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.

Causes of Bone Fractures

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)

Symptoms of Fractures

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

Types of Fractures

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.

Diagnosing Bone Fractures

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

Fracture Treatment

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.

This is an example of an external fixator applied to a broken femur (thigh bone).

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.

Here an intramedullary nail provides strong fixation for a thighbone fracture.

Recovery Period for Bone Fractures

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.

Fracture Care at OrthoMed Center in Modesto, CA

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.

Fractures FAQs

How do you know if you have a broken bone?

If you have a broken bone, you may hear or feel a snap or a grinding noise as the injury happens; there may be swelling, bruising, or tenderness around the injured area; or you may feel pain when you put weight on the injury, touch it, press it, or move it.

What is the difference between a cast and a splint?

A cast is custom-made with fiberglass or plaster and wraps all the way around the injured area. A splint is also made from fiberglass or plaster, but it does not wrap all the way around the injured area. Instead, a splint is held in place with a flexible bandage, and can be easily removed or adjusted.

Are hairline fractures the same as stress fractures?

Stress fractures are usually very small slivers or cracks in the bone, and are sometimes referred to as hairline fractures. Stress fractures occur more frequently in weight-bearing bones, such as the tibia (bone of the lower leg), metatarsals and navicular bones (bones of the foot).

How do you treat a hairline fracture?

For hairline fractures, elevate the extremity and rest while the bone heals itself. You should also ice the affected area for 24 to 48 hours and reduce your activity. You can use NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen, naproxen, or aspirin, to manage any pain you experience.

What causes a bone to fail to heal?

A bone fracture may fail to heal if a patient has certain risk factors such as diabetes, anemia, older age, and tobacco use. A bone that fails to heal is called a nonunion, and a bone that takes longer than normal to heal is called a delayed union.

What does a bone need to heal properly?

A bone needs stability, ample blood supply, and adequate nutrition through a balanced diet to heal properly.

Can osteoporosis cause fractures?

Typically, fractures linked to osteoporosis occur in the spine. These spinal fractures, called vertebral compression fractures, occur in nearly 700,000 patients each year. Other fractures linked to osteoporosis include fractured hips and wrists.

Does osteoporosis slow fracture healing?

Osteoporosis does not affect the healing process of a fractured bone. If you have a fracture, it generally takes 6 to 12 weeks to heal.

How can you prevent bone fractures?

To help prevent bone fractures, follow a proper diet that is rich in calcium and vitamin D to promote bone strength, and add weight-bearing exercises to help keep your bones strong.