Bone Fracture

BONE FRACTURE
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).
Fractures can occur in any bone of the body.
The word "break" is commonly used by lay (non-professional) people.
Among doctors, especially bone specialists, such as orthopedic surgeons,

"break" is a much less common term when talking about bones.
A crack (not only a break) in the bone is also known as a fracture.

Fractures can occur in any bone in the body.
There are several different ways in which a bone can fracture; for
example, a break to the bone that does not damage surrounding tissue or tear
through the skin is known as a closed fracture.
On the other hand, one that damages surrounding skin and penetrates the
skin is known as a compound fracture or an open fracture. Compound fractures
are generally more serious than simple fractures, because, by definition, they are
infected.
Most human bones are surprisingly strong and can generally stand up to
fairly strong impacts or forces. However, if that force is too powerful, or there is
something wrong with the bone, it can fracture.
The older we get, the less force our bones can withstand. Because
children's bones are more elastic, when they do have fractures they tend to be
different. Children also have growth plates at the end of their bones - areas of
growing bone - which may sometimes be damaged.
Different kinds of Fractures
There are many types of fractures, but the main categories are displaced, non-
displaced, open, and closed. Displaced and non-displaced fractures refer to the
alignment of the fractured bone.
In a displaced fracture, the bone snaps into two or more parts and moves so
that the two ends are not lined up straight. 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.
An open fracture 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 because with an open fracture there is a risk of a
deep bone infection.
Other types of Fractures
A transverse fracture is a specific type of broken bone where the break

is at a right angle to the long plane of the bone. Transverse fractures most often
occur as the result of a strong force applied perpendicular to the long axis of a
bone.
Linear fracture. Linear skull fractures are breaks in the bone that
transverse the full thickness of the skull from the outer to inner table. They are
usually fairly straight with no bone displacement. The common cause of injury is
blunt force trauma where the impact energy transferred over a wide area of the
skull.
An oblique fracture is a relatively common fracture in which the bone

breaks diagonally. Oblique fractures can vary in severity, depending on what
bone is affected and how large the break is. Oblique fractures tend to occur on
longer bones like the femur or tibia.
A spiral fracture, also known as torsion fracture, is a type of

complete fracture. It occurs due to a rotational, or twisting, force.
A greenstick fracture is a fracture in a young, soft bone in which the

bone bends and breaks. Greenstick fractures usually occur most often during
infancy and childhood when bones are soft. The name is by analogy with green
(i.e., fresh) wood which similarly breaks on the outside when bent.
A comminuted fracture is a break or splinter of the bone into more than

two fragments. Since considerable force and energy is required to fragment
bone,fractures of this degree occur after high-impact trauma such as in vehicular
accidents.
Signs and symptoms of a broken bone include:
 Swelling or bruising over a bone

 Deformity of an arm or leg
 Pain in the injured area that gets worse when the area is moved or
pressure is applied
 An inability to bear weight on the affected foot, ankle, or leg
 Loss of function in the injured area
 In open fractures, bone protruding from the skin
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.
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
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.
Diagnosis and treatment
Medical intervention focuses on supporting the bone as it heals naturally.
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.
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.
Delayed unions and non-unions
Non-unions are fractures that fail to heal, while delayed unions are those that
take longer to heal.
Ultrasound therapy - low-intensity ultrasound is applied to the affected area
daily. This has been found to help the fracture heal. Studies in this area are still
ongoing.
Bone graft - if the fracture does not heal, a natural or synthetic bone is
transplanted to stimulate the broken bone.
Stem cell therapy - studies are currently underway to see whether stem
cells can be used to treat fractures that do not heal.

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BONE FRACTURE

A bone fracture is a medical condition where the continuity of the bone is

A significant percentage of bone fractures occur because of high force

Fractures can occur in any bone of the body.

The word "break" is commonly used by lay (non-professional) people.

Among doctors, especially bone specialists, such as orthopedic surgeons,

A crack (not only a break) in the bone is also known as a fracture.

Different kinds of Fractures

A transverse fracture is a specific type of broken bone where the break

An oblique fracture is a relatively common fracture in which the bone

A spiral fracture, also known as torsion fracture, is a type of

A greenstick fracture is a fracture in a young, soft bone in which the

A comminuted fracture is a break or splinter of the bone into more than

Signs and symptoms of a broken bone include:

 Swelling or bruising over a bone

The signs and symptoms of a fracture vary according to which bone is

If possible, do not move a person with a broken bone until a healthcare

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