Bones fracture because of some kind of high force impact (either a direct or an indirect blow to the bone) or stress. Some medical conditions can also cause fractures because they weaken bones. These include: osteoporosis, some cancers and brittle bone disease. When a bone fractures, the continuity of its structure is broken causing pain, weakness and instability. Fractures can occur in any bone in the body.
As we get older we are more likely to experience fractures as our bones naturally weaken with age. Children’s bones are more elastic however they have growth plates at the end of their bones (areas where the bone is still growing) and these can become damaged as a result of fractures)
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Causes
Most bone fractures are caused by accidents and falls. The term compound fracture refers to a fracture that also causes damage to the overlying skin. Fractures caused by disease are called pathological fractures. There are several different types of fractures including:
- Avulsion: a muscle or ligament pulls on the bone causing it to fracture.
- Comminuted: the bone is shattered in several places.
- Hairline: small cracks or fissures appear in the bone, often as a result of sustained stress or overuse. These fractures can be hard to identify.
- Compression: these generally occur in the spine where the bones are more spongy.
- Dislocation Fracture: a joint becomes dislocated causing one of the bones in the joint to fracture.
- Impacted: a fragment of bone goes into another bone when it fractures.
- Greenstick: a type of fracture that is most common in children. The bone fractures on one side but does not break completely because the rest of the bone is able to bend.
- Spiral: a fracture that occurs as a result of twisting force.
- Stress: repeated stress (without time for natural healing) on the bone causes it to fracture. This is most common in athletes.
- Torus: the bone buckles but does not fracture. This is most common in children.
- Pathological: an underlying condition or disease weakens the bone causing it to fracture.
- Closed: a fracture that does not cause damage / penetrate the overlying skin.
- Compound: a fracture that damages surrounding tissue and penetrates the skin. These tend to be more serious as there is a risk of infection.
- Longitudinal: a fracture along the length of the bone.
- Oblique: a fracture diagonal to the bone’s long axis.
- Transverse: a straight break across the bone.
Bones heal naturally however they need to be given the right conditions to heal.
Symptoms
The symptoms will vary according to the type of fracture, the age of the patient and the severity of other injuries. Typical symptoms of a bone fracture include:
- Pain
- Bruising and swelling
- Bone projecting at an unusual angle
- Patient unable to put weight on the affected area or unable to move it
- Discoloured skin around the area
- Sometimes there is a grating sensation
- Bleeding, if it is an open fracture
- If a large bone fractures, the patient may be nauseous, sick or feeling faint.
Diagnosis
If you suspect a fracture, urgent medical treatment is needed. Doctors will ask about the circumstances surrounding the suspected fracture and will refer you for an X-ray. You may also have an MRI or CT scan.
Treatment
Bones have a natural capacity to heal, although this tends to slow down as we age. Any treatment you receive will be aimed at providing optimum conditions for your bones to heal themselves. Depending on the type and extent of the fracture, treatment may include:
- Fracture reduction: this is normally carried out under general anaesthetic. The ends of the bone are lined up so that it can heal cleanly.
- Immobilisation: bones need to stay in alignment and not move while they heal. Some fractures need metal plates and screws, plaster casts, intra-medullary nails or external fixators to hold the bones in place. Fractured bones may need to be immobilised for 2-8 weeks.
- Physical therapy: once the bone has healed, you may need physical therapy to restore muscle strength and mobility to the affected area.
- Surgery: in some instances surgery might be required to repair damage to skin and soft tissue following a fracture.
FAQ’s
What is a bone graft and why do I need it?
A bone graft is sometimes used if the fractured bone doesn’t heal properly. It is either a natural or a synthetic bone that is transplanted to stimulate the broken bone to heal.
Is there anything I can do to reduce the risk of fractures?
Keeping your bones health and strong for as long as possible is the best way to avoid fractures, particularly as you get older. It is important to eat a healthy balanced diet with plenty of calcium, which is found in dairy products, and green leafy vegetables. Exposure to sunlight, as well as eggs and oily fish, provides Vitamin D, which is also important for bone health. Weight-bearing exercise – walking, running, dancing – will cause your bones to become stronger and denser.
Why have I developed a bone marrow infection?
If you have a compound fracture, bacteria can get in and affect the bone or bone marrow. This can become a chronic infection, which may require hospitalisation. You may be treated with antibiotics or surgery.
Personal outcomes – what to expect
Our patient-care process
- Once all of your diagnostic procedures are completed, we will be able to explain whether surgery is recommended.
- We will go through the procedures with you, covering the operation itself, the recovery process and the future prospects.
- Your orthopaedic surgeon will also explain the risks: these are small, but it is important for you to understand them.
- You can feel reassured that you will receive expert care from the start of the process, including your after-care.
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