Because of legal restrictions, MOMSCIS cannot give specific medical advice. The following information is not a substitute for the personal care or advice of your physician. Please discuss any concerns with your physician regarding your medical care. Physicians in the Physical Medicine & Rehabilitation Department at the University of Missouri-Columbia are available to evaluate patient records, and can set up a clinic visit for a medical evaluation. The PM&R Department does extensive treatment of individuals with spinal cord injuries using a wide variety of physical therapies and state-of-the-art medications. Individuals with spinal cord injuries can be examined and treated on an outpatient or inpatient basis. For more information about the PM&R services available or to schedule a clinic visit, telephone the clinic at (573) 884-0033.

How are broken bones treated?

Q. A friend of mine, who has a spinal cord injury, recently broke his leg. I was surprised that his doctor did not put his leg in a cast. How are broken bones treated when a person has a spinal cord injury?

A. Bone fractures occurring above the level of a person's spinal cord injury are treated the same as fractures in persons without spinal cord injury. When a fracture happens below the level of injury, however, different treatment is necessary. Hard casts and splints can cause pressure sores and other complications such as inappropriate limitation of daily living activities and mobility, which could undermine the health of a person with spinal cord injury. The goal for treating a fracture below the level of spinal cord injury is to enable healing while minimizing complications. To achieve this, the broken bones are immobilized using soft material such as a pillow splint or a padded brace. This helps prevent pressure sores. Surgery is only recommended if the fracture does not heal using these materials.

There are other complications associated with fractures. Not the least of these is autonomic dysreflexia, a life-threatening condition. Other complications include blood clots in the leg, increased spasms, sweating, swelling, and reduced mobility.

During the first weeks after a fracture, a person with spinal cord injury may experience increased spasticity. Mild spasticity helps reduce the chance of blood clots in the leg. Blood thinners are sometimes prescribed to prevent or treat blood clots. For excessive spasticity, Valium or a similar drug may be used. Spasticity should subside within two to three weeks. Sweating can be controlled with medication. Swelling is managed with equipment modifications such as raising the leg rests on a wheelchair or propping up the leg which also facilitates healing. Fractures typically take 2-3 months to heal. During this time, a person can expect some limitation of daily living activities and mobility.