Fractures

Fractures or broken bones are common home injuries, sports injuries, and workplace injuries. They may involve the ankle, foot, hand, hip, knee, scaphoid (part of the carpal navicular, located in the palm), shoulder, or wrist. The word fracture is the clinical term for a break in a bone. Broken bones can range in severity from hairline fractures, which are small cracks in the bone, to compound fractures, where the broken bones puncture the skin.

The most common causes of bone fractures include:

• Trauma – a fall, a motor vehicle accident, or a tackle during a football game
• Osteoporosis – a medical condition that weakens bones and makes them more likely to break
• Overuse – repetitive motion can tire out muscles and place more force on the bone, causing fractures (for example, stress fractures in athletes)

The most common symptoms of fractures include:

• A snap or grinding sound when the injury occurs
• Swelling, redness, and bruising around the injured area
• Intense pain when the injury happens
• Pain that worsens when you move or touch the injured area
• Difficulty supporting weight with the injured area
• Visible deformity in the injured area
• A broken bone poking through the skin
• Dizziness or passing out
• Feeling chilly from the shock

Bones can fracture in any number of ways. Some common fracture types include:

• Comminuted Fractures. These are serious fractures where bones break into several fragments. These injuries often occur following a car accident or another serious event. 
• Greenstick Fractures. These fractures are most often seen in children whose bones have yet to develop fully. When incurring such an injury, the bones bend instead of breaking.
• Oblique Fractures. These fractures result in breaks that are curved or at an angle to the bones.
• Open, Compound Fractures. In such fractures, the skin may be pierced by the bones or by a blow that breaks the skin at the time of the fractures. The bones may not be visible in the wound.
• Pathologic Fractures. These fractures occur when the bones become weak due to certain diseases and thus fracture easily (for example, osteoporosis).
• Stable Fractures. In such fractures, the broken ends of the bones line up and are barely out of place. 
• Stress Fractures. These fractures are characterized by hairline fractures in the bones.
• Transverse Fractures. These fractures generally occur when a blow that is perpendicular to the bones causes bones to break at a 90-degree angle to the long axis of the bones.

A few common fracture types are shown here.

Broken bones can be easily identified in an x-ray of the injured area.

There are several treatment options available for bone fractures. The right treatment for you depends on the extent of your injury.

In most cases, fractures are treated with a cast, splint, or brace, which keeps the broken bones from moving while they heal. Casts don’t heal broken bones on their own, but rather they help the bones heal straight. Once bones are set, casts can be applied so that they don’t move. Even broken bones that don’t line up (called displaced) often will heal straight over time. 

Cast Immobilization. This is the most common type of fracture treatment. Once the bones have been repositioned, plaster or fiberglass casts are used to keep the broken ends in proper position while they heal.

Functional Casts or Braces. Casts or braces allow limited or “controlled” movement of nearby joints.

Traction. Traction is usually used to align the bones by a gentle, steady pulling action.

Surgery. If broken bones don't heal properly with casting or splinting alone, surgery may be required. Surgery is recommended for compound fractures where the bone is sticking through the skin, and for fractures that involve joints, such as wrists and ankles. 

• External Fixation. In cases where the skin and other soft tissues around the fracture are badly damaged, an external fixator may be applied until surgery can be tolerated. With an external fixator, metal pins or screws are placed into the broken bone above and below the fracture site. The pins or screws are connected to a metal bar outside the skin. This device is a stabilizing frame that holds the bones in the proper position while they heal. 

• Open Reduction and Internal Fixation (ORIF). In this procedure, bone fragments are first repositioned (reduced) in their normal alignment and then held together with special screws or metal plates that are attached to the outer surface of the bone. Rods may also be inserted down through the marrow space in the center of the bone to hold together the fragments.

The recovery period for bone fractures usually depends on the extent of the injury and how well you follow your doctor’s advice. Generally, it can take 6 to 12 weeks for a bone fracture to heal. Children heal faster than adults, so the recovery time for them tends to be shorter.

After a cast or brace is removed, you may need to continue limiting your movement until the bone is solid enough for normal activity. Your doctor will advise you on the best course of action.

During your recovery period, you are likely to lose muscle strength in the injured area due to immobilization. Once the cast is removed, specific exercises may be recommended to help restore normal muscle strength, joint motion, and flexibility.

If you would like to schedule a consultation with one of our orthopedic surgeons at OrthoMed Center for fracture care, please call (209) 524-4438. You may also request an appointment online.