Types
There is a range of fracture types, including:
- 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 – 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. This is more common among children, whose bones are softer and more elastic.
- Hairline fracture – a partial fracture of the bone. Sometimes this type of fracture is harder to detect with routine xrays.
- Impacted fracture – when the bone is fractured, one fragment of bone goes into another.
- Intraarticular fracture – where the break extends into the surface of a joint
- 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.
Symptoms
The signs and symptoms of a fracture vary according to which bone is affected, the patient’s age and general health, as well as the severity of the injury. However, they often include some of the following:
- pain
- swelling
- bruising
- discolored skin around the affected area
- angulation – the affected area may be bent at an unusual angle
- the patient is unable to put weight on the injured area
- the patient cannot move the affected area
- the affected bone or joint may have a grating sensation
- if it is an open fracture, there may be bleeding
When a large bone is affected, such as the pelvis or femur:
- the sufferer may look pale and clammy
- there may be dizziness (feeling faint)
- feelings of sickness and nausea.
If possible, do not move a person with a broken bone until a healthcare professional is present and can assess the situation and, if required, apply a splint. If the patient is in a dangerous place, such as in the middle of a busy road, one sometimes has to act before the emergency services arrive.
Causes
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 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.
Diagnosis and treatment
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 process 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.
Have Any Questions?
General Orthopedics
Specialist in treating a wide variety of injuries and conditions that impact bones, joints, ligaments, tendons, muscles and nerves.
Arthritis
Bursitis
Chronic Pain
Deformities
Disorders
Fractures
Injuries
Sprains
Strains
Tendonitis
Meniscal Tears
Professional Affiliations
Dr. Nourian is affiliated with American Academy of Orthopedic Surgeons, American Board of Orthopedic Surgery, California Medical Association, North American Spine Society, Ventura County Medical Association.
