Fractures
A fracture occurs when a bone counters a force stronger than it can bear as in, trauma due to a fall/fight/vehicular accident etc. Fractures may also be caused when the bones get weak due to conditions like osteoporosis, brittle bone disease, osteomalacia, etc.
Causes
A fracture occurs when the bones encounter a strong force (usually stronger than they can bear). Although the most common causes are trauma due to a fall/fight/vehicular accident etc., they may also be caused when the bones get weak due to conditions like osteoporosis (in old age mostly), brittle bone disease, osteomalacia etc.
Types
Most people assume there is only one kind of fracture – the kind that requires a white cast that is likely to last for a few months. But there is much more to a fracture than that. However, the fact is that there are many different kinds and based on the type, the line of treatment and recovery time varies.
Displaced or non-displaced: When the fractured fragments are separate, but are still aligned correctly and have not moved from their normal position, they are known as non-displaced fractures. If they have moved, it is known as a displaced fracture.
Open or closed fracture: When the fractured bone breaks the skin and comes out through a wound, it is called an ‘open’ fracture. When no such wound is present the fracture is called a ‘closed’ fracture.
Greenstick fracture: This type of fracture is generally seen in children, where the bone is bent, but not completely broken (this occurs because a child’s bones are suppler than an adult’s).
Comminuted fracture: Thisis where the fractured bone is fragmented into many small pieces.
Stress fracture: Also called a ‘hairline crack’, such fractures occur due to low-grade trauma over a long period of time to a part of a bone.
Pathological fracture: Sometimes bones may become weak and thin due to a disease like osteoporosis. In such cases a person may suffer from a fracture without any trauma or injury. Such a fracture is called a pathological fracture.
Symptoms
The symptoms vary depending upon the type of fractures. These include -
Displaced or non-displaced: A person with a displaced fracture will notice a disfigurement (a small protrusion) of the area that is fractured. In the case of a non-displacedfractureone will only notice a swelling in the region.
Open or closed fracture: The open fracture is the easiest to identify because of the wound seen on the person’s skin. In the case of the closed fracture, one will be able to see the broken bone pushing through the skin.
Greenstick fracture: Usually associated with immense pain and inability to use the fractured part, a greenstick fracture requires a lot of care and attention. The person will not notice the usual deformity seen with other fractures.
Comminuted fracture: A person with this type of fracture will notice bruising, pain and swelling. The person might also hear a snap or a crack when the bone breaks and be unable to put weight on that area. There might also be some disfigurement of the area.
Stress fracture: Here the patient will experience symptoms such as pain that develops gradually, one that increases with weight-bearing activity and goes away with rest, pain and tendernessaroundthe area of the fracture.
Pathological fracture: In this type of fracture the person will experience sudden symptoms associated with that particular type of fracture. While he/she might be experiencing painalongthe region of the break for a while (usually associated with the weakening of the bones)
Diagnosis
Diagnostic tests like X-rays or CT scans, MRI, etc. of the injured area are done to assess the type and extent of the fracture.
Treatment
Depending upon the type of fracture, the treatment options are determined. However after proper alignment or ‘reduction’, a fracture is immobilized with the help of a plaster of Paris cast, splint or traction. Certain fractures may require a minor surgery (open reduction) and metallic plates, rods, screws or pins are used to stabilize the bone fragments in position. The common treatment options for fractures are -
Displaced or non-displaced: In the case of a displaced fracture, the fragments have to be brought back into alignment, usually surgically. This procedure is called ‘reduction’, which can be ‘closed’ (without surgery) or ‘open’ (with surgery).
Depending on the severity of the fracture a person might need surgery. In such cases although the affected area usually returns to normal functioning, the period for complete recovery is anywhere from three to six months.
Open or closed fracture: In the case of an open fracture the wound needs to be carefully cleaned and dressed accordingly, so as to avoid an infection of the bone. Antibiotics may also be prescribed to prevent an infection.
In this type of fracture the patient almost always requires surgery to realign the bones and repair the damage to the skin. The doctor may require to place a plate or metal screws to hold the bones in place till they heal. The recovery time for such a fracture is usually about six months followed by physiotherapy to regain use of the fractured part.
Greenstick fracture: This type of fracture is usually cast in an immovable cast so as to allow the bones to heal. In the case of children the doctor may use a cast for the entire area, in order to minimize movements made by the child, especially in the case of a fractured arm or leg.
Usually seen in children the doctor usually prescribes the child to remain in the cast for at least three months, with close monitoring. If the fracture has not healed, he/she may extend the amount of time the casts is maintained.
Comminuted fracture: This type of fracture often requires surgery to realign all the bone fragments and insertion of a metal plate or wires to hold them in place till they heal.
Depending on the severity of the fracture, a patient may need to remain in the case and regular post operative checkups to make sure that the area is healing well. He/she may be required to remain in a cast for a few months and will require a significant amount of physiotherapy after the treatment.
Stress fracture: Most stress fractures only require a cast to heal, but there are others that require surgical intervention to help the bones join and heal. Depending on the case, the patient will require anywhere between a few week to a few months to heal and can return to normal activity.
Pathological fracture: In such cases the patient is treated for the fracture and given appropriate medical care for the underlying reason.
People who suffer from a fracture due to pathological reasons usually have a long road to recovery. Even after the fracture has healed it takes a long while to rehabilitate that area and make the bones strong enough to support their weight and the stress of everyday activities.It is important for one to realise that a fracture does require first aid when it occurs. To know more about the type of first aid you should provide, read our article on
It is important for one to realise that a fracture does require first aid when it occurs. To know more about the type of first aid you should provide, read our article on Fractures: First-aid and treatment options you should know about
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