Broken bone or fracture: types, symptoms, treatment

A bone fracture or fracture is a break or crack in a bone. Any bone can break, but some parts of the skeleton are extra sensitive due to their shape or location in the body. Fractures of the long bones in the limbs are common. What types of bone fractures can you encounter? What are the symptoms and how are the fractures treated? What is a splint fracture, a spiral fracture, a compression fracture? What is the prognosis for fractures?

Article content

  • Broken bone or fracture
  • Types of bone fractures
  • Symptoms of bone fractures/fractures
  • Complications of bone fractures/fractures
  • Diagnosis
  • Therapy
  • Prognosis

Broken bone or fracture

Any bone can break , most fractures are caused by a direct injury (for example a collision) or an indirect injury (for example a twist during sports). If someone already suffers from osteoporosis, the risk of a fracture increases. A bone fracture can also be caused by a growth, which is called a pathological fracture. Older people are often more likely to break something, often involving the hip or wrist. If someone falls on their hand with an outstretched arm, this sometimes results in a Colles fracture.

Types of bone fractures

There are two types of bone fractures:

  1. Closed fractures: In these fractures, the bone does not protrude through the skin.
  2. Open or complicated fractures: In these fractures, the bone protrudes through the skin. These fractures are more serious because there is a risk of infection and blood vessels and nerves may be damaged.

Subdivision of open and closed fractures by shape and pattern

  • Transverse fracture : the bone is broken straight in half. This often occurs in the long bones of the arms or legs, as a result of a very hard blow. Consider, for example, a traffic accident.
  • Spiral fracture : this fracture is also called an oblique fracture. These fractures are usually caused by a twisting movement that is made suddenly, such as during a fall. Spiral fractures most often occur in the bones of the arms and legs.
  • Green stick fracture : when the long bone of a child’s arm or leg breaks, but the periosteum remains intact. A green stick fracture is also called a twig fracture.
  • Comminuted fracture : the bone is broken into several small pieces. These fractures are usually caused by a serious direct injury. There is a good chance that soft tissues surrounding it are also damaged. Another word for this fracture is crush fracture or splinter fracture.
  • Avulsion fracture : A small piece of bone is torn off. Avulsion fractures usually occur when bone tissue tears off at a tendon attachment due to force.
  • Compression fracture : a compression fracture involves impressions of cancellous bone. You can find this bone in the spine, among other places. You are more at risk of a compression fracture if you suffer from osteoporosis or calcium deficiency.

There are also stress fractures : fractures caused by long-term repeated peak loads. You often encounter this in the feet of long-distance runners (mars fracture). In the elderly, fractures can occur due to coughing a lot, for example, which can lead to a broken rib.

Symptoms of bone fractures/fractures

The symptoms depend on the type of fracture. Possible symptoms:

  • Pain complaints or complaints of pressure pain.
  • It is more difficult to use the part of the body that is affected.
  • Swelling may occur, but bruising is also possible.
  • Crepitation may occur, which is a cracking sound caused by the fracture ends moving when pressure is applied or they are moved.
  • If there is an open fracture, you may see blood or exposed bone.
  • The body part affected may be abnormal in shape.

All fractures have the similarity that there is internal blood loss due to damage to blood vessels in the bone. Fracture ends can damage the tissues and blood vessels surrounding them, which can result in severe blood loss, even shock .

Complications of bone fractures/fractures

Complications that may occur:

  • In a rib fracture, the rib can puncture the lung.
  • A skull fracture can cause damage to the brain.
  • If there is an open fracture, an infection can occur.
  • If a fracture surface is large and a lot of fatty bone marrow is released, there is a risk of a fat embolism.
  • If an artery is torn, or an artery is compressed by swelling, there is a risk that the tissue beyond the fracture will not receive enough blood. For example, with a broken arm, the hand may turn blue due to lack of oxygen. The blood supply must be restored quickly to prevent permanent damage.
  • If you wait a long time before treating a bone fracture, it is possible that the bone will no longer heal properly. Permanent disfigurement (or disability) may occur. So always visit a GP if you think something is broken.

Diagnosis

X-rays will be taken of the affected body part to determine the type of bone fracture and how serious it is. Multiple fractures may require a CT scan or MRI. If a fracture occurs for no apparent reason, it must be determined whether the bones are weakened due to a disease.

Therapy

Bone pieces that have been displaced will first be returned to their normal position. This is also called reduction . It depends on the location and severity of the fracture whether this is done under local or general anesthesia, without surgery (closed reduction) or with surgery (open reduction).

The broken bone can be held in place to heal in several ways:

  • Immobilization with plaster;
  • Internal fixation;
  • External fixation;
  • Traction (hardly used anymore).

Sometimes immobilization of a broken bone is not useful , for example when it concerns a broken rib. The chest must be able to expand when breathing. With a broken rib, someone may pick up superficially and cough less well. Because this can increase the risk of pneumonia, the person should be told that regular breathing is important.
If an older person breaks a hip, a partial or total replacement of the hip joint with a hip prosthesis may be a solution. Physiotherapy is often necessary after healing.

Prognosis

In adults, it takes approximately six to eight weeks for a fracture to heal. In children it usually happens much faster and in a baby a fracture can be healed in two weeks.