A fracture is when the continuity o a bone is broken. in simple words a break or a crack in a bone. A bone fracture occurs when a force is exerted against a bone that is stronger than the force that the bone can bear. This disturbs the structure and strength of the bone and leads to pain, loss of function, and sometimes bleeding and injury around the site.
Causes for bone fractures
Falls
Traumatic incidents such as sporting injuries, vehicle accidents, and gunshot wounds.
Direct strikes to your body
Conditions such as osteoporosis and some types of cancer that cause bones to fracture more easily, meaning even minor trauma and falls can become serious.
Risk factors for fractures
Anyone can experience a fracture. but you are more likely to develop one if you have brittle bones/ low bone density. causes for brittle bones are,
Older age
Osteoporosis
Endocrine/ intestinal disorders
Physical inactivity
Drink alcohol
Smoking
Symptoms of bone fractures
Intense Pain when the initial injury occurs.
Snap/ grinding sound can be heard when the injury initially takes place.
Swelling, bruising around the injured area.
Sometimes Deformity can be seen in the injured area.
Inability to use the limb, especially in weight-bearing.
The symptoms of a fracture depend on the particular bone and the severity of the injury.
Types of bone fractures
There are several types of bone fractures.
Closed (simple) fracture -
The broken bone has not pierced the skin.
Open ( compound ) fracture -
The broken bone juts out through the skin, or a wound leads to the fracture site. Infection and external bleeding are more likely.
Greenstick fracture -
A small, slender crack in the bone. it's an incomplete fracture. This occurs in children because their bones are more flexible than an adult's bones.
Hairline fracture -
The most common form is a stress fracture, often occurring in the foot or lower leg as a result of repeated stress from activities such as jogging or running.
Complicated fracture -
Structures surrounding the fracture are injured. There may be damage to the veins, arteries, or nerves, and there may also be an injury to the lining of the bone (the periosteum).
Comminuted fracture -
The bone is shattered into three or small pieces. fragments present at the fracture site. This type of complicated fracture tends to heal more slowly.
Avulsion fracture -
Muscles are anchored to the bone with tendons, a type of connective tissue. Powerful muscle contractions can wrench the tendon free and pull out pieces of bone. This type of fracture is more common in the knee and shoulder joints.
Compression fracture -
Occurs when two bones are forced against each other. The bones of the spine, called vertebrae, can have this type of fracture. Older people, particularly those with osteoporosis, are at higher risk.
Common Fractures of upper limb
Clavicle -
Commonly fractured by falling on the outstretched hand. The lateral fragment is displaced downwards.
Scapula fracture
Humeral fracture -
Common sites of fracture of the humerus are the surgical neck, shaft, and supracondylar region. The supracondylar fracture may cause injury to the median nerve. It may also lead to Volkmann's ischaemic contracture caused by occlusion of the brachial artery.
Fracture of shaft of humerus commonly causes injury to the radial nerve. This results in wrist drop.
Radius fracture
Fracture of the head of the radius
Fracture of lower end of radius -
This fracture is caused by a fall on the outstretched hand. The distal fragment is displaced upwards and backward. it is known as Colle's fracture. If the distal fragment gets displaced anteriorly it is called Smith's fracture.
Olecranon fracture
Scaphoid fracture
Bennett fracture - Fracture of the base of the first metacarpal bone.
Common Fractures of lower limb
Femoral fracture - Common sites of fracture of the femoral neck, shaft, and supracondylar fractures. A femoral neck fracture (hip fracture) is common in older people.
Tibia fracture
Fibula fracture
Patella fracture
Ankle fracture - Common injury to the bones around the ankle joint.
Calcaneal fracture
Fractures in adults/ elderly
Due to the weakening of architecture due to osteoporosis, the seniors have a unique pattern of fractures. The bones typically break in the region where they are weak.
The most common sites are,
Hip region
Vertebrae
Wrist/distal radius
Proximal humerus
Hip fractures in the elderly are typically serious fractures and could be associated with high mortality if not treated aggressively to make the patient upright.
Fractures in children
A fracture in a child can be very different from a fracture in the same location in an adult. Because children are still growing, their injuries need different evaluations and sometimes different treatment.
Fractures may occur in sports from falls, twisting, or direct blows.
The most common areas are,
Wrist
Elbow
Forearm
Complications of bone fractures
Blood loss -
Bones have a rich blood supply. A bad break can make you lose a large amount of blood.
Injuries to organs, tissues, or surrounding structures -
For example, the brain can be damaged by a skull fracture. Chest organs can be injured if a rib breaks.
Stunted growth of the bone -
If a child's long bone breaks close to the joint where the growth plates are found.
Diagnosis of bone fracture
Bone fractures are diagnosed with,
X - rays
CT scans
MRI scans
Fracture prevention
You can’t prevent all fractures. But you can keep your bones strong so they'll be less susceptible to fracture.
To maintain and improve bone strength,
Get enough calcium and vitamin D, have a well-balanced diet.
Engage in regular exercises, weight-bearing exercises are particularly helpful to improve bone strength.
Eat foods that are good for bone health, such as fruits and vegetables.
Avoid smoking and limit alcohol.
Yashodha Madhurangi
References
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bone-fractures
https://www.healthline.com/health/fracture
https://orthoinfo.aaos.org/en/diseases--conditions/fractures-broken-bones/
