Bone fracture

A bone fracture is when a bone in the body breaks partially or completely. This can happen when there is a strong force, like falling from a height or in an accident. It can also happen with only a small injury if the bones are already weak. Conditions like osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta can make bones more likely to break easily.

When a broken bone goes through the skin, it is called an open fracture. This type needs special care right away. Most broken bones need prompt medical help to make sure the person gets the right treatment. Broken bones can sometimes be fixed with a splint or a cast, and in more serious cases, doctors might use special equipment to help the bone heal properly.

Signs and symptoms

A broken bone can hurt a lot because it stretches the layers around it, which do feel pain. It can also cause swelling and bruising near the broken bone. Your muscles might tighten up to try to hold the bone pieces in place.

Sometimes, a broken bone can affect nearby parts of your body, like nerves, muscles, or blood vessels. This can cause extra signs or symptoms depending on where the bone is broken.

Complications

Some broken bones can cause bigger problems later on. This might include the bone not healing properly or healing in the wrong shape. Problems from fractures can happen right away, in the first few days after the break, or even a long time later.

Pathophysiology

Main article: Bone healing

When a bone breaks, the body starts healing it right away. First, the injured area bleeds and forms a clump of blood called a hematoma. This blood clot helps protect the broken pieces and starts the healing process. Over the next few days, new blood vessels grow into the clot, bringing cells that clean up damaged tissue.

These new blood vessels also carry cells called fibroblasts, which make a strong material called collagen. This collagen helps hold the broken bone pieces together. Later, these cells start building new bone material, which hardens and turns into real bone over time. This new bone, called callus, can usually be seen on an X-ray after about six weeks. It takes several months for the bone to fully heal.

Smoking can slow down this healing process, and getting enough nutrients like calcium helps bones repair better.

Effects of smoking

Main article: Health effects of tobacco

People who smoke often have weaker bones and are more likely to break them. Smoking can also make it harder for bones to heal after an injury.

Diagnosis

A bone fracture happens when a bone breaks partially or completely. Doctors find out if someone has a broken bone by talking to the person and checking them. They often use X-rays to see the break clearly. Sometimes they use more detailed pictures to be sure.

Classification

In bone health medicine, fractures can be grouped in many ways. Sometimes they are named after the doctor who first described them, but there are also more organized ways to group them.

Fractures can be stable, meaning they are less likely to move, or unstable, meaning they might shift more.

Mechanism

• Traumatic fracture – a break caused by an injury like a fall or accident.
• Pathologic fracture – a break in a bone that was weakened by a disease, like osteoporosis.
• Periprosthetic fracture – a break near where a medical implant has been placed.

Soft-tissue involvement

• Closed/simple fractures are when the skin is not broken.
• Open/compound fractures are when the broken bone comes through the skin, which can lead to infection.

Displacement

• Non-displaced – the bone pieces stay in place.
• Displaced – the bone pieces move, which can happen in several ways like sideways, angled, twisted, or shortened.

Fracture pattern

• Linear fracture – a straight break along the length of the bone.
• Transverse fracture – a break across the width of the bone.
• Oblique fracture – a diagonal break.
• Spiral fracture – a twist-like break.
• Compression fracture – often in the spine, where part of the bone collapses.
• Impacted fracture – where bone pieces are pushed into each other.
• Avulsion fracture – where a small piece of bone is pulled off.

Fragments

• Incomplete fracture – the bone is cracked but not fully broken.
• Complete fracture – the bone is fully broken into separate pieces.
• Comminuted fracture – the bone breaks into several pieces.

Anatomical location

Fractures can happen in many parts of the body, such as the skull, spine, ribs, arms, hands, pelvis, legs, and feet. Each area has its own types of common breaks.

Prevention

Both big and small injuries can cause bones to break. To help prevent big injuries from car accidents, it’s important not to drive distracted—like not texting or calling while driving—and to always wear a seatbelt. Lower speed limits, like 30 km/h or 20 mph, can also help reduce the chance of serious accidents.

Falls at home are another common way bones can get hurt. To make your home safer, keep cords out of the way, add handrails on stairs, and keep stairways well-lit. Having a support bar in the bathtub can also help prevent falls.

Some sports can increase the chance of bone injuries, so learning the right techniques, wearing proper protective gear, and knowing your own limits can help keep you safe. Taking calcium and vitamin D can also strengthen bones and help prevent fractures.

Patterns

Bone fractures happen when a part of a bone breaks. Sometimes, a bone can break into many pieces. In very serious cases, a broken bone might break through the skin.

Treatment

Treatment for broken bones can be done in two ways: surgery or non-surgical methods. Non-surgical treatment includes managing pain, keeping the bone still, and helping it heal. Doctors might use a special cast or splint to hold the bone in place while it heals.

Sometimes, surgery is needed for serious breaks like hip fractures. Surgeons can use special tools to keep the bone pieces together. After treatment, physical therapy helps a person regain strength and movement.

Children

Main article: Child bone fracture

In children, bones are still growing, which can lead to special types of injuries. One common injury is called a greenstick fracture, where the bone bends and partially breaks but does not snap all the way through. Another concern is injury to the growth plate, a special area near the end of a growing bone. These injuries need careful care to help the bone grow properly again. Sometimes, a child's bone can bend without breaking, which is known as plastic deformation. Certain fractures, like those in the collarbone or near the elbow, happen more often in children.