fracture and broken bones

Fractures 101: Causes, Treatment & Types of Broken Bones

Worried about a fracture? Find out the causes and symptoms of fractures and what to do in the event of broken bones.

by Lorraine Bunag, R.N.

What is a Fracture?

A fracture is a break in the continuity of the bone. This could mean that the bone sustained a crack or broke into two or more pieces. Many things could result in bone fractures, but in general, it happens because the bone cannot withstand the force exerted on it. The most common locations of fracture are the wrists, ankles and hips.

Symptoms of a Fracture

Fractures need to get checked by the doctor regardless of how mild it is. While most fractures heal on their own, medical intervention is required to make sure that they heal in their proper alignment.

To identify if you have a broken bone, you should first understand the most common signs and symptoms of fractures:

  • Pain
  • Bruising
  • Swelling
  • Deformity
  • Inability to use the affected area

These symptoms are rather common, and a fracture may easily be mistaken for another orthopaedic condition. For this reason, it is crucial to consult the doctor to get the correct diagnosis and appropriate treatment.

Potential Complications of Fractures

Another reason why talking to the doctor is essential is to avoid complications. Reports have stated that untreated broken bones can lead to:

  • Blood Loss: It is easy to imagine that bones are nothing but hard masses without blood supplies, but the truth is, our bones and their surrounding tissues are rich in blood supply. In other words, a bad break can trigger blood loss when not treated right away.
  • Organ Damage: Another possible complication is organ damage, especially in times when the broken bones pierce through adjacent tissues. Case in point, a fracture in the skull can hurt the brain, while a broken ribcage can puncture the lungs.
  • Stunted Growth: This can happen when a growing child experiences fractures in the long bones near where the growth plates are located.

First Aid for Fractures

At this point, we already understand how crucial it is to consult a doctor if you suspect that you’ve broken a bone, but there is another essential aspect of treatment: first aid.

Handling the affected area properly reduces pain, bleeding, and the possibility of organ damage. This ultimately makes treating the broken bone less complicated. But, how do you properly apply first aid to a fracture?

Experts say that first aid on fractures centres on immobilization or limiting movement. Hence, if you suspect that you or someone you love has broken a bone, remember the following:

  • Keep still: As much as possible, do not move the person unless there is an immediate danger to him or her, in which case, move them very carefully, especially if the skull, spine, pelvis, ribs, and upper leg are involved.
  • Immobilize the area: For potential breaks that do not appear very deformed, consider using a splint above and below the site. If professionally-made splints are unavailable, a makeshift one using cardboard and folded magazines work, too, in many cases.
  • Use a sling when needed: If the arms are affected, consider using a sling for support.
  • Elevate the area and apply ice. When possible, raise the suspected fractured area and then apply ice to reduce any swelling.
  • Do not eat or drink anything. Stop the person from eating or drinking anything until the doctor has checked them.
  • Stop the bleeding: Should you see visible bleeding, apply pressure to the area with a clean cloth. When the cloth gets soaked, simply add another cloth on top. Now, in case a bone protrudes out of the bleeding site, apply pressure to the surrounding area. Remember that heavy bleeding, extreme pain, and protruding bone necessitate emergency help. 
  • Cover the area with a cloth: Once the bleeding stops, cover the affected area with a clean dressing. 

And finally, if you see a severe deformity due to broken bones, do not use a splint unless the bones have been aligned. Only trained healthcare professionals can do the re-alignment.

Types of Fractures

Doctors use various terms to identify the kind of fracture a person sustains. With these terminologies, they can be more specific in the location of the broken bone and the direction by which the bones broke.

Terms Describing the Location of the Fracture

  • Proximal refers to an area close to the centre of the body, and distal points somewhere farther.
  • Anterior, describes an area to the front, and posterior means somewhere to the back. For example, the chest is anterior to the back, and the back is posterior to the chest.
  • Medial, goes to the centre of the body; lateral, goes to the side.

Terms Describing the Direction of the Break

  • Transverse fracture happens when the break (or the crack) travels across the bone.
  • Oblique fracture also occurs across the bone, but at an angle (diagonally).
  • Spiral fracture resembles a corkscrew break or one that looks like winding stairs. Usually, a spiral fracture results from a twisting force — when an extremity is planted, but the body continues a swinging or twisting motion.
  • Comminuted fracture happens when a portion of the bone breaks into several smaller fragments.

Other Terms Describing Fractures

Doctors also use the terms complete and incomplete (greenstick) to describe a type of fracture. An incomplete or a greenstick fracture happens when the bone breaks and perhaps even bends, but the pieces do not separate. Should the fragments separate from each other, you now call it a complete fracture.

We also have displaced and non-displaced broken bones. A displaced fracture indicates that the bone broke and the fragments become misaligned. If there is no misalignment, then what you have is a non-displaced fracture.

However, please note that for many doctors, all fractures — no matter how mild — have a certain level of displacement. Hence, they may use the term minimally displaced.

Finally, we have closed and open fractures. Closed fractures refer to broken bones that do not pierce through the skin. If the bones break badly enough to puncture the skin, then you have an open fracture. An open fracture is a medical emergency.

Other Types of Fractures

  • Hairline Fracture: This type of fracture describes cracks or bruises in the bone, often as a result of repeated stress. Due to this, some doctors also refer to it as a stress fracture.  Hairline fractures are common among athletes and typically occur in the foot or lower leg.
  • Avulsion Fracture: Tendons are connective tissues that attach bones to muscles. In an avulsion fracture, a small portion of the bone “breaks free” from the tendon and detaches from the main bone. It commonly occurs in the shoulders and knees.
  • Compression Fracture: From the name itself, compression fractures result from two or more bones pressing against each other. It can happen in the vertebrae, especially in seniors who experience osteoporosis.
  • Colles Fracture: This is a type of fracture where the distal radius (one of the bones in the forearm) breaks and bends backward, often resulting in a bulging wrist.
  • Chance Fracture: It happens due to excessive flexion of the spine, which triggers a fracture in the vertebrae.
  • Metatarsal Fracture: Metatarsals are the long bones below the shorter bones of your toes, and tarsals are the shorter bones below the metatarsals. A metatarsal fracture happens when one of the metatarsals in the foot breaks. There’s a kind of metatarsal fracture called the Lisfranc fracture which occurs when one or a few of the metatarsals break away from the tarsals.
  • Supracondylar Fracture: This refers to a break in the humerus bone — the bone in the upper arm. This type of fracture commonly occurs in kids.

Common Causes of Fractures

Our bones are typically very strong because they do not only serve as our body’s framework but also as a shield to protect our internal organs. However, some forces are stronger than our bones, and several conditions make the bones more vulnerable to fractures.

The most common causes of fractures are:

  • Accidents: External forces from incidences like sports injuries or traumatic vehicular accidents are often stronger than what the bones can withstand.
  • Health conditions: Certain health conditions may make a person’s bones weaker, which means that even minor trauma can result in fractures. Examples include osteoporosis and bone cancer.

Please remember that anyone can have their bones broken, but those more at risk are:

  • Children, because they are naturally curious and adventurous.
  • Seniors, since their bones are weaker.
  • Athletes, because of their extensive training.

Diagnosis

To diagnose a broken bone, the doctor will physically assess the injury and then order one or more of the following imaging tests:

  • X-ray
  • Bone scan; doctors often request for a bone scan if they don’t observe the fracture after an x-ray. This procedure is longer and you might need two visits hours apart.
  • CT or computerized tomography scan
  • MRI or magnetic resonance imaging scan

Treatment for Fractures

The treatment for fractures depends on several factors, including:

  • Your age and overall health status
  • The severity of the fractures
  • How well you tolerate certain medications, therapies, and procedures
  • Your preferences

Nevertheless, the goal of the treatment is to promote healing of correctly aligned bones, reduce pain, prevent complications, and restore the use of the fractured area. Treatment strategies include:

  • Splinting or casting: Casting involves wrapping the affected area with hard protection all around, while splinting involves wrapping just one side. Both of these methods disable movement, allowing the bones to heal and grow back together. Smaller bones typically do not need a cast. There may also be times when a splint will be used first, until the swelling stops, then the doctor will order a cast.
  • Tractions: Another strategy is traction, which uses weight and pulleys to “manipulate” or stretch the muscles and tendons surrounding the affected bone.
  • Surgery: In cases where bones need help to be kept in place, your doctor may recommend surgery. During the surgery, the doctor might use screws, pins, and plates to promote healing.

The duration taken for a person to recover from broken bones depends on the severity of the injury, their adherence to the treatment regimen and their age. To put things into perspective, a broken leg needs more time to heal than a broken wrist. Similarly, seniors tend to recover more slowly than younger people. On average, you may need around 6 to 8 weeks to recover from a broken bone.

After your recovery, you may also require physical therapy to regain your bone and muscle strength faster.

Preventing Fractures

Most fractures can be avoided by being careful, staying in shape and attending to any condition that may make them vulnerable to fractures.

Be Careful and Take Measures to Prevent Accidents

One of the best ways to prevent fractures is to be careful and take the following measures to reduce the risk of accidents and prevent falls:

  • Remove clutter indoors and out.
  • Make sure that the rooms in the house are well-ventilated.
  • Use skid-free mats and rugs; also consider wearing shoes or slippers indoors.
  • Use canes or walkers when necessary.
  • Always pay attention to where you’re stepping to avoid falls.

Additionally, it will also help if you talk to the doctor about doing some exercises that promote balance and attend eye check-ups regularly or as recommended.

Stay in Shape

Weight-bearing and aerobic exercises not only promote good balance but also strengthen your muscles and bones. However, do not begin a new exercise regimen without your doctor’s approval.

Having a healthy and balanced diet helps too. Ensuring that you have adequate calcium and Vitamin D intake protects your bones from injuries. Foods rich in calcium and vitamin D are as follows:

  • Dairy products
  • Eggs
  • Beans
  • Nuts like almonds
  • Whole grains
  • Vegetables like broccoli and spinach

If you feel that you are not getting enough calcium and vitamin D, talk to your doctor about taking supplements.

Attend to Your Other Health Conditions

As mentioned, there are certain health conditions that can make you more vulnerable to fractures. For this reason, you should work closely with your healthcare team to treat conditions such as osteoporosis and cancer.

Are You Worried about Fractures?

If you suspect a broken bone, the best thing to do is go to the hospital or clinic as soon as possible. Should you need additional support at home while recovering from a fracture, we can help. Our Care Professionals can help with activities of daily living like showering and home physiotherapy. You can even engage a house call doctor for medical advice and treatment, all in the comfort of your home.

References
  1. Bone fractures. (n.d.). Better Health Channel – Better Health Channel. Retrieved March 14, 2021, from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bone-fractures#types-of-bone-fracture
  2. Bone fractures: Causes, symptoms, diagnosis, treatment & prevention. (n.d.). Cleveland Clinic. Retrieved March 14, 2021, from https://my.clevelandclinic.org/health/diseases/15241-bone-fractures
  3. Fracture. (n.d.). MedlinePlus – Health Information from the National Library of Medicine. Retrieved March 14, 2021, from https://medlineplus.gov/fractures.html#:~:text=A%20fracture%20is%20a%20break,cause%20weakening%20of%20the%20bones
  4. Fractures (broken bones): First aid. (2020, June 26). Mayo Clinic. Retrieved March 14, 2021, from https://www.mayoclinic.org/first-aid/first-aid-fractures/basics/art-20056641
  5. Fractures. (2019, November 25). Retrieved March 14, 2021, from https://www.cedars-sinai.org/health-library/diseases-and-conditions/f/fractures.html
  6. Types. (n.d.). Stanford Health Care (SHC) – Stanford Medical Center | Stanford Health Care. Retrieved March 14, 2021, from https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/fracture/types.html
  7. Wedro, B. (n.d.). Types of broken bones: Symptoms, treatment, healing & surgery. MedicineNet. Retrieved March 14, 2021, from https://www.medicinenet.com/broken_bone_types_of_bone_fractures/article.htm

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About the Writer
Lorraine Bunag, R.N.
Lorraine is a registered nurse who spends most of her time writing informative articles on health and wellness. At the end of the day, she relaxes by reading a book or watching documentaries about unsolved mysteries.
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