A fracture is a broken bone. It can range from a thin crack to a complete break. Bone can fracture crosswise, lengthwise, in several places, or into many pieces. Most fractures happen when a bone is impacted by more force or pressure than it can support.
A bone fracture is a medical condition where the continuity of the bone is broken.
A significant percentage of bone fractures occur because of high force impact or stress.
However, a fracture may also be the result of some medical conditions which weaken the bones, for example osteoporosis, some cancers, or osteogenesis imperfecta (also known as brittle bone diseases).
If you suspect you have a fracture, seek medical help immediately.
What is Bone Fracture?
In short, a fracture is a broken bone. Your bones are designed to be flexible and even bend to a certain degree. When a force against your body is too strong your bones can break. The severity of the break determines what kind of fracture it is.
The four most common types of fracture are:
- Stable fracture: The ends of your broken bones bone line up and are not significantly out of place
- Compound fracture: This is when your broken bone pierces the skin, exposing your bone to air. The bone may or may not be visible from the wound.
- Transverse fracture: This fracture occurs in a horizontal line across your bone.
- Oblique fracture: This type of fracture happens at an angle.
Additional bone fracture types include:
- Avulsion fracture: One piece of bone is separated from the rest of your bone.
- Buckled fracture: The ends of two bones are driven into each other.
- Comminuted fracture: Your bone breaks into multiple pieces.
- Compression or wedge fracture: This is common among the vertebrae in your back.
- Greenstick fracture: Your bone is bent but not broken.
- Linear fracture: The break runs vertically down the length of your bone.
- Oblique fracture: The place where your bone broke is curved.
- Pathologic fracture: A fracture caused by weakened bones.
- Spiral fracture: Your bone twisted at the place where it is broken.
- Stress fracture: This is also called a hairline fracture because it is so small.
- Transverse fracture: The broken piece of bone is at a right angle to the rest of your bone.
Types of Bone Fractures
Transverse fractures are breaks that are in a straight line across the bone. This type of fracture may be caused by traumatic events like falls or automobile accidents.
As the name suggests, this is a kind of fracture that spirals around the bone. Spiral fractures occur in long bones in the body, usually in the femur, tibia, or fibula in the legs. However, they can occur in the long bones of the arms. Spiral fractures are caused by twisting injuries sustained during sports, during a physical attack, or in an accident.
This is a partial fracture that occurs mostly in children. The bone bends and breaks but does not separate into two separate pieces. Children are most likely to experience this type of fracture because their bones are softer and more flexible.
Stress fractures are also called hairline fractures. This type of fracture looks like a crack and can be difficult to diagnose with a regular X-rays. Stress fractures are often caused by repetitive motions such as running.
When bones are crushed it is called a compression fracture. The broken bone will be wider and flatter in appearance than it was before the injury. Compression fractures occur most often in the spine and can cause your vertebrae to collapse. A type of bone loss called osteoporosis is the most common cause of compression fractures.
An oblique fracture is when the break is diagonal across the bone. This kind of fracture occurs most often in long bones. Oblique fractures may be the result of a sharp blow that comes from an angle due to a fall or other trauma.
An impacted fracture occurs when the broken ends of the bone are driven together. The pieces are jammed together by the force of the injury that caused the fracture.
The same bone is fractured in two places, leaving a “floating” segment of bone between the two breaks. These fractures usually occur in long bones such as those in the legs. This type of bone fracture may take longer to heal or cause complications.
A comminuted fracture is one in which the bone is broken into 3 or more pieces. There are also bone fragments present at the fracture site. These types of bone fractures occur when there is a high-impact trauma, such as an automobile accident.
An avulsion fracture occurs when a fragment is pulled off the bone by a tendon or ligament. These types of bone fractures are more common in children than adults. Sometimes a child’s ligaments can pull hard enough to cause a growth plate to fracture.
What Are The Signs And Symptoms Of A Broken Bone?
Broken bones hurt. The lining of the bone (periosteum) is rich with nerve endings that can cause pain when inflamed; and the muscles surrounding the fracture go into spasm to prevent movement of the fracture site, and this spasm may intensify the pain.
Bones have a rich blood supply and will bleed when injured. This will cause swelling and the blood that seeps into the surrounding tissue will also cause further pain. The discoloration due to the blood can show up as dark red or purple bruise in the area of the fracture site.
Because muscles and tendons may not be damaged, the person may be able to move the injured extremity. For that reason, just because you can move the injured area, doesn’t mean it’s not broken.
If there is damage to a nearby artery, the injury may be cool and pale (distal to the injury), and if there is nerve damage, there may be numbness (distally).
Most fractures are caused by a bad fall or automobile accident. Healthy bones are extremely tough and resilient and can withstand surprisingly powerful impacts. As people age, two factors make their risk of fractures greater: Weaker bones and a greater risk of falling.
Children, who tend to have more physically active lifestyles than adults, are also prone to fractures.
People with underlying illnesses and conditions that may weaken their bones have a higher risk of fractures. Examples include osteoporosis, infection, or a tumor. As mentioned earlier, this type of fracture is known as a pathological fracture.
Stress fractures, which result from repeated stresses and strains, commonly found among professional sports people, are also common causes of fractures.
How Is A Fracture Diagnosed?
If you suspect you have a fracture, get medical attention immediately. Your doctor will likely ask you about your symptoms and perform a visual examination of the injured area. They may ask you to move the area in certain ways to check for pain or other signs of injury.
If they think you may have a fracture, your doctor will likely order X-rays. According to the American Academy of Orthopaedic Surgeons, X-rays are the most common method of fracture diagnosis. They can create images of your bone and reveal breaks or other signs of damage. X-rays also help determine fracture type and location.
In some instances, your doctor may also order magnetic resonance imaging (MRI) or computed tomography scans (CT or CAT scan) to examine your bones or surrounding tissues.
A doctor will carry out a physical examination, identify signs and symptoms, and make a diagnosis.
The patient will be interviewed – or friends, relatives, and witnesses if the patient cannot communicate properly – and asked about circumstances that caused the injury or may have caused it.
Doctors will often order an X-ray. In some cases, an MRI or CT scan may also be ordered.
Bone healing is a natural processTrusted Source which, in most cases, will occur automatically. Fracture treatment is usually aimed at making sure there is the best possible function of the injured part after healing.
Treatment also focuses on providing the injured bone with the best circumstances for optimum healing (immobilization).
For the natural healing process to begin, the ends of the broken bone need to be lined up – this is known as reducing the fracture.
The patient is usually asleep under a general anesthetic when fracture reduction is done. Fracture reduction may be done by manipulation, closed reduction (pulling the bone fragments), or surgery.
Immobilization – as soon as the bones are aligned they must stay aligned while they heal. This may include:
- Plaster casts or plastic functional braces – these hold the bone in position until it has healed.
- Metal plates and screws – current procedures may use minimally invasive techniques.
- Intra-medullary nails – internal metal rods are placed down the center of long bones. Flexible wires may be used in children.
- External fixators – these may be made of metal or carbon fiber; they have steel pins that go into the bone directly through the skin. They are a type of scaffolding outside the body.
Usually, the fractured bone area is immobilized for 2-8 weeks. The duration depends on which bone is affected and whether there are any complications, such as a blood supply problem or an infection.
Healing – if a broken bone has been aligned properly and kept immobile, the healing process is usually straightforward.
Osteoclasts (bone cells) absorb old and damaged bone while osteoblasts (other bone cells) are used to create new bone.
Callus is new bone that forms around a fracture. It forms on either side of the fracture and grows toward each end until the fracture gap is filled. Eventually, the excess bone smooths off and the bone is as it was before.
The patient’s age, which bone is affected, the type of fracture, as well as the patient’s general health are all factors which influence how rapidly the bone heals. If the patient smokes regularly, the healing process will take longer.
Physical therapy – after the bone has healed, it may be necessary to restore muscle strength as well as mobility to the affected area. If the fracture occurred near or through a joint, there is a risk of permanent stiffness or arthritis – the individual may not be able to bend that joint as well as before.
Surgery – if there was damage to the skin and soft tissue around the affected bone or joint, plastic surgery may be required.