Fractures

A fracture is a break in the bone. It can occur in almost any bone of our body due to different reasons. A bone may be completely fractured or partially fractured in any number of ways like crosswise, lengthwise or in multiple pieces.

Common types of fractures

  • Stable fracture: The broken ends of the bone line up and are barely out of place.

  • Open, compound fracture: The skin is pierced by the bone or by a blow that breaks the skin at the time of the fracture. The bone may or may not be visible in the wound.

  • Transverse fracture: Fracture with horizontal fracture line at a right angle to the bone’s axis.

  • Oblique fracture: Fracture with an angled pattern.

  • Comminuted fracture: Bone shatters into three or more pieces.

  • Pathological fracture: Caused by a disease that weakens the bones.

  • Stress fracture: A hairline crack due to overstressing on the area.

Causes of fracture

  • Trauma: It is the most common cause of fracture and includes fall, a motor vehicle accident, blow or messing up during a football game or other sports.

  • Osteoporosis: It is the most common risk factor that causes weakening of the bones and makes them more likely to break.

  • Overuse: Repetitive motion and stress can make the muscles tire and place more force on bone.

  • Low bone density: Especially in females, it is the most common reason for fracture.

Symptoms of fracture

Almost all the fractures are very painful and may cause many of the following symptoms:

  • Inability to move the injured area

  • Loss of function in the injured area

  • Swelling and tenderness around the injury

  • Bruising

  • Deformity

  • Numbness and tingling

  • Problems moving the injured area

  • Out of place bone

  • Popping of bone through the skin

  • Pain worsens when the area is moved or pressure is applied

Diagnosis of Fracture

A careful physical examination of the patient to assess the overall condition, as well as the extent of the injury is the first step to evaluate the possibility of a fracture. This is followed by thorough history taking of the injury including how the injury occurred, patient symptoms, and medical history. After this, following diagnostic tests are performed to confirm the diagnosis of fracture:

  • X-ray

  • CT-Scan

Management of fracture

Management of all forms of broken bones must follow one basic rule: the broken pieces must be placed into position and prevented from moving out of place until they are healed.

The type of treatment depends upon the severity of the break, type of fracture and the specific bone involved. Any of the following treatments can be used to treat fractures:

  • A plaster or fiberglass cast after repositioning of the bones to keep the broken ends in proper position while they heal

  • Functional cast or brace to allow limited or “controlled” movement

  • Traction to align a bone or bones by a gentle, steady pulling action

  • External fixation is done to place metal pins or screws into the broken bone above and below the fracture site so that the bones can be kept in the proper position while they heal.

  • Open reduction and internal fixation is done to first reposition (reduce) the broken bones in their normal alignment, and then holding them together with special screws or by attaching metal plates to the outer surface of the bone.