Fractures
Fractured means broken. Whether you have a complete or a partial fracture, you have a broken bone. A bone may be completely fractured or partially fractured in any number of ways (cross-wise, lengthwise, in the middle).
How do fractures happen?
Bones are rigid, but they do bend, or "give" somewhat when an outside force is applied to them. When this force stops, bone returns to its original shape. For example, if you fall forward and land on your outstretched hand, there's an impact on the bones and connective tissue of your wrist as you hit the ground. The bones of the hand, wrist and arm can usually absorb this shock by giving slightly and then returning to their original shape and position. If the force is too great, however, bones will break, just as a plastic ruler breaks after being bent too far.
Fractures can happen in a variety of ways, but there are three common causes:
- Trauma accounts for most fractures. For example, a fall, a motor vehicle accident or a tackle during a football game can all result in a fracture.
- Osteoporosis also can contribute to fractures. Osteoporosis is a bone disease that results in the "thinning" of the bone. The bones become fragile and easily broken.
- Overuse sometimes results in stress fractures. These are common among athletes.
Usually, you will know immediately if you've broken a bone. You may hear a snap or cracking sound. The area around the fracture will be tender and swollen. A limb may be deformed, or a part of the bone may puncture through the skin. Doctors usually use an X-ray to verify the diagnosis. Stress fractures are more difficult to diagnose, because they may not immediately appear on an X-ray. However, there may be pain, tenderness and mild swelling.
Types of fractures
- Closed or simple fracture. The bone is broken, but the skin is not lacerated.
- Open or compound fracture. The skin may be pierced by the bone or by a blow that breaks the skin at the time of the fracture. The bone may or may not be visible in the wound.
Particular types of fractures are:
- Transverse fracture. The fracture is at right angles to the long axis of the bone.
- Greenstick fracture. Fracture on one side of the bone, causing a bend on the other side of the bone.
- Comminuted fracture. A fracture that results in three or more bone fragments
As soon as a fracture occurs, the body acts to protect the injured area, forming a protective blood clot and callus or fibrous tissue. New "threads" of bone cells start to grow on both sides of the fracture line. These threads grow toward each other. The fracture is closed and the callus is absorbed.
Treatment for fractures
The following treatments are used for various types of fractures.
- Cast immobilization-A plaster or fiberglass cast is the most common type of fracture treatment, because most broken bones can heal successfully once they have been repositioned and a cast has been applied to keep the broken ends in proper position while they heal.
- Functional cast or brace-The cast or brace allows limited or "controlled" movement of nearby joints. This treatment is desirable for some but not all fractures.
- Traction-Traction is usually used to align a bone or bones by a gentle, steady pulling action. The pulling force may be transmitted to the bone through skin tapes or a metal pin through a bone. Traction may be used as a preliminary treatment, before other forms of treatment.
- Open reduction and internal fixation-In this type of treatment, an orthopaedist must perform surgery on the bone. During this operation, the bone fragments are first repositioned (reduced) into their normal alignment, and then held together with special screws or by attaching metal plates to the outer surface of the bone. The fragments may also be held together by inserting rods down through the marrow space in the center of the bone. These methods of treatment can reposition the fracture fragments very exactly. Because of the risks of surgery, however, and possible complications, such as infection, they are used only when the orthopaedic surgeon considers such treatment to be the most likely to restore the broken bone to normal function.
- External fixation-In this type of treatment, pins or screws are placed into the broken bone above and below the fracture site. Then the orthopaedic surgeon repositions the bone fragments. The pins or screws are connected to a metal bar or bars outside the skin. This device is a stabilizing frame that holds the bones in the proper position so they can heal. After an appropriate period of time, the external fixation device is removed.
Each of these treatment methods can lead to a completely healed, well-aligned bone that functions well. Remember that the method of treatment depends on the type and location of the fracture, the seriousness of the injury, the condition and needs of the patient, and the judgment of the orthopaedist and the patient.
Successful treatment of a fracture also depends greatly on the patient's cooperation. A cast or fixation device may be inconvenient and cumbersome, but without one a broken bone can't heal properly. The result may be a painful or poorly functioning bone or joint. Exercises during the healing process and after the bone heals are essential to help restore normal muscle strength, joint motion and flexibility. Help your broken bone heal properly-follow your orthopaedist's advice.
Prevention
Even though healthy bones are very strong, any bone will break if the force applied against it is great enough. Bones that are weakened by disease or misuse may break more easily than healthy bones. To develop and maintain healthy bones, a person needs adequate amounts of calcium and proper exercise.
Because of the way bones are made, calcium is very important in the growth, development, and maintenance of strong bones. Adequate amounts of calcium are necessary as a child grows and for the adult as well. Women, in particular, must have enough calcium in their diet. The female hormone estrogen regulates the use of calcium in women's bodies. Following menopause, when women produce far less estrogen, calcium regulation is more difficult. So it is very important that women make their bones as strong as possible before menopause, through weight-beating exercise and adequate calcium in their diets. In some women after menopause, bones fracture very easily because they have been weakened by calcium depletion.
Because of the way bones are made, they also get stronger with regular but not excessive exercise. If a person is active, bones will become stronger and more dense. The bones of an inactive person are often not as strong and may fracture more easily than those of an active person. For this reason, older people should try to remain physically active.
Proper diet and exercise, along with an understanding of what bones are made of and how they break, may help in preventing some fractures. If you do break a bone, seek medical treatment and remember-follow your orthopaedist's advice.
Informations obtained from National Institute of Health.