Fracture
A fracture is a partial or complete break in a bone.
Anatomy
The 206 bones in your body come in many shapes and sizes. Though healthy bone is rigid to support the weight of the body's soft tissues, it does have some flexibility. This flexibility allows bone to absorb normal stress from blows, bumps, and falls encountered in daily activities. Bones are made of living tissue and can repair themselves when injured.
Types of Fractures
Just as there are many types of bones, there are many ways to break them. Below are descriptions of some common types of fractures:
- Complete fracture: break is completely through the bone
- Incomplete fracture: partial break in the bone
- Open (compound) fracture: broken bone breaks through the skin
- Closed fracture: broken bone does not break the skin
- Comminuted fracture: bone is broken into more than two fragments
- Compression fracture: bone is broken under extreme pressure
- Avulsion fracture: bone is torn away by the force of a muscular contraction
- Impacted fracture: one bony fragment is wedged into the other
- Stress fracture: crack caused by overuse and extreme pressure on the bone
- Spiral fracture: a break in the bone that occurs at an angle
- Pathologic fracture: break to a diseased or fragile bone caused by weak force that would not normally break a bone
Symptoms
Fractures can cause pain, swelling, and bruising at the site of the injury. You may notice deformity of the bone. Blood loss is present with open fractures. Complete loss of sensation below the fracture is less common and should be considered very serious.
Treatment
Immediate Care - Rest the affected area. For open fractures, apply pressure with a clean bandage to control bleeding. Apply an ice pack wrapped in a towel to control swelling. Elevate the fracture if possible. Immobilize the area and go to an Emergency Room as soon as possible.
Medical Care - Your doctor will physically examine your fracture and ask questions about your injury and symptoms. X-rays will be used to determine the exact location and extent of the break. Further care will depend on the severity, location, and type of fracture. Treatment may include several interventions, such as:
- Hands-on manipulation to set the bone
- A rigid cast (plaster or fiberglass) to hold the bone in place
- A functional cast or brace that allows some movement
- Surgery to set the bone and repair damage to surrounding soft tissues
- External fixation with hardware that goes through the skin into the bone to hold it in place
- Traction that pulls on the bone to hold it in good alignment
Medications
Antibiotics and surgery may be required if the bone has broken the skin. Anesthesia and muscle relaxants may be used when the bone is set or during surgery. Nonsteroidal anti-inflammatories medications can offer pain relief while you heal.
Recovery
During the healing phase, your doctor may recommend applying heat to the area to promote blood flow. Increased circulation helps speed the healing process. If you must wear a cast, you can begin ice massages after its removal to control pain and swelling. This can be completed for 10 to 15 minutes at a time, three to four times a day. Your doctor may also recommend physical and/or occupational therapy to guide your rehabilitation.
Recovery time varies with each individual. Your outcome largely depends on the extent of the fracture, your health before the injury, and how well you follow your rehabilitation program.
Complications
Complications with fractures may include:
- Infection
- Poor healing at the fracture site
- Bone shortening or deformity
- Impaired sensation
- Impaired blood circulation
- Loss of range of motion