What is the recommended management for comminuted fractures?

For comminuted fractures, open reduction and internal fixation (ORIF) is often the recommended management approach. Comminuted fractures, which involve the bone being broken into multiple fragments, can compromise the stability and alignment of the bone. ORIF allows for precise alignment and stabilization of the fragments using implants like plates, screws, or rods. This method encourages optimal healing by maintaining bone integrity and allows for early mobilization, which can lead to better functional outcomes compared to non-surgical methods.

In this context, the other options may not provide adequate stability or can lead to complications. For instance, external fixation might be utilized in certain cases of comminuted fractures, particularly when there's soft tissue involvement or when surgery is delayed, but it does not provide the same degree of stability and precision as ORIF. Conservative management could involve rest and immobilization, which is generally inadequate for comminuted fractures, particularly if alignment is significantly disrupted. Splinting may also provide temporary stabilization but ultimately does not address the need for internal fixation to ensure proper healing and function.

Thus, ORIF is favored for its comprehensive approach to restoring anatomical alignment and ensuring stable fixation in cases of comminuted fractures.