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Fracture

Anatomy of a Fracture

If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures the skin, it is called an open fracture (compound fracture). A stress fracture is a hairline crack in the bone that develops because of repeated or prolonged forces against the bone.

Orthopedic surgeons treat fractures throughout the skeletal frame, except for the skull (neurosurgeon) and face (ENT, or ear, nose, and throat, surgeon). Extremity fractures, such as arm, wrist, leg and ankle are most common, and usually occur in men younger than age 45, and then become more common in women over age 45. The reason for the difference is that when women go through menopause, and stop producing estrogen, the rate of bone loss increases. This is why women are particularly susceptible to osteoporosis and subsequent fractures. The most common fracture prior to age 75 is a wrist fracture. In those over age 75, hip fractures become the most common broken bone.

There are several types of bone fractures:

  • Oblique - A fracture which goes at an angle to the axis
  • Comminuted - A fracture of many relatively small fragments
  • Spiral - A fracture which runs around the axis of the bone
  • Compound - A fracture (also called open) which breaks the skin

Signs & Symptoms

  • A visibly out-of-place or misshapen limb or joint
  • Swelling
  • Intense pain
  • Numbness and tingling
  • Broken skin with bone protruding
  • Limitation or unwillingness to move a limb

Treatment Options

Since the cells that make up our bone constantly replace themselves, even when injured or broken, healing comes about quite naturally. You can see this process demonstrated here.

However, in order for a fracture to heal as well as possible, a good reduction, or placement, of the bones must be attained. The reduction or a fracture, or reducing the broken bone, comprises improving the alignment of the broken ends of the bone.

In most cases reduction of a fracture involves placing the broken bone in a cast, often after a little pulling and tugging to achieve improved alignment. If the reduction cannot be satisfactorily achieved (meaning the alignment is either not adequate or not sufficiently stable), then a further procedure may be necessary. This usually means surgery with fixation of the bone with pins, plates, screws or rods.

The treatment of specific fractures is far too complicated to be addressed in a general overview of broken bones, but depends on factors such as these:

  • Location of the fracture
  • Severity of angulation or deformity
  • Potential for healing
  • Other injuries
  • Age and activity level of the patient
  • Many other factors...

In order to understand your treatment, and the options you may have for treatment, you need to discuss your fracture with your doctor. Because treatment is individualized based on the patient, an x-ray of the fracture, and the other factors mentioned above, each case must be treated on an individual basis.

Call your doctor if the following occurs:

  • Swelling does not go down within 2 days
  • You have severe pain and cannot put any weight on the injured joint
  • The area over the injured joint or next to it is very tender when you touch it
  • You cannot move the injured joint
  • You cannot walk more than four steps without significant pain
  • You have numbness in any part of the injured area
  • You injure an area that has been injured several times before
  • You have pain, swelling, or redness over a bony part of your foot
  • You are in doubt about the seriousness of the injury or how to care for it