The medical term for a broken bone is fracture. Fractures are very common. Some statistics show that the average person will have at least two during their lifetime. When the physical force exerted on the bone is stronger than the bone itself, a fracture can occur. Fractures can be attributed to blows, falls, and other traumatic events. However, pathologic fractures are caused by disease like cancer, causing the bone to weaken. Pathologic fractures occur with minimal or no trauma.
Osteoporosis, a condition that causes bones to lose strength as they age has caused a staggering 1.5 million fractures annually (in the United States). Fractures attributed to osteoporosis often occur in the wrist, hip, and spine.
The fracture’s severity will depend on its location and the damage to the bone and tissue near it. Serious fractures can have dangerous complications if not properly treated including damage to the adjacent joints, nerves or blood vessels. Recuperation time will vary depending on key factors like type of fracture and overall health and age of the patient.
There are several types of fractures. However, the main categories are open, closed, displaced, and non-displaced.
Non-displaced and Displaced fractures refer to the way the bone breaks. In a non-displaced fracture, the bone can crack partly or all the way through. However, it does not move and its proper alignment is maintained. In a displaced fracture, the bone will snap into two (or more) parts and is moved so the two ends are no longer lined up end-to-end. When the bone breaks but there is no open wound or puncture, the condition is called a Closed fracture. An Open fracture on the other hand occurs when the bone breaks through the skin.
Other fracture patterns include:
- Greenstick Fracture – an incomplete fracture where the bone is bent in place like a young bamboo stick. This type often occurs in children.
- Oblique Fracture – the break has a sloped or curved pattern.
- Transverse Fracture – the broken part is at the right angle to the bone’s axis.
- Buckled Fracture (impacted fracture) – the ends of the bones are driven into each other. This type is commonly seen in forearm fractures involving children, and in shoulders and spine of elderly women.
Telltale indicators of broken bone can include:
- Pain (can get worse during movement or when pressure is applied)
- Loss of function (in the injured area)
- Bone protruding from the skin (in the case of open fractures)
Doctors can recognize most fractures through physical examination and X-Rays. However, sometimes, X-rays will not show an incomplete fracture. This is especially common in hip fractures (especially in the elderly), wrist fractures, and stress fractures. In similar cases, the doctor may order other tests like magnetic resonance imaging (MRI), computed tomography (CT) scan, or a bone scan. Occasionally, even if a fracture diagnosis has been made, other tests may be needed (i.e. MRI, angiogram, CT scan, and a special X-ray of the blood vessels) to check for any damage on the tissues around the bones.
Fractures often require emergency treatment especially if the broken bone is located in the neck, hip, or back. For broken leg or arm bones, putting a splint (made of plastic, wood, metal, or other rigid materials) against the area is recommended to prevent movement. If there is bleeding, applying the pressure to stop the bleeding should be done before splinting. Bones that are fractured are set in their proper place and held there to facilitate proper healing. The process of setting the bone is called “reduction.”
Repositioning the bone without surgery is called “closed reduction.” Many fractures in children are treated by closed reduction and casting. However, serious fractures will require open reduction. Often, plates, pins, rods, and screws are used to hold the fracture in place. After reduction a splint, cast, and in some cases, a traction is used to immobilize the fracture, minimize the pain, and promote healing. Medication may also be prescribed to reduce pain. In open fractures however, antibiotics will be required to prevent infection.
Rehabilitation will commence as soon as possible, even if the bone is still in a cast. Starting rehabilitation early is recommended as it helps prevent stiffness and blood clots and promotes blood flow and healing. After removing the splint or the cast, the area around the fracture is often stiff for a few weeks. Once the splint or cast has been removed, patients are advised to gradually use the affected area again. Bone strength is often regained after four to six weeks. To help ensure proper healing, doctors will often recommend activity types (and intensity) that are safe, taking into account the type of fracture and the patient’s overall health.
To help keep fractures at bay, the following safety precautions should be kept in mind:
- Always wear a seat belt when in a motor vehicle.
- Wear proper safety equipment (i.e. helmets and protective pads) when engaged in contact sports and other recreational activities (i.e. snowboarding, biking, etc.).
- Keep stairs and walkways free from objects that can cause tripping.
- For patients with osteoporosis, regular exercise is recommended to improve balance and strength to prevent accidental falls.