There are 2 types of fracture fixation: inside and outside bone fixation. Both methods of fixation are surgical.
External Fracture Fixation is shown in our cartoon above at A. You're seeing some pins driven into the bone from outside the skin to hold the broken bones together. This method is preferred in open fractures (because using types B & C will risk infection through the gaping wound). It's also used in comminuted fractures because you can put as many pins in as you need. Once the bone has fused, the pins are taken out and discarded.
Internal Fracture Fixation is shown in B as a rod pushed down the center of the bone, or as C, a plate with screws going into the two ends of the bone. Both of these methods are used in broken bones that will not stay together but there's no open wound. For B, the skin over the top of the bone is surgically slit and with a special hammer the nail is beaten down from the top, through the center of the bone, down through the crack, into the other end. It is left in the bone permanently strengthening it. In type C The skin over the crack(s) is also surgically slit and the 'hardware' introduced and screwed in one side of the bone over the crack. It too is left in.