Fracture is a general term that indicates disruption of the continuity of a bone. Fractures can be as simple as a slight crack that needs rest to heal or as devastating as a compound — more than one break — fracture requiring a cast, traction, or specialized structure to heal properly. People who suffer a fall or accident that results in lasting pain should see a medical practitioner. Specialized equipment and guidance can prevent worsening symptoms and ensure that the bones heal properly, to preserve a full range of motion.
Closed vs. Open Fractures
A closed fracture is one in which the bone does not cause tearing or damage to the surrounding tissue. The bone may crack, but the two halves remain in line with each other. This type of fracture is common in smaller areas of the body, such as fingers and toes, although arm and leg bones, as well as ribs, can experience closed fractures too. An open fracture is one in which the fragments of the bone tear through muscle tissue, the epidermis, or even pierce the exterior skin. This type of fracture is more serious, as damage to the tissue and the exposure through the skin can lead to infection. Re-setting the break is more complicated with open fractures, though both types require immediate medical attention.
Avulsion fractures occur where a ligament or tendon attaches to the bone. Upon injury, the tissue pulls on the bone, causing a crack or fracture. These types of fractures are common in tackle sports such as football and rugby. Repetitive motion can also lead to a higher risk of avulsion fractures, as it may stress the tendons and ligaments, putting more force on them and pulling on the bone. They’re more common in children and teens than adults, as tendons and ligaments tend to attach to the weaker growth plates of the bone. Most avulsion fractures are closed fractures.
Transverse fractures are straight breaks across the bone. They may result in either an open or closed fracture and are characterized by a 90-degree break along the long axis of the bone; as such, they can be quite painful. Blows with a large amount of force perpendicular to the bone typically cause transverse fractures, such as impacts from an auto accident or workplace injuries. In these cases, the bone may crack, break, or shatter. An orthopedic surgeon must set and realign the bone.
Oblique fractures are similar to transverse fractures — the difference is the angle at which the bone breaks. Oblique fractures result in a diagonal break at an angle to the long axis of the bone. The break may be a curve or a straight line. They are generally caused by a sharp blow at an angle to the limb, either from above or below, with a great amount of concentrated force. Oblique fractures are most common in the long bones of the arms and legs. Treatment involves resetting the bone and keeping it aligned with a cast until it heals. Medication includes anti-inflammatory drugs, antibiotics, and pain relievers.
When a bone shatters, this is a comminuted fracture. Such injuries are classified as open fractures because the bone fragments become embedded in the surrounding tissue. Comminuted fractures are severe and require surgery to remove the pieces and reset the bone. Smaller bones, such as those in the hands and feet, are more susceptible to comminuted fractures., as they often occur in high-impact situations such as vehicle collisions or hard falls broken with outstretched hands. Many comminuted fractures require surgery to repair, and in some cases need a bone graft or artificial bone replacement.
Greenstick fractures are most common in children less than ten years of age, as their bones are still growing and developing. When a child’s softer bones are struck with high force, they may bend instead of break like an adult’s. Sometimes, the side of the bone away from the impact breaks while the rest of the bone bends. Prompt medical attention is critical to treatment, as a bend in a growing bone can result in mobility complications.
A stress fracture is a hairline fracture common to athletes and endurance sports enthusiasts. Repeated stress and strain on a bone can cause slim cracks, as can repeated force from hard surfaces such as concrete. Distance runners may be especially susceptible to this in the feet and lower legs. These can impede athletic performance and worsen over time. They typically don’t require a splint or a cast, but doctors advise limited use of the affected bones until the cracks have fully healed, to prevent complications.
Pathologic fractures differ from other fractures, as outside force or impact does not cause them. When an individual has a disease that weakens the bones significantly, such as cancer or osteoporosis, the bones can fracture simply from the weight of the person’s body. While many health conditions can cause the bones to weaken, most diseases do not impact their ability to heal. For the conditions that do, a specialist will determine treatment to help the bone heal and reduce the risk of future pathologic fractures.
A compression fracture is another type of fracture that isn’t caused by severe force. Instead, these fractures occur in the spongy tissue inside the bones. They’re especially common in the spine, as a result of osteoporosis. The front portion of the vertebra may collapse under the steady pressure of the rest of the body. Back pain and hunched over posture are indicators that one has experienced a compression fracture; x-rays and medical evaluation can determine if it is a stress fracture, loss of cartilage, or other effects of aging. These fractures may heal on their own, but excessive movement, including leaning over too frequently, may cause the condition to worsen.
When a bone breaks, generally the broken pieces split apart. An impacted fracture is one in which an injury forces the two ends of the broken bone into each other. These result in open fractures and can lead to infection in the surrounding tissue of treatment is not prompt. The fragments can end up inside another piece of the bone through the force of the impact.