Hip
Impingement (FAI), labral tears, dysplasia, gluteal tendon tears and arthritis. The hip is Dr. Lázaro's sub-specialty.
Fracture care
Sports and traumatic fractures
Hip, knee, shoulder, collarbone, elbow, wrist and ankle fractures and stress fractures in athletes, with non-operative care or surgical fixation (ORIF).
Overview
A fracture is a break in a bone. It can happen suddenly — in a fall, an accident or a play on the field — or gradually from repeated stress, as with stress fractures in runners and athletes.
Treatment depends on which bone is involved, whether the fracture has shifted or reaches the joint, and your age and activity level. The goal is for the bone to heal in good position so you can regain the function of the joint.
Common conditions we treat
Fractures around the hip
Include fractures of the femoral neck, and the intertrochanteric area. In younger people they usually follow high-energy trauma; in older adults, falls.
Fractures around the knee
Can involve the kneecap, the lower femur or the tibial plateau (the top of the shinbone), which is part of the joint surface.
Fractures around the shoulder
Include fractures of the upper humerus and the shoulder blade or glenoid. They are common after falls onto the shoulder or an outstretched arm.
Clavicle (collarbone) fractures
Very common after falls and contact sports. When the collarbone is displaced or shortened, it can be fixed with a plate and screws (ORIF).
Elbow (olecranon) fractures
The olecranon is the tip of the elbow. These usually happen from a direct fall onto the elbow and, if the pieces separate, are treated with surgical fixation (ORIF).
Wrist fractures
Usually of the distal radius, from falling on an outstretched hand. Displaced fractures or those that reach the joint can be aligned and fixed with a plate (ORIF).
Ankle fractures
Happen when the ankle is twisted or struck. If the ankle is left unstable or out of alignment, it is repaired with open reduction and internal fixation (ORIF).
Stress fractures
Small cracks in the bone from repetitive stress, common in runners and athletes. They can occur in the hip (femoral neck), the shinbone or the foot.
Sports fractures
Caused by impact or falls during sports. For athletes, the plan aims for solid healing and a safe, gradual return to play.
Fractures that reach the joint
When the fracture line enters the joint surface, restoring its shape is important to lower the risk of future arthritis.
Symptoms that deserve an evaluation
- Severe pain after a fall, blow or accident
- Swelling or bruising around the area
- Visible deformity or a bone out of place
- Inability to bear weight or move the joint
- Pain that increases with activity and improves with rest (possible stress fracture)
- Pinpoint pain when pressing on a specific spot of the bone
Treatment options
Every plan is individual. Whenever appropriate, we start with the least invasive treatment and only recommend surgery when it can truly help you.
Step 1 · Non-operative
Non-operative treatment
Many stable or non-displaced fractures heal without surgery, with close follow-up.
- Cast, splint or braceTo hold the bone in place while it heals.
- SlingFor certain shoulder and collarbone fractures.
- Protected weight bearingCrutches or a walker and a plan to increase weight gradually.
- Follow-up X-raysTo confirm the bone is healing in good position.
Step 2 · Joint preservation
Surgical fixation
When a fracture is displaced, unstable or involves the joint, surgery helps align and stabilize the bone.
- Open reduction and internal fixation (ORIF)The bone is aligned and held with plates and screws — for example, in ankle, wrist, olecranon (elbow) and clavicle fractures.
- Intramedullary nailingA rod inside the bone to stabilize certain long-bone fractures.
- Screw fixationFor selected fractures, including some high-risk stress fractures.
- Arthroscopy-assisted techniquesFor some fractures that reach the joint, to see and align the surface.
Step 3 · Joint replacement
Joint replacement
For some complex fractures, especially in older adults, replacing the joint may be the best option.
- Hemiarthroplasty or total hip replacementFor certain femoral neck fractures.
When to see an orthopedic specialist
- You have pain, swelling or bruising after a fall or blow that is not improving
- You were diagnosed with a fracture in the emergency room and need orthopedic follow-up
- You are an athlete or runner with pain that worsens with activity
- Your fracture does not seem to be healing or still hurts after several weeks
- Seek emergency care (911) if the bone breaks through the skin, there is obvious deformity, you cannot move the limb or you feel numbness
Frequently asked questions
Do all fractures need surgery?
No. Many stable or non-displaced fractures heal with a cast, splint, brace or sling. Surgery is considered when the bone has shifted, the fracture is unstable or it involves the joint surface.
How long does a fracture take to heal?
It depends on the bone, the type of fracture, your age and your overall health. Most bones need several weeks to heal, and fully regaining strength and motion can take longer. Your doctor will give you an estimate for your case.
What is a stress fracture?
It is a small crack in the bone caused by repetitive stress, such as running or training more than the bone can tolerate. It sometimes does not show on early X-rays, so an MRI may be needed.
I was seen in the ER. Do I need to see an orthopedic surgeon?
Yes. The emergency room usually immobilizes the fracture and refers you to an orthopedic surgeon to decide on definitive treatment. Book your visit soon and bring your X-rays, imaging and reports.
What is recovery like after a fracture?
It usually includes a period of protection, follow-up X-rays and physical therapy to regain motion and strength. Returning to work or sports is gradual, based on how the bone heals.
This content is educational and does not replace a medical evaluation. Every case is different: diagnosis and treatment are determined during your visit.
Other areas we treat
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