FRACTURES: Types, Causes, Symptoms, and Prevention

Sometimes, when I see a person in pain, I can literally feel their pain, like it’s happening to me. Have you ever seen an open fracture? Bones sticking out through the muscles and skin, the sight of it sends shivers down my spine. I’ve never had a fracture, and I pray I never do, but I feel a fracture is perhaps the most painful injury a person can have. 

WHAT IS A FRACTURE?

A fracture is a partial or complete break in the bone. It is simply a medical term for a broken bone.

TYPES OF FRACTURES

There are 2 ways to classify fractures:

A. Depending on whether it comes through the skin:

1. Open fracture (also called compound fracture): The bone pokes through the skin and can be seen, or a deep wound exposes the bone through the skin.
2. Closed fracture (also called simple fracture). The bone is broken, but the skin is intact.

B. Depending on how the fracture affects the bone involved, there are:

1. Greenstick fracture: This is an incomplete fracture. A portion of the bone is broken, causing the other side to bend.
2. Transverse fracture: The break is in a straight line across the bone.
3. Spiral fracture: The break spirals around the bone; common in a twisting injury.
4. Oblique fracture: The break is diagonal across the bone.
5. Compression fracture: The bone is crushed. This causes the broken bone to be wider or flatter in appearance.
6. Comminuted fracture: The bone has broken into three or more pieces and fragments are present at the fracture site.
7. Segmental fracture: The same bone is fractured in two places, so there is a “floating” piece of bone.

WHAT CAUSES FRACTURES?

Fractures most often happen when more force is applied to the bone than the bone can take. Bones are weakest when they are twisted.

Bone fractures can be caused by:

• Falls

• Trauma

• Direct blow or kick to the body.

• Overuse or repetitive motions can tire muscles and put more pressure on the bone. This causes stress fractures. This is more common in athletes.

• Fractures can also be caused by diseases that weaken the bone, such as osteoporosis or cancer in the bones.

WHAT ARE THE SYMPTOMS OF A FRACTURE?

Each person may experience symptoms differently. 

Symptoms of a broken or fractured bone may include:

1. Sudden pain
2. Trouble using or moving the injured area or nearby joints
3. Swelling
4. Obvious deformity
5. Warmth, bruising, or redness

The symptoms of a broken bone may resemble other medical conditions or problems. Always see a doctor for a diagnosis.

HOW IS A FRACTURE DIAGNOSED?

Your doctor will ask for a complete medical history (including asking how the injury happened), do a physical exam, and ask you to do some tests. Tests for this purpose may include the following:

1. X-ray: A diagnostic test which makes pictures of internal tissues, bones, and organs on a film.
2. Magnetic resonance imaging (MRI): An imaging test that makes detailed pictures of structures within the body.
3. Computed tomography scan (also called a CT or CAT scan): Also makes detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs.

HOW IS A FRACTURE TREATED?

The goal of treatment is to:

1. put the pieces of bone back in place
2. Control the pain
3. Give the bone time to heal
4. Prevent complications, and
5. Restore normal use of the fractured area.

Treatment may include:

1. Splint or cast:
   This stops the injured area from moving, to keep the bone in straight. It protects the injured area from movement or use while the bone heals.

2. Medicines:
   Like pain killers may be needed to control pain.

3. Traction:
   Traction is the use of a steady pulling action to stretch certain parts of the body in a certain direction. Traction often uses pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the broken bone to help the bone ends to align and heal.

4. Surgery:
   Surgery may be needed to put certain types of broken bones back into place. Occasionally, internal fixation (by putting metal rods or pins inside the bone) or external fixation devices (putting metal rods or pins outside of the body) are used to hold the bone fragments in place while they heal.

Fractures can take months to heal as broken bones need time to grow back together while new bone is formed between the broken parts.

WHAT CAN I DO TO PREVENT FRACTURES?

Most fractures are caused by accidents, such as falls, or other injuries. But there are some things you can do to lower your chances of bone fractures, for instance:

1. Follow a healthy diet that includes vitamin D and calcium to keep bones strong.
2. Do weight-bearing exercises help to keep bones strong.
3. Do not use any form of tobacco. Tobacco and nicotine increase the risk of bone fractures and interfere with the healing process.
4. Osteoporosis, a common cause of fractures in older people. Talk to your doctor about your risk of osteoporosis and get treatment if you have it.

You should see a healthcare provider any time you think you may have a broken bone.

An open fracture (one in which the bone comes through the skin so you can see it or a deep wound exposes the bone through the skin) is considered an emergency. Get medical attention right away for this type of fracture.

Any injury to the bones of the spine is also a medical emergency. These cause severe back pain and may cause nerve problems. These include numbness, tingling, weakness, or bowel/bladder problems.