A fracture is a break in any bone in the body. Fractures are usually caused by trauma. This may be falls, twists, blows or collisions. There are different kinds of fracture:
- The bone may be fractured but stable (simple fracture)
- Bone fragments may be sticking through the skin (open)
Fractures may also be described as:
- Chip (avulsion fracture)—A small piece of bone is broken away from the main bone.
- Compression—The bone is compressed together (ie, vertebrae).
- Comminuted—The bone is in pieces.
- Greenstick—This is a fracture in which one side of the bone is broken, and the other side is bent but not broken.
- Intra-articular—The joint is affected.
- 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
Fractures are caused by trauma to the bone. Trauma includes:
The trauma is a physical force applied to the bone that the bone cannot withstand. Stronger bones can withstand more physical force than weaker bones.
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for a fracture include:
Symptoms of a fracture include:
- Pain, often severe (primary symptom)
- Instability of the area around the break
- Inability to use the limb or affected area normally (there may be full or partial restriction in movement)
- Swelling or bruising caused by the bleeding from the bone and surrounding tissues
- Numbness caused by damage to a nearby nerve (rare)
- Fainting or even shock (rare–only in a severe trauma)
The doctor will ask about your symptoms and how you injured yourself, and examine the injured area.
Tests may include:
- X-rays]]> —to look for a break in the bone.
- ]]>CT scan]]> CT scan—uses computerized x-rays to make pictures of structures inside the body.
- ]]>MRI scan]]> —a test that uses a strong magnetic field and radio waves to make pictures of structures inside the body.
- ]]>Bone scan]]> —typically for stress fractures.
- Putting the pieces of bone together (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.
- 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 result of a 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.
If you are diagnosed with a fracture, follow your doctor's instructions .
You can reduce your chances of getting a fracture by:
- Not putting yourself at risk for an accident or other trauma to the bone
- Eating a diet rich in calcium and vitamin D
- Regularly doing weight-bearing exercise to build and maintain strong bones
- Regularly doing strengthening exercises to build strong muscles and prevent falls
- Patients with osteoporosis may benefit from bisphosphonate medications
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
American Academy of Orthopaedic Surgeons website. Available: http://www.aaos.org .
Browner: Skeletal Trauma: Basic Science, Management, and Reconstruction 3rd ed. Philadelphia; Elsevier; 2003.
Fractures in Adults . Vol 4. Lippincott, Williams, and Wilkins; 1994.
Gruntmanis U. Male osteoporosis: deadly, but ignored. American Journal of the Medical Sciences . 2007;333:85-92.
McCarus DC. Fracture prevention in postmenopausal osteoporosis: a review of treatment options. Obstetrical & Gynecological Survey . 2006;61:39-50.
*¹1/30/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : 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 November 2008 by ]]>John C. Keel, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.