DefinitionA fracture is a break in any bone in the body. There are different kinds of fracture:
- The bone may be fractured but stable, which is known as a simple fracture or a closed fracture.
- Bone fragments may be sticking through the skin, which is known as a compound fracture or an open fracture.
- Chip (avulsion fracture)—A small piece of bone is broken away from the main bone and usually attached to a ligament or tendon.
- Compression—The bone is compressed together, such as vertebrae.
- Comminuted—The bone is in pieces.
- Greenstick—One side of the bone is broken and the other side is bent but not broken.
- Intra-articular—The joint is affected.
- Growth plate fracture —A child's developing tissue is fractured.
- Transverse—The bone is broken in a horizontal line that is perpendicular to the surface of the bone cortex.
- Oblique—The bone is broken in a line that is less than a 90° angle to the surface of the bone cortex.
- Spiral—The line of the fracture forms a spiral.
- Stress—A thin fracture line occurs due to overuse rather than a single traumatic incident.
|The Bones of the Body|
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CausesFractures are caused by trauma to the bone. Trauma includes:
Risk FactorsFractures are more common in older adults. Factors that increase the risk of fracture include:
- Decreased muscle mass
- Osteoporosis —decreased bone mass which weakens bones and affects both men and women
- Certain medication used to treat type 2 diabetes
- Accidents or violence
- Participation in sports
- Certain chronic diseases
- Child abuse
- Conditions that increase the risk of falls, such as nerve or muscle disorders
- Certain congenital bone conditions—rare
SymptomsSymptoms of a fracture include:
- Pain, often severe
- Instability of the area around the break
- Inability to use the limb or affected area normally
- Swelling or bruising
DiagnosisYou will be asked about your symptoms and how you injured yourself. The injured area will be examined.Images may be taken of your bodily structures. This can be done with:
TreatmentProper treatment can prevent long-term complications or problems. Treatment will depend on how serious the fracture is, but may include:
Initial CareExtra support may be needed to protect, support, and keep your fracture in line while it heals. Supportive steps may include a splint, brace, or cast. A sling may be necessary to help stabilize your arm.Some fractures cause pieces of bone to separate. Your doctor will need to put these pieces back into their proper place. This may be done:
- Without surgery—you will have anesthesia to decrease pain while the doctor moves the pieces back into place
- With surgery—pins, screws, plates, rods, or wires may be needed to reconnect the pieces and hold them in place
Healing and RehabilitationHealing time ranges from three weeks for a simple finger fracture to many months for a complicated fracture of a long bone. All fractures require rehabilitation exercises to regain muscle strength and joint motion.
- Delayed union—It takes longer than usual to heal, but does heal.
- Nonunion—The bone does not heal and needs some special treatment.
- Infection—This is more likely to happen after an open fracture or surgery.
- Nerve or artery damage—This usually occurs as a result of severe trauma.
- Compartment syndrome—This is severe swelling in the spaces of the limbs that causes damage to body tissues.
- Late arthritis—This may happen if the surface of a joint is badly damaged.
PreventionYou can reduce your chances of getting a fracture:
- Avoid putting yourself at risk for an accident or other trauma to the bone.
- Do weight-bearing exercise regularly to build and maintain strong bones.
- Do strengthening exercises regularly to build strong muscles and prevent falls.
- Wear protective equipment when playing sports.
- Use proper fitness techniques.
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Fractures: an overview. American Academy of Orthopaedic Surgeons website. Available: http://orthoinfo.aaos.org/topic.cfm?topic=A00139. Updated October 2012. Accessed September 25, 2014.
Gruntmanis U. Male osteoporosis: deadly, but ignored. Am J Med Sci. 2007;333(2):85-92.
McCarus DC. Fracture prevention in postmenopausal osteoporosis: a review of treatment options. Obstet Gynecol Surv. 2006;61(1):39-50.
1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Loke YK, Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009;180:32-39. Epub 2008 Dec 10.
- Reviewer: Michael Woods, MD
- Review Date: 08/2014
- Update Date: 09/25/2014
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