Fracture

A fracture is a crack or “break” in a bone where the continuity of the bone is broken or disrupted due to a force that is too strong for the bone to withstand. A bone can be completely fractured or partially fractures and the fracture can present in various ways (horizontally across the bone, vertically down the bone, in an angle, in a spiral formation, shattered, ect)

The severity of a fracture depends on the amount of force that caused the break, whether that force is internal or external. The way in which it breaks will depend on the way the force is applied to the bone.

Common types of fractures include:

Type of Fracture	Description
Stable/non-displaced fracture	Ends of the broken bone line up and are minimally out of place
Non-stable/displaced fracture	Ends of the broken bone do not line up and are not aligned
Open/compound fracture	A piece or pieces of the broken bone pierce through the skin or are exposed through an open wound (this type has a high risk of infection)
Closed/simple fracture	The pieces of the broken bone do not pierce the skin and stay under the skin
Transverse fracture	A horizontal fracture across the bone (perpendicular to bone)
Linear fracture	A vertical fracture down the bone (parallel to the bone)
Oblique fracture	An angled fracture pattern across the bone
Spiral fracture	Occurs when a rotating force is applied along the long axis of a bone and the fracture twists around the bone. Spiral fractures often occur when the body is in motion while one extremity is planted.
Comminuted fracture	The bone shatters into three or more pieces (this is common in car crashes)
Stress fracture	Hairline crack most often caused by overuse
Greenstick fracture	Occurs when the bone bends but does not break (only occurs in children)
Buckle fracture	Compression of two bones forced into each other
Growth plate fracture	Occurs at the end of the bone near the joint where the growth plate is and could affect growing/cause a limb length discrepancy if not treated properly (only occurs in children)

 

Symptoms

• Pain- usually localized to a specific point

• Swelling/inflammation

• Bruising

• Deformity

 

Causes

• Trauma such as a fall, car accident, or getting hit with something

• Osteoporosis

• Overuse repetitive motions that place excessive and continuous strain on the bone

 

Risk factors

• Age- common in childhood and old age

• Osteoporosis

• Low bone density

• High contact sport

• Lack of calcium and vitamin D in the diet

 

Prevention

• Proper diet and exercise may help in preventing some fractures. 

• A diet rich in calcium and Vitamin D will promote bone strength. 

• Weightbearing exercise also helps keep bones strong.

 

Diagnosis

• Physician evaluation

• X-ray: The doctor will likely use an x-ray to verify the diagnosis. X-rays can show whether a bone is intact or broken. They can also show the type of fracture and exactly where it is located within the bone.

• Bone scan or MRI- for smaller fractures or a fracture in a delicate area these more sensitive scans may be ordered 

 

Treatment

Non-Surgical Treatment:

• Cast Immobilization: A plaster or fiberglass cast is the most common type of fracture treatment, because most broken bones can heal successfully once they have been repositioned and a cast has been applied to keep the broken ends in proper position while they heal.

• Functional Cast or Brace: The cast or brace allows limited or "controlled" movement of nearby joints. This treatment is desirable for some, but not all, fractures.

• Traction: Traction is usually used to align a bone or bones by a gentle, steady pulling action.

 

Surgical Treatment:

• External Fixation: In this type of operation, metal pins or screws are placed into the broken bone above and below the fracture site. The pins or screws are connected to a metal bar outside the skin. This device is a stabilizing frame that holds the bones in the proper position while they heal. In cases where the skin and other soft tissues around the fracture are badly damaged, an external fixator may be applied until surgery can be tolerated.

• Open Reduction and Internal Fixation: During this operation, the bone fragments are first repositioned (reduced) in their normal alignment, and then held together with special screws or by attaching metal plates to the outer surface of the bone. The fragments may also be held together by inserting rods down through the marrow space in the center of the bone.