The old plaster of Paris cast is often replaced today by a fiberglass one, but plaster is still used when a particularly snug-fitting cast is needed. The physician takes X-rays periodically to check that the bones have remained in place. Adults' bones are less forgiving when broken and don't remodel as well. With the help of new technology, orthopedists have become much more aggressive in treating adult fractures. Better imaging techniques reveal the precise position of the broken bones, and methods have improved for holding the bones in place.
Some fractures require surgery to carry out the bone repair and keep the fragments in place.
Here, too, the specialist has more options available in the form of pins, screws, and plates than in the past, Van Flandern says. Infrequently, such as in fracture patients with underlying diseases, normal calcification does not take place, and the bone ends don't knit properly. Sections of bone from a donor area of the patient or from a bone bank can be used in these so-called nonunions to bridge the gap. Devices that generate magnetic fields sometimes are implanted next to the bone or are used externally to stimulate bone growth. The magnetic devices, as well as ultrasound treatments used for the same purpose, are controversial.