Fractures

FRACTURES

A bone fracture is a medical condition where the continuity of the bone is broken. They occur when the physical force exerted on the bone is stronger than the bone itself. A fracture can range from a thin crack to a complete break. In the same vein, a bone can fracture crosswise, lengthwise, in several places or into many pieces.

A significant percentage of bone fractures occur because of high force impact or stress. However, some medical conditions could also result in a fracture due to weak bonese.g. osteoporosis, some cancers, or brittle bone disease(also known asosteogenesis imperfecta).

FACTS ON FRACTURES

• Falls and accidents are the cause of most bone fractures.
• A compound fracture is one that causes injury to both the bone and the overlying skin. Compound fractures are generally more serious than simple fractures, because, by definition they are infected.
• The processof bone healing is natural. Most treatments involves giving the bone optimum conditions to heal on its own.
• Bone fractures that are caused by disease are called pathological fractures.

SYMPTOMS

Fractures are usually accompanied by intense pain at the time when initial injury occurs. Whenthe injured areais moved or touched the pain may become worse. In some cases, people have even passed out from the pain. One may also feel dizzy from shock.

Potential symptoms include:

• A snap or grinding sound at the time the injury occurs
• In some cases, one may see broken bone piercing through the skin.
• Difficulty supporting weight with the injured area
• Swelling, redness, and bruising in the injured area
• Visible deformity in the injured area

TYPES OF FRACTURE

Fractures are classified as closed or open, as against incomplete or complete.

1. Closed vs. open: Also called a simple fracture, a closed fracture is one in which the broken bone doesn’t break the skin.

An open fracture (also called a compound fracture) is one in which the end of the broken bone tears the skin. One is at a higher risk of infectionwhen the bone and other internal tissues are exposed.

1. Incomplete vs. complete

In an incomplete fracture, the bone doesn’t break completely. In other words, it cracks without breaking all the way through. Types of incomplete fracture include:

• Hairline Fracture: In which the bone is broken in a thin crack.
• Buckle Or Torus Fracture: In which the bone is broken on one side and a bump or raised buckle develops on the other side
• Greenstick Fracture: In which one side of the bone is broken, while it is benton the other side.

Note: Childrens’ bones are softer than those of adults as a result, they’re more likely to bend than break. Therefore, incomplete fractures are more common in children

Types of complete fracture include:

In a complete fracture, the bone breaks completely or crushed into two or more pieces

• Single fracture: The bone is broken in one place into two pieces
• Compression fracture:-The bone collapses under pressure
• Non-displaced fracture: The bone breaks into pieces but those pieces stay in their normal alignment
• Displaced fracture: The bone breaks into pieces but those pieces move out of their normal alignment
• Comminuted fracture: The bone is broken or crushed into three or more pieces
• Segmental fracture: The bone is broken in two places in such a way that at least one segment floats and is unattached.

Complete fractures can happen at any age.

Other types of fracture

• Avulsion fracture: A muscle or ligament pulls on the bone fracturing it in the process.
• Fracture dislocation: A joint becomes dislocated and then one of the bones of that joint has a fracture.
• Impacted fracture: A bone is fractured, a fragment of the bone goes into another.
• Intra-articular fracture: The broken bone extends into the surface of a joint
• Longitudinal fracture: The break is along the length of the bone.
• Oblique fracture: The fracture runs diagonal to a bone’s long axis.
• Pathological fracture: When an underlying disease or condition has already weakened the bone, resulting in a fracture.
• Spiral fracture: At least one part of the bone has been twisted.
• Stress fracture: A bone breaks because of repeated stresses and strains. (common among athletes)
• Transverse fracture: A break runs straight across a bone.

CAUSES OF FRACTURE

When the bone is impacted with greater pressure or force than it normally can support, one can develop a fracture. This usually occurs suddenly and is very intense. The severity of the fracture will be determined by the strength of the force or exerted pressure.

Commonly causes of fractures will include:

Falls

Direct strikes to the body

Traumatic events e.g. car accidents or gunshot wounds

Injuries from sports

WHO IS AT RISK

Anyone can experience a fracture. But you’re more likely to develop one if you have brittle bones, or low bone density.

Brittle bones are likely to develop if you:

• Are older
• Have Osteoporosis
• Have Endocrine or intestinal disorders
• Are taking Corticosteroids
• Are physically inactive
• Drink alcohol
• Smoke

TREATMENT

The treatment plan for a fracture will depend on its type and location. Generally, a doctor will try to put the broken bone pieces back into their proper positions and stabilize them as they heal.

• It’s important to keep pieces of broken bone immobile until they’re mended. Within the process of healing, new bone will form around the edges of the broken pieces and if they have been properly aligned and stabilized, the new bone will eventually connect the pieces.
• Our doctors' may decide to use a cast made from plaster or fiberglassto stabilize the broken bone. The cast will help keep the injured area stabilized and prevent the broken bone pieces from moving while they are healing.
• In very rare cases, traction may be needed to stabilize the injured area. Traction will stretch the muscles and tendons around the bone. The doctor will administer it by using a system of pulleys and weights positioned in a metal frame over the patient’s bed. The traction will produce a gentle pulling motion that the doctor can use to stabilize the injured area.
• Surgery may be needed for more complex or compound fractures. Our doctors' may use appropriate options such as;

Open reduction,

Internal fixation or

External fixation to keep your bones from moving during the healing process.

During open reduction and internal fixation, our doctors' will first reposition the pieces of broken bone into their normal alignment. The next will be to connect the broken bone with screws or metal plates, or both. In some cases, rods may be inserted through the center of the bone.

With external fixation, the doctor will fix pins or screws into your bone above and below the fracture area. These pins or screws will be connected to a metal stabilizing bar positioned on the outside of the skin. The bar is aimed at holding the bone in place as it heals.

To control painduring the healing process, the doctor may prescribe medication, this could also be to fight infection, or manage other symptoms or complications. After the initial treatment stages, physical therapy or other strategies may be recommended to help a patient regain normal use.

PREVENTION

The best prevention is to work to keep the bones strong so they will be less susceptible to damage. Maintaining bone strength will depend on the consumption of nutritious diet, especially foods that are rich in calcium and vitamin D. Regular exercise is also important. Weight-bearing exercises such as walking, hiking, running, dancing, and weight training are particularly helpful for building and maintaining bone strength.