Know the basics
1. What is fracture?
Fracture is the medical term for a broken bone. There are four main categories: displaced, non-displaced, open, and closed.
Displaced and non-displaced fractures refer to the way the bone breaks. In a displaced fracture, the bone snaps into two or more parts and moves so that the two ends are not on a straight line. In a non-displaced fracture, the bone cracks either part or all of the way through, but does move and maintains its proper alignment.
A closed fracture is when the bone breaks but there is no puncture or open wound in the skin. The open type is one in which the bone breaks through the skin; it may then recede back into the wound and not be visible through the skin. This is an important difference from a closed fracture. As with an open fracture, there is a risk of a deep bone infection.
There are many types of fractures. Some common types include:
- Avulsion fracture – a muscle or ligament pulls on the bone, fracturing it.
- Comminuted fracture – the bone is shattered into many pieces.
- Compression (crush) fracture – generally occurs in the spongy bone in the spine. For example, the front portion of a vertebra in the spine may collapse due to osteoporosis.
- Fracture dislocation fracture – a joint becomes dislocated, and one of the bones of the joint has a fracture.
- Greenstick fracture – the bone partly fractures on one side, but does not break completely because the rest of the bone can bend. More common among children, whose bones are softer and more elastic.
- Hairline fracture – a partial fracture of the bone. Often this type of fracture is harder to detect.
- Impacted fracture – when the bone is fractured, one fragment of bone goes into another.
- Longitudinal fracture – the break is along the length of the bone.
- Oblique fracture – a fracture that is diagonal to a bone’s long axis.
- Pathological fracture – when an underlying disease or condition has already weakened the bone, resulting in a fracture (bone fracture caused by an underlying disease/condition that weakened the bone).
- Spiral fracture – a fracture where at least one part of the bone has been twisted.
- Stress fracture – more common among athletes. A bone breaks because of repeated stresses and strains.
- Torus (buckle) fracture – bone deforms but does not crack. More common in children. It is painful but stable.
- Transverse fracture – a straight break right across a bone.
Fracture is extremely common. It can affect patients at any age. However, you can manage this by reducing the risk factors. Please discuss with your doctor for further information.
The common symptoms are:
- Swelling and tenderness around the injury;
- Deformity of an arm or leg;
- Pain in the injured area that gets worse when the area is moved or pressure is applied;
- Loss of function in the injured area;
- In open fractures, bone protruding from the skin.
There may be some symptoms not present above. If you have any concerns about a symptom, please consult your doctor.
Diagnosis and Treatments
1. How is fracture diagnosed?
The most common way to evaluate this health condition is with X-rays, which provide clear images of bone. Your 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 locate it within the bone.
Sometimes an X-ray will not show a fracture. This is especially common with some wrist fractures, hip fractures (especially in older people), and stress fractures. In these situations, your doctor may perform other tests, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI) or a bone scan.
In some cases, such as a possible wrist fracture with an initially normal X-ray, your doctor may apply a splint to immobilize the area and order a second X-ray 10 to 14 days later.
Occasionally, even after getting the diagnosis, you may need other tests (such as a CT scan, MRI, or angiogram, a special X-ray of blood vessels) to determine whether other tissues around the bone have been damaged.
If your doctor suspects a skull fracture, he or she will probably skip the X-rays altogether and proceed directly to a CT scan, which will diagnose the fracture and any more important related injuries inside the skull, such as bleeding around the brain.
2. How is fracture treated?
♦ Basics of Treatment
Treatment follows one basic rule: the broken pieces must be put back into position and prevented from moving out of place until they are healed. Broken bone ends heal by “knitting” back together with new bone being formed around the edge of the broken parts.
Surgery is sometimes required to treat a fracture. The type of treatment required depends on the severity of the break, whether it is “open” or “closed,” and the specific bone involved.
♦ Classification of Treatment
Doctors use a variety of treatments to treat this health condition:
◊ Cast immobilization
A plaster or fiberglass cast is the most common type of 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, broken bones.
Traction is usually used to align a bone or bones by a gentle, steady pulling action.
◊ 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 injured site 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.
1. What causes fracture?
- Trauma: a fall, a motor vehicle accident, or a tackle during a football game can all result in fractures.
- Osteoporosis: this disorder weakens bones and makes them brittle and more likely to break.
- Overuse: repetitive motion can tire muscles and place more force on bone. This can result in stress fractures. Stress fractures are more common in athletes.
2. What increases my risk for fracture?
Your risk of broken bone depends partly on your age. Broken bones are very common in childhood, although children’s fractures are generally less complicated than ones in adults. As you age, your bones become more brittle and you are more likely to suffer this from falls that would not occur when you were young.
Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.
GO.CARE does not provide medical advice, diagnosis or treatment.
Understanding Bone Fractures — the Basics. http://www.webmd.com/a-to-z-guides/understanding-fractures-basic-information. Accessed October 3, 2016.
Fractures (Broken Bones). http://orthoinfo.aaos.org/topic.cfm?topic=a00139. Accessed October 3, 2016.
Fractures: Causes, Symptoms and Diagnosis. http://www.medicalnewstoday.com/articles/173312.php#what_is_a_fracture. Accessed October 3, 2016.
Fractures. https://medlineplus.gov/fractures.html. Accessed October 3, 2016.