The second fracture is similar to the first fracture in that there is localized swelling, pain, limited mobility, and longitudinal tenderness. If the fracture was internally fixed and the internal fixation is loose and not broken, the swelling and pain are not as severe as the first fracture, and the longitudinal tenderness is not as obvious. However, if the internal fixation has been broken or if the first fracture was not internally fixed at that time, the second fracture may be more serious, and there may be localized bone friction or pseudoarticular movement, and there may be localized deformity, and the second fracture must usually be treated surgically again, with surgical cut-and-replace internal fixation.