is a medical condition that occurs when a person’s bones
are subject to cracks or breakage. While fractures are known as broken bones, the term “break” does not form part of the medical terminology used in orthopedics.
Many fractures are caused by a high force, stress or strong impact on the bone
. Fractures occur as a result of traumas caused by falls, car accidents, or injuries from playing sports. Sometimes fractures may be a result of diseases such as osteoporosis
, a condition characterized by “porous” bones, osteogenesis imperfecta, and some types of cancer
. Overuse may also lead to stress fractures, which are manifested by miniature cracks appearing on the surface of the bone.
There are various classifications of fractures based on the characteristics of each injury. A closed fracture is a fracture where a person’s skin remains intact. Open or compound fractures involve a wound caused when the fractured bone punctures the surrounding skin. This kind of fracture carries a high risk of infection as the open wound exposes the fractured bone to all kinds of contamination. Open or compound fractures are considered medical emergencies that need immediate surgical and antibiotic treatment to remove all traces of dirt, dead tissue, and contaminants.
Simple fractures are a classification of fractures that occur on one line of the bone, splitting it into two, while the injured bone splitting into many different pieces characterizes multi-fragmentary fractures. Doctors find it easier to treat a simple closed fracture, as this kind of bone injury presents a better prognosis compared to an open or compound multi-fragmented fracture that is likely to be exposed to contamination
TYPES OF BONE FRACTURES
A compression fracture is a kind of fracture that occurs in the bones of the spine, or the vertebrae. Due in part to osteoporosis, the front portion of a person’s vertebra may collapse due to the brittleness of the bones and despite the absence of any trauma. Complete fractures are another type of fracture wherein bone segments separate completely from one another, while an incomplete fracture characterizes a type of fracture where fragments of the bone remain partially joined.
Other types of bone fractures are linear fractures that occur parallel to the long axis of a bone, and a transverse fracture occurs at right angles to the long axis of a bone. On the other hand
, fractures that are diagonal to the bone’s long axis are called oblique fractures. A spiral fracture is characterized a twisted bone, and a compacted fracture occurs when bone fragments are wedged into one another due to a forceful impact.
A person who has a fracture will exhibit a misshapen limb or a joint
that may look out-of-place. There may be swelling
, bleeding, or bruising on area of the skin surrounding the fracture, and the affected person may experience intense pain. Numbness and tingling may also accompany this injury, as well as a limited scope of motion or the inability to fully move the affected limb.
While bone tissues themselves contain no pain
sensors or nociceptors
, bone fractures cause pain due to the large number of nociceptors that are found around the bones themselves. These nociceptors become overly stimulated due to the bruising or fracturing of nearby bones, giving rise to pain. When the surrounding tissues of a fracture begin to bleed, they also cause a considerable degree of pain, as with the case of muscle spasms that occur during instances when the surrounding muscles attempt to hold the bone fragments together.
When a person suffers from a fractured or broken bone, they will most certainly be the first to notice it when they hear a sudden snap or a cracking sound within the area of the fracture. Immediately preceding this, the surrounding area will become tender and swollen, and the affected limb may appear deformed. In cases of an open or compound fracture, a person will most certain notice when a piece of the fractured bone punctures out through the skin.
To further verify the extent of the damage, the doctor will order a series of x-rays to be taken. This is particularly true in the case of stress fractures as they are not immediately apparent to the naked eye.
FRACTURES FIRST AID
Before the patient is transported to a medical facility for proper treatment, first aid will need to be administered to a person who has a suspected fracture. The affected limb will require a splint to stabilize the injured area and to prevent any sudden movements that may worsen the fracture, cause additional damage to the surrounding tissue, or sever the blood vessels
around the affected area.
Medical professionals at a hospital will order an x-ray
to be taken of the injury in order to determine what type of fracture it is and the kind treatment to be administered.
Depending on the type of the fracture, a doctor may undertake surgery if the injury involves hip fractures resulting from osteoporosis or osteogenesis imperfecta. Damage to joints
may also require surgery to restore its smoothness and enable normal movement afterwards. Some fractures need to be reinforced with metal implants to encourage the bone to heal properly.
The surgeon restores the fractured pieces of bone to their proper positions, or aligns the bone in its natural location. The fractured piece or pieces are often held together with a variety of materials such as surgical nails, plates, screws, or wire. The surgeon then secures the injured area in a fiberglass cast, splint, or plaster outside the affected limb to hold the fractured bones in place and immobilize any possible movement that might dislodge the fractured pieces.
Treating smaller bones, such as fingers or toes, do not require the use of a cast. The doctor will secure them by buddy wrapping them to allow limited movement.
Bones start to heal when the blood
from the surrounding injured tissues form clots around the fractured bone fragments. Blood vessels then grow into the jelly-like material of the clots and bring in white blood cells
, as well as fibroblasts that work to produce collagen fibers. Gradually, the blood clot is replaced with a wall of collagen. When this happens, the fibroblasts start to rebuild the bone matrix composed of calcium
hydroxypatite crystals, which stiffens within the collagen wall and slowly transforms this hardening substance into bone. This whole healing process takes place within 18 months or so, and adults will experience 80% bone normalcy within the span of 3 months following a fracture.