Fractures

Bones are living tissue which serves to provide support and structure to the human body. Fractures as defined in the most basic meaning is the breaking of a bone. Under normal circumstances, bones are able to take a certain amount of force. However, if the force put upon the bone exceeds the limit that the bone can withstand, a fracture will result.

There are several clinical subtypes that fractures can be divided into. The first is a fragility fracture, which is a result of minor trauma. An example of this would be a fracture in an individual with osteoporosis whose bones are frail. Even a simple accident could result in a fracture. The second type of fracture is a pathological fracture, which is a result of a structurally abnormal bone. An example of this is a fracture in an individual who has a type of bone disease which makes their bones abnormally susceptible to fractures. The fractures in an individual with a pathological cause can result spontaneously or secondary to trauma. The third type of fracture is a high-energy fracture which is a result of serious trauma. An example of this would be an individual who falls off the roof and breaks a bone. This third type of trauma is equal to stress fractures; however, an example of stress fractures would be in an athlete who does repetitive minor trauma. The key to stress fractures and high-energy fractures is that they occur in people who have normal bones. Finally, if the fracture occurs in such a way that the bone pierces through the skin, it is called an “open” fracture.

The typical clinical presentation of a fracture would be acute pain followed by swelling. In most cases, the physician's differential diagnosis would be whether the bone is broken or there is a soft tissue injury. A fracture is fairly easy to diagnose. Signs of a fracture are pain, swelling, abnormal movement of the limb with the fracture, and deformity. Symptoms vary according to the area in which the bone is affected. A plain radiograph taken in two views is useful in confirming a suspected fracture. Although this will often confirm a suspected diagnosis, a higher type of imaging method may be used if a fracture is still not found after a plain radiograph and the symptoms are still highly suggestive of a fracture.

When treating a fracture, it is important to treat it according to the location of the fracture, as well as the type. The initial management of a fracture is to immobilize the area where the bone has been broken so that additional damage can be prevented. Other things that can be done are elevation of the broken bone to reduce bleeding and swelling. According to the Academy of Orthopedics, the treatment of broken bones follows one rule: “The broken pieces must be put back into position and prevented from moving out of place until they are healed.” After the healing process of the broken bone, rehabilitation is also important. Rehabilitation helps to avoid joint stiffness as well as muscle wasting around the affected bone.

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