FAQ: BONE FRACTURE

A: A fracture is a break or crack in a bone.

Anyone can fracture a bone. Those with low density (osteoporosis), bone tumors, certain cancers, or a brittle bone disease called osteogenesis imperfecta are at higher risk for bone fractures. Children and adults who are extremely active and participate in contact sports are also more likely to experience bone fractures. After middle age, women are more likely than men to suffer bone fractures because of diseases that affect bone strength.

Here are some examples of the most common types of fractures

A: In general, a bone fracture results in pain, swelling, and, sometimes, bruising from internal bleeding. The patient cannot bear weight or pressure on the injured area, and may be unable to move it without severe pain. The soft tissues around the broken bone may also be injured. The area around or below the fracture may feel numb or paralyzed due to a loss of pulse in that area. There are many different types of fractures. These include a closed or simple, fracture, in which the skin around the fractured bone is not broken. An open, or compound, fracture does include a break in the skin, revealing the bone and making the wound more susceptible to infection. A fracture is called complete if the break is the whole way through the bone, and incomplete (or greenstick) if the break is partial. Greenstick fractures are more commonly seen in children.
Stress fractures are small cracks in a bone that occur over time as a result of repeated activities that put stress on the bone. There are many other classifications of fractures according to characteristics such as where they occur and their appearance. A person can have just one fracture or multiple fractures at the same time.

A: A bone fracture is diagnosed by a physical examination and x-rays of the injured area. However, some types of fractures are difficult to see on an x-ray. In this case, your doctor may order other diagnostic imaging tests, such as computed tomography (CT), magnetic resonance imaging (MRI), or bone scans. Open fractures require additional laboratory tests to determine whether blood has been lost and if there is infection.

A: The treatment for a bone fracture depends upon the type and location of the fracture and the patient’s age and medical history. When a fracture is suspected, the affected area should be immobilized to prevent any further damage. Minor fractures can be treated in the office of an orthopedic specialist. Orthopedics is the branch of medicine that deals with the treatment of injuries to or disorders of the skeletal system. More severe fractures, such as those that are open, multiple, or to the hip or back, are treated in a hospital. Most fractures are immobilized with a cast, brace, splint, or sling. If there is severe swelling, your doctor may wait until the swelling has gone down before casting the fracture.

Stress fractures often require no more than rest, ice packs, anti-inflammatory medicines, and temporarily discontinuing the activity that has caused the injury. If a fracture results in the bone being misaligned, the doctor must realign the bone through a procedure called fracture reduction. This may be done manually and/or through traction, which holds the bone in place for period of time using weights and pulleys.

Surgery may be necessary when a fracture is open, severe, or has resulted in severe injury to the surrounding tissues. Severe fractures may require internal devices, such as screws, rods, or plates, to hold the bone in place or replace lost bone during the healing process. Bone grafts, where healthy bone is taken from another area of the body to fill in the fracture, may also be used. The length of time it takes for a bone fracture to heal and the need for physical therapy after treatment depends upon the severity of the fracture and the age and health of the patient.

A: Bone fractures should be treated as quickly as possible to avoid complications and ensure complete healing. Weight-bearing exercise and sufficient amounts of calcium in the diet help strengthen the bones and prevent bone fractures. You can also help prevent bone fractures and other automobile-related injuries by wearing a seat belt when riding in a motor vehicle. People who participate in contact sports should wear appropriate protective gear. Doctors recommend estrogen therapy for women over the age of 50. This, as well as calcium supplements, can help lower the risk of osteoporosis and related bone injuries.

A: If you fracture a bone, it's important that you limit your movement as much as possible. You may need to use a sling or splint. This helps minimize pain and can also prevent further injuries caused by movement of the sharp ends of broken bone.

A: The repair of a fracture by the body is a gradual process. Fractures in children usually heal quickly. The speed of recovery also depends on the bone you break. It will take longer for fractures in lower limbs, such as the thighbone, to recover than those in smaller bones, such as the finger bones. This is because the thighbone is larger and more difficult to immobilize. After this it's important to begin gentle movements and exercise as this helps to build up strength in the healing bone. You may need to have physiotherapy to promote healing and increase your movement of the affected area. This will be specific to your injury.

Ultrasound or pulsed electromagnetic energy may be used for fractures that are not healing or are healing slowly.

A: The time it takes for the broken ends of the bone to knit back together (unite) varies depending on the type of fracture and where the fracture is. Generally during the first two to six weeks after a fracture, a firm mass called a callus forms around the fracture. Then the bone becomes harder and stronger and minerals such as calcium are deposited (this process is called ossification). It can take up to two years for the bone to heal and be back to full strength.