Fractures

A fracture is a partial or complete break in the bone. When a fracture happens, it’s classified as either open or closed:

• Open fracture (also called compound fracture): The bone pokes through the skin and can be seen, or a deep wound exposes the bone through the skin.

• Closed fracture (also called simple fracture). The bone is broken, but the skin is intact.

Fractures have a variety of names. Here is a listing of the common types that may happen:

• Greenstick. This is an incomplete fracture. A portion of the bone is broken, causing the other side to bend.

• Transverse. The break is in a straight line across the bone.

• Spiral. The break spirals around the bone. It’s common in a twisting injury.

• Oblique. The break is diagonal across the bone.

• Compression. The bone is crushed. This causes the broken bone to be wider or flatter in appearance.

• Comminuted. The bone has broken into three or more pieces and fragments are present at the fracture site.

• Segmental. The same bone is fractured in two places, so there is a "floating" piece of bone.

Fractures most often happen when more force is applied to the bone than the bone can withstand and can be caused by twisting injuries, falls or as a result of a direct blow to the extremity.

Overuse or repetitive motions can tire muscles and put more pressure on the bone. This causes stress fractures. These types of fractures are more common in athletes.

Fractures can also be caused by processes that weaken the bones, such as osteoporosis, malnutrition, infection or cancer in the bones.

While each person may experience a fracture differently, the common symptoms of a fractured bone may include:

• Sudden pain.

• Trouble using or moving the injured area or nearby joints.

• Swelling.

• Obvious deformity.

• Warmth, bruising or redness.

• The symptoms of a broken bone may resemble other medical conditions or problems. Always see a healthcare provider for a diagnosis.

In addition to a complete medical history (including asking how the injury happened) and physical exam, tests used for a fracture may include the following:

• X-ray. A diagnostic test that uses invisible electromagnetic energy beams to make pictures on film of internal tissues, bones and organs.

• Magnetic resonance imaging (MRI). An imaging test that uses large magnets, radio-frequencies and a computer to produce detailed pictures of structures within the body.

• Computed tomography scan (also called a CT or CAT scan). This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat and organs.

The goal of treatment is to reestablish anatomy and alignment of the limb (put the pieces of bone back in place), control the pain, allow the bone time to heal and restore normal function—all while preventing complications.

Treatment may include:

• Splint or cast. This immobilizes the injured area to keep the bone in alignment. It protects the injured area from motion or use while the bone heals.

• Medicine. This may be needed to control pain.

• Traction. Skeletal traction uses pulleys, strings, weights, and a metal frame attached to a bed to pull on the extremity. This keeps it temporarily lined up and at normal length, until a more definitive form of stabilization can be performed. Traction is often utilized in patients with multiple injuries who are too sick or require further resuscitation prior to  fixing the fracture.

• Surgery. Surgery may be needed to physically put the fragments of broken bone back into their correct place and hold them in place with internal fixation (metal rods or pins located inside the bone) or external fixation devices (metal rods or pins located outside of the body) while they heal.

Fractures can take months to heal as broken fragments “knit” back together while new bone is formed between the broken parts. When fractures are completely healed, they are just as strong as they were prior to being broken.

Most fractures are caused by accidents, such as falls, or other injuries. But there are some things you may be able to do to decrease your risk of bone fractures, for instance:

• Follow a healthy diet that includes vitamin D and calcium to keep bones strong.

• Exercise regularly to help keep your bones strong.

• Osteoporosis is a common cause of fractures in older people. Talk to your healthcare provider about your risk of osteoporosis and get treatment if you have it.

You should see a healthcare provider any time you think you may have a broken bone.

An open fracture (one in which the bone comes through the skin so you can see it or a deep wound that exposes the bone through the skin) is considered an emergency. Get medical attention right away for this type of fracture.

Any injury to the bones of the spine is also a medical emergency. These cause severe back pain and may cause nerve problems. These include numbness, tingling, weakness or bowel/bladder problems. Call 911 if you suspect a person has a break in the bones of their spine.