Fracture recovery: before and after the plaster comes off

A broken bone goes through stages: a blood clot forms around the break, soft new bone (callus) bridges the gap over a few weeks, and that callus hardens and remodels over months. Most adult fractures are stable enough to come out of a cast in 6 to 8 weeks, but the bone continues to strengthen for months afterwards.

Healing is slower in older adults, smokers, people with diabetes or poor nutrition, and in some bones such as the scaphoid in the wrist. Your doctor will decide when the cast comes off based on X-rays and examination.

Keep the injured limb raised above heart level as much as possible in the first days to control swelling. Move every joint that is not in the plaster. For a wrist fracture, that means fingers, elbow and shoulder. For an ankle fracture, the toes, knee and hip.

If you are on crutches or not allowed to put weight on a leg, ankle pumps on the other leg and exercises for the hip and knee help prevent stiffness and clots. Older adults should keep getting out of bed and moving within their limits.

Go to the hospital urgently if the plaster feels too tight, the fingers or toes turn pale, blue or cold, you have numbness, or pain is getting worse rather than better.

In India, some families take a fracture to a traditional bone setter. Whatever treatment you choose, get an X-ray to check the bone is lined up, because a bone that heals out of position can cause lasting problems.

Expect stiffness, weakness, swelling and some discomfort. The skin may be dry and the muscles visibly thinner. None of this means the bone has not healed. It is the result of weeks without movement.

The first goal is getting movement back, gently and often. Short sessions several times a day work better than one long session. Warm water can help stiff joints move more easily.

For an ankle fracture, walking may start with crutches or a boot and build up to full weight as your doctor allows. Ankle pumps, calf stretches and gentle walking come first.

Once movement is improving, strengthening starts. For a wrist, that means grip exercises, wrist movements against light resistance, and gradually bearing weight through the hand. For an ankle, heel raises, balance work and stairs.

Balance is often badly affected after an ankle fracture, and poor balance is a common reason for re-injury. Standing on one leg, first holding a counter, is a simple and effective exercise.

Most people regain most of their function by 3 to 6 months. Some stiffness, swelling at the end of the day, or aching in cold or wet weather can continue for longer.

Return to sport, heavy work, and riding a two-wheeler depends on the bone, how it was fixed and how well strength has recovered. A physiotherapist can test strength and balance and guide when to return.

A wrist fracture from a simple fall is often the first sign of osteoporosis, especially in women after menopause. It is worth asking the doctor about a bone density check.

It is also worth asking why the fall happened. Weak legs, poor balance, medicines that cause dizziness, poor eyesight and hazards at home are all things that can be improved. A strength and balance programme lowers the risk of the next fall.