Bone fractures, or breaks in a bone, cause significant disability and can lead to long-term complications. Fractures can occur in any bone at any age and are usually easily visualized on X-ray. Bone can regenerate and heal broken pieces together as long as the pieces are in close proximity to one another.
Types
Fractures fall into one of several categories. Closed or simple fractures don't penetrate the skin, while open fractures break through the skin, leaving the jagged edge of the bone visible. A transverse fracture breaks at a right angle to the bone.
Greenstick fractures often occur in young children; the bone breaks on one side and bends on the other. Comminuted fractures result in three or more bone fragments, while stress fractures leave small cracks in a bone. Avulsion fractures result in small pieces of bone breaking off. Spiral fractures come from twisting motion and leave triangular, sharp bone ends.
Causes
Trauma, the most common cause of bone fracture, can cause any type of fracture. Stress fractures often occur from overuse. Osteoporotic fractures occur from bone thinning as people age, particularly women, and often affect the vertebrae in the back, the hip or the wrist. People with cancer may also be prone to fractures from weakened bone.
Symptoms
Pain, the main symptom of bone fracture, usually occurs at the time of the break. A cracking or snapping sound may be heard at the time of fracture, states the American Academy of Orthopaedic Surgeons.
Swelling, tenderness, discoloration and bruising often appear quickly. It's often difficult to move the broken bone, and the bone may appear deformed. Weight bearing may be impossible if a leg or hip is fractured. Numbness or paralysis below the break may occur if blood flow is disrupted by the break.
Treatment
Bone fractures need immobilization to prevent further damage and so the broken ends can knit together and mend. If the broken bone ends are not approximated or near each other, the bone may need to be manipulated so the edges are close enough to heal.
Internal fixation devices such as pins, plates or screws placed during surgery hold bone together so it can heal. External fixation devices such as casts and splints also keep the bone in alignment. Stress fractures may require no treatment other than rest, ice and anti-inflammatory medications, the Milton S. Hershey Medical Center reports.
Complications
Many fractures are uncomplicated and heal within a few months, but complications can occur. Infection can set in after open fractures. Internal bleeding can cause low blood pressure from blood in the fractures of large bones like the pelvis or femur.
Compartment syndrome, a rare but dangerous complication, occurs when muscles and tissues swell after fracture. Blood flow can be compromised by the limited space within the case and muscle death occurs, Merck Manuals states. Pain and numbness are signs of compartment syndrome.
Pulmonary embolism occurs when small clots break loose after fractures of the hip and pelvis, and then lodge in the lungs, damaging tissue and decreasing oxygenation to tissues. Pulmonary embolism is the most common cause of death after hip and pelvic fractures, according to Merck. Nerve injuries, poor healing and weakness also may complicate fractures.
