Definition

A fracture refers to a break in a bone, which can range from a small crack to a complete separation of the bone. Medically, it’s defined as a disruption in the bone’s continuity caused by force or pressure that exceeds the bone’s natural strength, usually from an injury or physical trauma.

Fractures are common and occur when a bone can no longer withstand an applied force. In some cases, the broken bone punctures the skin and becomes visible—this is known as an open fracture. On the other hand, if the bone remains under the skin and the fracture can only be seen through imaging, like an X-ray, it’s referred to as a closed fracture.

Fractures also come in different forms based on how the bone breaks. The break might run in a spiral, slanted, or straight line. In some cases, parts of the bone separate completely, or the bone may even be shattered into several pieces.

Causes

Fractures occur when the bone is subjected to intense pressure that it cannot absorb. This pressure may result from a fall, injury, sports-related activity, direct blow, being struck, or hit by a heavy object. Additionally, repetitive motion, like running over long periods, can strain muscles and transfer excess stress to the bones. This type of stress-related fracture is especially common among athletes.

Certain medical conditions can weaken bones, making them more prone to breaking. These include osteoporosis, which reduces bone density, and bone cancers that compromise the bone’s structure.

Risk Factor

There are a number of factors that may increase someone’s chances of experiencing a fracture, such as:

• Smoking, which reduces bone mass.

• Excessive alcohol intake.

• Older age.

• Obesity or being significantly overweight.

• Having specific medical conditions like:

  • Diabetes.

  • Rheumatoid arthritis (an autoimmune disease).

  • Bone cancers.

  • Osteoporosis.

  • Chronic illnesses such as Crohn’s disease.

• Long-term use of corticosteroid medications.

• A history of previous fractures.

• A family history of bone fractures.

Symptoms

Fracture symptoms can vary depending on where the bone is broken, how it happened, and how serious the break is. However, in general, most people with fractures will experience the following signs:

• Pain in the affected area.

• Swelling or noticeable bruising.

• Skin discoloration around the injury.

• A visible lump or bulge where the bone is broken.

• Limited or restricted movement of the affected limb.

• Inability to put weight on the injured area.

• In open fractures, bleeding and visible bone through the skin.

In more serious cases, such as open fractures, symptoms like dizziness, nausea, or fainting can occur. These cases require urgent medical care.

Diagnosis

To confirm a fracture, doctors will perform a series of tests, which include a detailed interview, physical test, and imaging tests to assess the injury.

Medical Interview

The healthcare provider may ask about:

• The main complaint and other symptoms being experienced.

• How the injury occurred.

• The sequence of events leading to the injury.

• The patient’s medical background.

• Any history of similar conditions within the family.

Physical Examination

During the physical examination, the doctor checks the patient’s overall condition and vital signs. A closer evaluation is then made of the area where the fracture is suspected. The following are assessed:

• Abnormal shape or unusual skin color.

• Skin temperature differences.

• Presence of bleeding or visible wounds.

• Protruding or misaligned bone segments.

The doctor will gently press on the area to identify pain levels and may try to move the injured part slightly to understand the severity, if movement is necessary to complete the assessment.

Diagnostic Tests

To confirm the exact type and pattern of a fracture, doctors will perform a series of diagnostic tests. These imaging tools help determine the location and severity of the break. Common radiological tests include:

• X-Ray: X-rays are the most commonly used and trusted method for detecting fractures. They provide clear images of bones and are readily available in most healthcare settings.
• MRI: MRI (Magnetic Resonance Imaging) is a more advanced imaging technique used to see detailed pictures of bones, organs, muscles, and soft tissues, including nerves. It is especially useful when a fracture is suspected but not visible on an X-ray.
• CT Scan: CT Scan (Computerized Tomography) provides a more in-depth view and is used to detect structural abnormalities in bones and muscles. It is also helpful in identifying tumors or possible cancers in the affected area.

Management

The main goal of fracture management is to realign the broken bone and support the healing process. Treatment also aims to ease pain, prevent complications, and restore the bone’s normal function.

Here are several common treatment approaches:

Using Splints and Casts

A splint helps immobilize the injured area using a firm support device that limits movement and promotes healing. A cast, usually made from materials like fiberglass or plaster with calcium sulfate, is shaped to fit the affected area. Whether to use a cast or splint is a decision made by an orthopedic specialist based on the severity and type of fracture.

Treatment

Medications are given to control pain, depending on how severe the discomfort is. In some cases, calcium supplements may be prescribed to support bone healing and strength.

Traction

This method uses weights and pulleys to gently stretch and align the bones. Traction reduces unnecessary movement, minimizes deformities, and keeps the bones in proper position during recovery.

Surgical Procedures

Certain fractures require surgery. During the procedure, the orthopedic surgeon may use metal hardware to stabilize the bone. These may be placed internally (inside the bone) or externally (outside the skin) depending on the fracture. Only a qualified orthopedic surgeon can perform this kind of operation.

Complications

Fractures can lead to various health complications, such as:

• Hypovolemic shock, where severe blood loss from the fracture leads to a dangerous drop in blood pressure.

• Compartment syndrome, caused by increased pressure in muscles due to bleeding or swelling.

• Deep Vein Thrombosis (DVT), which is a blood clot forming in a deep vein.

• Fat embolism, where fat particles enter the bloodstream and block blood flow.

• Bone infection (osteomyelitis).

• Cellulitis, an infection of the skin near the fracture.

• Sepsis, a widespread infection throughout the body.

• Malunion, which refers to abnormal bone healing or misalignment after a fracture.

Prevention

To lower the risk of fractures, consider the following steps:

• Eat a diet rich in calcium and vitamin D. Foods like fish, eggs, and leafy greens help build stronger bones.

• If needed, take supplements, but only after consulting with a doctor.

• Exercise regularly, focusing on building strength in muscles and bones.

• Practice safe driving habits to reduce the chance of traffic-related injuries.

When to See a Doctor?

You should seek medical attention immediately after an injury—especially if a bone is visible through the skin, which may indicate an open fracture. Also consult a doctor if you have difficulty moving a limb or feel pain in your spine or joints after trauma.

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