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Fracture

Definition

A fracture is a break in any bone in the body. There are different kinds of fracture:

  • The bone may be fractured but stable, which is known as a simple fracture or a closed fracture.
  • Bone fragments may be sticking through the skin, which is known as a compound fracture or an open fracture.

Fractures may also be described as:

  • Chip ( avulsion fracture)—A small piece of bone is broken away from the main bone and usually attached to a ligament or tendon.
  • Compression—The bone is compressed together, such as vertebrae.
  • Comminuted—The bone is in pieces.
  • Greenstick—One side of the bone is broken and the other side is bent but not broken.
  • Intra-articular—The joint is affected.
  • Growth plate fracture —A child's developing tissue is fractured.
  • Transverse—The bone is broken in a horizontal line that is perpendicular to the surface of the bone cortex.
  • Oblique—The bone is broken in a line that is less than a 90° angle to the surface of the bone cortex.
  • Spiral—The line of the fracture forms a spiral.
  • Stress—A thin fracture line occurs due to overuse rather than a single traumatic incident.

The Bones of the Body

Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

Causes    TOP

Fractures are caused by trauma to the bone. Trauma includes:

  • Falls
  • Twists
  • Blows
  • Collisions

Trauma is a physical force applied to the bone that the bone cannot withstand. Stronger bones can withstand more physical force than weaker bones.

Risk Factors    TOP

Factors that increase the risk of fracture include:

  • Increased age
  • Postmenopause
  • Decreased muscle mass
  • Osteoporosis —decreased bone mass which weakens bones and affects both men and women
  • Certain medication used to treat type 2 diabetes
  • Accidents or violence
  • Participation in sports
  • Malnutrition
  • Certain chronic diseases
  • Child abuse
  • Inactivity
  • Conditions that increase the risk of falls, such as nerve or muscle disorders
  • Certain congenital bone conditions—rare

Symptoms    TOP

Symptoms of a fracture include:

  • Pain, often severe
  • Instability of the area around the break
  • Inability to use the limb or affected area normally
  • Swelling or bruising
  • Numbness
  • Fainting

Diagnosis    TOP

The doctor will ask about your symptoms and how you injured yourself. The doctor will examine the injured area.

Images may be taken of your bodily structures. This can be done with:

Treatment    TOP

Treatment involves:

  • Putting the pieces of bone together if necessary—may require anesthesia and/or surgery
  • Keeping the pieces together while the bone heals itself

Devices that can hold a bone in place while it heals include:

  • A cast—may be used with or without surgery
  • Metal pins across the bone with a frame holding them outside the bone—requires surgery
  • A metal plate with screws—requires surgery
  • Screws alone—requires surgery
  • A rod down the middle of the bone—requires surgery

Healing and Rehabilitation

Healing time ranges from three weeks for a simple finger fracture to many months for a complicated fracture of a long bone. All fractures require rehabilitation exercises to regain muscle strength and joint motion.

Possible Complications

  • Delayed union—It takes longer than usual to heal, but does heal.
  • Nonunion—The bone does not heal and needs some special treatment.
  • Infection—This is more likely to happen after an open fracture or surgery.
  • Nerve or artery damage—This usually occurs as a result of severe trauma.
  • Compartment syndrome—Severe swelling in the spaces of the limbs that causes damage to body tissues.
  • Late arthritis—This may happen if the surface of a joint is badly damaged.

Prevention    TOP

You can reduce your chances of getting a fracture:

  • Avoid putting yourself at risk for an accident or other trauma to the bone.
  • Do weight-bearing exercise regularly to build and maintain strong bones.
  • Do strengthening exercises regularly to build strong muscles and prevent falls.
  • Patients with osteoporosis may benefit from bisphosphonate medications.
  • Wear protective equipment when playing sports.
  • Use proper fitness techniques.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org
American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org
Canadian Orthopaedic Foundation
http://www.canorth.org

References:

Fractures: an overview. American Academy of Orthopaedic Surgeons website. Available: http://orthoinfo.aaos.org/topic.cfm?topic=A00139 . Updated October 2012. Accessed October 9, 2013.
Gruntmanis U. Male osteoporosis: deadly, but ignored. Am J Med Sci. 2007;333(2):85-92.
McCarus DC. Fracture prevention in postmenopausal osteoporosis: a review of treatment options. Obstet Gynecol Surv. 2006;61(1):39-50.
Rockwood CA, Green DP. Fractures in Adults. Vol 4. Philadelphia, PA: Lippincott, Williams, and Wilkins; 1994.
1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Loke YK, Singh S, Furberg CD. Long-term use of thiazolidinediones and fractures in type 2 diabetes: a meta-analysis. CMAJ. 2009;180:32-39. Epub 2008 Dec 10.
Last reviewed September 2013 by Michael Woods, MD
Last Updated: 9/30/2013
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