & pelvis
Open fractures & healing problems
What Surgery Day Looks Like
Fracture surgery is often more urgent than planned, so the timeline depends on your injury. A wrist or ankle fracture is frequently fixed as a same-day or outpatient procedure once swelling allows. A hip fracture is usually repaired within a day or two of arrival so you can stand and walk soon after. The anesthesia team keeps you comfortable, often with a nerve block, and you leave with written instructions, weight-bearing limits, and a follow-up plan. Someone needs to drive you home.
Recovery and What to Expect
Bone takes time. Most fractures need roughly six to twelve weeks to heal enough to bear normal load, though the exact timeline depends on which bone broke, how it was fixed, and your own healing. Your surgeon sets specific milestones for each phase: when you can put weight through the limb, when to come out of a splint or boot, and when to start therapy to rebuild motion and strength.
Healing follows the biology of the bone, not a calendar, so your restrictions are adjusted based on how your X-rays and your recovery are progressing. Physical therapy is usually part of getting back to full function once the bone is stable.
Who You Will See Here
All three of our board-certified orthopedic surgeons treat fractures and perform fracture surgery, with trauma experience that includes Dr. Twitero's prior role as Chief of Orthopedics at Fort Hood. The surgeon who treats your fracture follows you through healing. Meet our providers.
