Fractures: Types, causes, symptoms, and treatment (original) (raw)

A bone fracture is a crack or break in a bone. Bone fractures usually result from a high force impact or stress. People with osteoporosis or bone cancer may experience a fracture with very little impact.

A fracture that results from a medical condition that weakens the bones is called a pathological fracture.

In this article, we detail the different types of bone fractures, their various causes, and the treatments available.

A bone fracture is a full or partial break in the continuity of bone tissue. Fractures can occur in any bone in the body.

There are several different ways in which a bone can fracture. For example, a closed fracture is a break to the bone that does not damage surrounding tissue or tear through the skin.

By contrast, a compound fracture is one that damages surrounding tissue and penetrates the skin. Compound fractures are generally more serious than simple fractures due to the risk of infection.

• Avulsion fracture: A muscle or ligament pulls on the bone, fracturing it.
• Comminuted fracture: An impact shatters the bone into many pieces.
• Compression, or crush, fracture: This generally occurs in the spongy bone in the spine. For example, the front portion of a vertebra in the spine may collapse due to osteoporosis.
• Fracture dislocation: This occurs when a joint dislocates, and one of the bones of the joint fractures.
• Greenstick fracture: The bone partly fractures on one side but does not break completely, because the rest of the bone can bend.
• Hairline fracture: This is a thin, partial fracture of the bone.
• Impacted fracture: When a bone fractures, a piece of the bone may impact another bone.
• Intra-articular fracture: This occurs when a fracture extends into the surface of a joint.
• Longitudinal fracture: This is when the fracture extends along the length of the bone.
• Oblique fracture: An oblique fracture is one that occurs opposite to a bone’s long axis.
• Pathological fracture: This occurs when an underlying condition weakens the bone and causes a fracture.
• Spiral fracture: Here, at least one part of the bone twists during a break.
• Stress fracture: Repeated stress and strain can fracture a bone. This is common among athletes.
• Transverse fracture: This is a straight break across the bone.

Symptoms of a fracture vary depending on its location, a person’s age and general health, and the severity of the injury.

However, people with a bone fracture will typically experience some of the following:

• pain
• swelling
• bruising
• discolored skin around the affected area
• protrusion of the affected area at an unusual angle
• inability to put weight on the injured area
• inability to move the affected area
• a grating sensation in the affected bone or joint
• bleeding if it is an open fracture

In more severe cases, a person may experience:

• dizziness
• faintness or lightheadedness
• nausea

Healthy bones are extremely resilient and can withstand surprisingly powerful impacts. However, under enough force, they may crack or break.

Physical trauma, overuse, and health conditions that weaken the bones, such as osteoporosis, are the leading causes of bone fractures. Other factors can also increase an individual’s risk of sustaining fractures.

A person’s bones will typically weaken with age, which increases the risk of them breaking. As a person ages, the likelihood of their developing a condition that weakens the bones is also greater.

A doctor will inquire about the circumstances that led to a person’s fracture. They will then carry out a physical examination to reach a diagnosis.

Often, they will order an X-ray, and in some cases, an MRI or CT scan, to fully assess the fracture.

Bone healing is a natural process that, in most cases, will occur naturally. Therefore, treatment typically focuses on providing the injured bone with the best circumstances for healing, and ensuring optimal future function.

For the natural healing process to begin, a doctor will reduce the fracture. This involves lining up the ends of the broken bones. In smaller fractures, a doctor can do this by manipulating the affected area externally. However, in some instances, this may require surgery.

Once a medical professional has aligned the fracture, they will ensure it stays in place. Methods of doing so include:

• casts or braces
• metal plates and screws
• intramedullary nails, or rods, placed in bone cavities
• external fixings

Fractures can take several weeks to several months to heal, depending on their severity. The duration is contingent on which bone has become affected and whether there are any complications, such as a blood supply problem or an infection.

Other factors that can affect bone healing include:

• smoking
• excessive alcohol consumption
• a high body mass index
• nonsteroidal anti-inflammatory drug use
• a person’s age

After the bone has healed, it may be necessary to restore muscle strength and mobility to the affected area through physical therapy.

If the fracture occurs near or through a joint, there is a risk of permanent stiffness or arthritis. If this happens, a person may not be able to bend that joint as well as before the injury.

While bone fractures typically heal well with appropriate treatment, there can be complications, such as:

• Bone heals in the wrong position: A fracture may heal in the wrong position, or the bones may shift during the healing process.
• Disruption of bone growth: If a childhood bone fracture becomes disrupted during healing, this may affect the typical development of that bone. This can raise the risk of future deformity in the bone.
• Bone or bone marrow infection: In a compound fracture, bacteria can enter through a break in the skin and infect the bone or bone marrow. This can become a persistent infection.
• Bone death (avascular necrosis): If the bone loses its essential supply of blood, it may die.

Delayed unions and non-unions

Non-unions are fractures that fail to heal, while delayed unions are those that take longer to heal.

Treatments for non-unions and delayed unions include:

• Ultrasound therapy: A medical professional will apply low intensity ultrasound to the affected area. This may help fractures heal.
• Bone graft: If the fracture does not heal, a surgeon will transplant a natural or synthetic bone to stimulate the broken bone.
• Stem cell therapy: Stem cell-derived therapies may assist in the healing of bone fractures.

A person can reduce their risk of bone fractures through a number of remedies and lifestyle changes.

The body also requires vitamin D to absorb calcium. Exposure to sunlight and eating eggs and oily fish are good ways of getting vitamin D.

Engaging in weight-bearing exercise can help improve muscle mass and bone density. Both of these can reduce the risk of bone fractures.

Research has shown that regular exercise and a balanced diet can reduce the risk of a fracture in people with osteoporosis.

Moreover, levels of estrogen, which plays a role in bone health, drop substantially during menopause. This makes calcium regulation more difficult and increases the risk of osteoporosis and fractures.

Consequently, people need to be particularly careful about the density and strength of their bones during and after menopause.

A fracture is a break in the continuity of a bone. Fractures range from small partial cracks to complete breaks and can occur in any bone.

Physical trauma, overuse, and conditions such as osteoporosis are the most common causes of fractures. Additionally, a person’s bones typically become weaker through late adulthood. This increases their risk of fracturing a bone.

The body can repair most fractures, but medical intervention will usually be necessary to keep the broken bones in place. These interventions can range from external casts and splints to surgical screws and plates.