Understanding Bone Fractures

The average person will suffer two fractures in his/her lifetime. Children and older adults typically suffer more fractures than other age-groups, and fractures can be caused by a variety of different reasons. As adults age, the bones become more brittle and balance becomes less stable. Rather than bouncing back from a fracture like children, older adults might be incapacitated for months and possibly suffer life-threatening complications from the fracture.

Fractures are caused by more force being applied to a bone than it can handle, causing it to break. The most common causes result from trauma such as a car accident or a football tackle; a disease like osteoporosis or cancer that weakens bones; or repetitive motions that weaken a muscle’s ability to absorb impact and ultimately places more stress on a bone. Trauma and repetitive motions are common causes for athletes. Fortunately, there are several effective treatment options for the different types of fractures.

The Main Types of Fractures

The severity of a fracture varies on what type it is. Some fractures cause a complete bone break; some cause a bone to break in more than one place; some compress bone; and some bend a bone and create a break only on one side without breaking entirely through or may not break it at all. Some break through the skin and some do not.

As you can see, several types of bone fractures exist. However, the main types are categorized as displaced, non-displaced, open, and closed.

1.Displaced Fractures: The terms displaced and non-displaced refer to the alignment of a fractured bone. Displaced fractures occur when a bone snaps into two or more parts and moves so the various ends are misaligned.

2. Non-displaced Fractures: Non-displaced fractures contain a cracked bone, regardless of whether it’s fully broken. Although the bone moves, it remains properly aligned.

3. Closed Fractures: Closed fractures, also referred to as stable fractures or simple fractures, occur when a bone breaks, but no puncture or open wound in the skin exists.

4. Open Fractures: Open fractures occur when a bone punctures the skin. Open fractures are very serious because of a bone’s exposure to contaminants in the external environment. The many germs a bone can be exposed to while outside the body, regardless of the amount of time, creates dangerous opportunities for a deep bone infection to develop.

Common Fractures in Children

The following subtypes of fractures only occur in children because their bones have not yet matured and are more pliable than adult bones.

• Greenstick fractures occur when a bone bends and does not fracture or fractures only on one side of the bone.
• Buckle fractures, also known as Torus fractures, occur when two bones, driven into each other, compress. While painful, this type of fracture is stable.
• Growth plate fractures occur when a child breaks a bone at a joint, which may prevent the affected bone reaching its proper shape and length as a child grows. Orthopedists categorize these types of fractures from Type I through Type V, depending upon where the damage occurs on or around the growth plate.

Other Common Fracture Types

Both children and adults can suffer from these types of fractures:

• Comminuted fractures occur when a bone breaks into more than three pieces.
• Transverse fractures occur when a break is perpendicular to a bone’s shaft.
• Spiral fractures, common in twisting injuries, and occur when a break spirals around bone.
• Compression fractures occur when a bone is crushed, making the bone appear flatter or wider.
• Oblique fractures occur when a break develops on an angle through a bone.
• Pathological fractures occur when a disease, like osteoporosis or cancer, weakens a bone.
• Stress fractures present as hairline cracks in bones and often occur in athletes.
• Segmental fractures occur when one bone fractures in two places, causing one segment to appear as if it’s floating.

Diagnosis and Testing

Doctors, aside from performing a physical examination and taking an oral history of the injury, can use diagnostic tools such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI). By far, X-rays are the most-often-used diagnostic tool for fractured bones since bone tissue is clearly visible. X-rays travel through soft tissue without much absorption, making it difficult to see. The latter two diagnostic tools allow doctors to obtain more detailed soft tissue views to determine if muscles, nerves, and blood vessels surrounding the fracture sustained injury. Once the doctor has diagnosed the fracture, he or she will proceed with treatment options.

Treatment Options

Effective treatment provides the best environment for healing given the type of fracture being treated. The goals of treatment are to control pain, promote healing, prevent complications, and to return the injured bone to as normal a function as possible.

The first parts of treatment involve fracture management to control bleeding, prevent bone death, and remove sources of infection by extracting foreign bodies and dead tissue. Next, the fracture must be repositioned and immobilized.

Non-surgical immobilization consists of manually repositioning a fractured bone, known as manipulation, and then applying either casting or traction. Orthopedists use traction to treat fractures that cannot be managed by casting. Traction applies force to stretch muscles and tendons around the fractured bone to align the bone ends and facilitate healing.

When surgical therapy is required to realign and immobilize fractures, orthopedic surgeons use either internal fixation or external fixation. Internal fixation employs metal rods or pins inside broken bones to hold bone fragments in place to promote proper alignment and healing. External fixation employs the same type of hardware outside the body to hold bone fragments in place with the same goal.

Prevention: The Best Treatment

Sometimes you just cannot prevent a situation that causes a bone fracture. However, you can be proactive: Take control of your body and incorporate some healthy habits into your daily routine to help prevent fractures.

• Always wear your seatbelt when in a moving vehicle.
• Always wear the correct safety equipment for all your recreational activities.
• Always keep walkways and stairs obstruction-free to prevent unnecessary stumbles and falls.
• Engage in regular weight-bearing exercises to strengthen your bones and improve their density. Also, learn and perform exercises that will improve your balance.
• Even though it can be difficult, eat balanced, healthy meals as often as you can.
• Discuss with your doctor beginning a medication and/or supplement regimen to help build and maintain your bone density.
• Visit an orthopedic surgeon or sports medicine specialist and find out what more you can do today.