Fractures

Bone fractures are the medical definition for the broken bone.

A fracture is a partial or complete break in the bone. There are many different types of fractures. Bone fractures are often caused by falls, trauma, or as a result of a direct blow or kick to the body. Overuse or repetitive motions can cause stress fractures.

Fractures are usually caused by traumas like falls, car accidents or sports injuries. But some medical conditions and repetitive forces (like running) can increase your risk for experiencing certain types of fractures.

If you break a bone, you might need surgery to repair it. Some people only need a splint, cast, brace or sling for their bone to heal. How long it takes to recover fully depends on which of your bones are fractured, where the fracture is and what caused it.

Types of Bone Fractures

An Orthopedic Specialist will diagnose a specific fracture type depending on a few criteria, including its:

• Pattern: A fracture pattern is the medical term for the shape of a break or what it looks like.
• Cause: Some fractures are classified by how they happen.
• Body part: Where in your body your broke a bone.

Fractures diagnosed by pattern or shape

Some fractures are classified by their pattern. This can either be the direction a break goes (if it’s a straight light across your bone) or its shape (if it’s more than a single line break).

Fractures that have a single straight-line break include:

• Oblique fractures
• Transverse fractures
• Longitudinal fractures (breaks that happen along the length of the bone)

Fracture patterns that don’t break your bone in a single straight line include:

• Greenstick fractures
• Comminuted fractures
• Segmental fractures
• Spiral fractures

Diagnosed by cause

A few types of fractures are named or classified by what causes them. These include:

• Stress fractures (sometimes referred to as hairline fractures)
• Avulsion fractures
• Buckle fractures (sometimes referred to as torus or impacted fractures)

Diagnosed by location

Lots of fractures are specific to where they happen in your body. In some cases, it’s possible to experience a location-based fracture that’s also one of the other types listed above. For example, someone who experiences a severe fall might have a comminuted tibia (shin bone) fracture.

Fractures that affect people’s chest, arms and upper body include:

• Clavicle fractures (broken collarbones)
• Shoulder fractures
• Humerus (upper arm bone) fractures
• Elbow fractures
• Rib fractures
• Compression fractures
• Facial fractures

Some fractures that can affect your hands or wrists include:

• Barton fractures
• Chauffeur fractures
• Colles fractures
• Smith fractures
• Scaphoid fractures
• Metacarpal fractures (breaking any of the bones in your hand that connect your wrist to your fingers).

Fractures that damage the bones in your lower body and legs include:

• Pelvic fractures
• Acetabular fractures
• Hip fractures
• Femur fractures
• Patella fractures
• Growth plate fractures
• Tibia (your shin bone) and fibula (your calf bone) fractures

Fractures that affect your feet and ankles are more likely to have complications like nonunion. They include:

• Calcaneal stress fractures
• Fifth metatarsal fractures
• Jones fractures
• Lisfranc fractures
• Talus fractures
• Trimalleolar fractures
• Pilon fractures

Open vs. closed fractures

An Orthopedic Surgeon will classify your fracture as either open or closed. If you have an open fracture, your bone breaks through your skin. Open fractures are sometimes referred to as compound fractures. Open fractures usually take longer to heal and have an increased risk of infections and other complications. Closed fractures are still serious, but your bone doesn’t push through your skin.

Displaced vs. non displaced fractures

Displaced or non-displaced are more words your provider will use to describe your fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke. Non-displaced fractures are still broken bones, but the pieces weren’t moved far enough during the break to be out of alignment. Displaced fractures are much more likely to require surgery to repair.

Symptoms

• Pain
• Swelling
• Tenderness
• Inability to move a part of your body like you usually can.
• Bruising or discoloration
• A deformity or bump that’s not usually on your body.

Causes

Bone fractures are almost always caused by traumas. Anything that hits one of your bones with enough force can break it. Some of the most common causes include:

• Road Accidents
• Falls
• Sports injuries

Sometimes you can fracture a bone without experiencing a trauma. Repetitive forces — like running or practicing a sport — can cause stress fractures. Similarly, repeating one movement or motion constantly over a long period of time can lead to overuse syndrome in your hands and arms. If you play an instrument or use your hands in the same way every day at work you’re more likely to develop a stress fracture.

Your risk of experiencing a fracture is greatly increased if you have osteoporosis. Osteoporosis causes more than one million fractures each year.

Diagnosis

Orthopedic Specialist at Shreya Hospital will diagnose a bone fracture with a physical exam and imaging tests. In some cases, this may be done in the emergency room if you’re admitted after a trauma.

If you’re taken to the ER, a team of Doctors stabilize you and treat your injuries in the order of severity, especially if some are life-threatening. After you’re stabilized, you will need imaging tests to confirm any fractures.

• X-Ray
• MRI
• CT-Scan
• Bone Scan

Treatment

• Immobilization

If your fracture is mild and your bones did not move far out of place (if it’s non-displaced), you might only need a splint or cast. Splinting usually lasts for three to five weeks. If you need a cast, it will likely be for longer, typically six to eight weeks. In both cases you’ll likely need follow up X-rays to make sure your bones are healing correctly.

• Closed reduction

More severe breaks require a closed reduction to set (realign) your bones. During this non-surgical procedure, Doctor will physically push and pull your body on the outside to line up your broken bones inside you. To prevent you from feeling pain during the procedure you’ll receive one of the following:

• Local anesthetic to numb the area around your fracture.
• Sedatives to relax your whole body.
• General anesthesia to make you sleep through the procedure.

After the closed reduction, your provider will put you in a splint or cast.

• Bone fracture surgery

Some bone fractures require surgery. Depending on which type of fracture you have — and how badly your bones are damaged — there are few techniques your surgeon might use.

• Internal fixation

Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. You’ll need to limit how much you use that part of your body to make sure your bone can fully heal.

Internal fixation techniques include:

• Rods: A rod inserted through the center of your bone that runs from top-to-bottom.
• Plates and screws: Metal plates screwed into your bone to hold the pieces together in place.
• Pins and wires: Pins and wires hold pieces of bone in place that are too small for other fasteners. They’re typically used at the same time as either rods or plates.

Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.

• External fixation

You might need an external fixation. Your surgeon will put screws in your bone on either side of the fracture inside your body then connect them to a brace or bracket around the bone outside your body. This is usually a temporary way to stabilize your fracture and give it time to begin healing before you have an internal fixation.

• Arthroplasty

If you fracture a joint (like your shoulder, elbow or knee) you might need an arthroplasty (joint replacement). Your surgeon will remove the damaged joint and replace it with an artificial joint. The artificial joint (prosthesis) can be metal, ceramic or heavy-duty plastic. The new joint will look like your natural joint and move in a similar way.

• Bone grafting

You might need bone grafting if your fracture is severely displaced or if your bone isn’t healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they’ll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:

• Internally from somewhere else in your body — usually the top of your hip bone.
• An external donor.
• An artificial replacement piece.

After your surgery, your bone will be immobilized. You’ll need some combination of a splint, cast, brace or sling before you can start using it like you did before your fracture.