Fractures

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Introduction

What are fractures?

A fracture is a broken bone. Fractures can range in severity from a crack (known as a hairline or greenstick fracture), to a complete break and separation of a bone that may protrude through your skin (known as an open or compound fracture).

Fractures can occur in any bone in the body, but the most common fractures are of bones in the extremities and of the ribs. Fractures are most common in young adults who are adventurous by nature, and in the older population as bones become more fragile.

A closed fracture is one in which the bones do not break the skin, while in an open (also known as compound) fracture, one or more bone fragments protrudes through the skin. Open fractures are more difficult to treat and have a greater risk of infection. Stress fractures are tiny cracks that develop in bone due to repeated force, such as overuse injuries.

Some fractures are mild and require little treatment other than pain relievers, icing, and time to heal. Other fractures, however, can be very serious and can put important nearby tissue, such as the spinal cord, large vessels, or the brain, at risk.

Seek immediate medical care (call 911) for serious symptoms associated with a fracture including loss of consciousness, difficulty breathing, a bone that has broken through the skin, or any suspected fracture of the neck, back, or skull.

Seek prompt medical care if you have a fracture, such as a broken arm or hand, without the serious symptoms above.

Symptoms

What are the symptoms of fractures?

Symptoms of a broken bone commonly include pain, swelling, bruising, and a change of shape at the surface of the skin due to the protrusion of a bone in the affected region. More rarely, a fractured bone can break through your skin, resulting in bone protruding from a wound.

Common symptoms of fractures

You may experience symptoms immediately after an injury, while sometimes it may take more time for symptoms to appear. Common fracture symptoms include:

  • Bleeding
  • Deformity
  • Inability to move a joint
  • Numbness and tingling in the affected region
  • Pain
  • Redness and warmth
  • Swelling

Serious symptoms that might indicate a life-threatening condition

In some cases, fractures can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:

  • Bone protruding through the skin
  • Confusion or loss of consciousness for even a brief moment
  • Profuse bleeding
  • Suspected fracture of the neck, back, skull, pelvis, hips or femur (thigh bone)
  • Vision changes or loss
Causes

What causes fractures?

Your bones are some of the strongest tissues in your body. If an impact or a force is stronger than the strength of the bone on which it is acting, then a fracture may result. The most common causes of fracture are falls, motor vehicle accidents, and a weakening of the bone called osteoporosis.

What are the risk factors for fractures?

Risk factors for fractures include:

  • Advanced age

  • Certain genetic disorders

  • Excessive tobacco or alcohol consumption

  • Female gender

  • Lack of physical activity on a regular basis

  • Lack of proper nutrition, especially calcium

  • Osteoporosis (thinning and weakening of the bones)

  • Participation in sports

  • Thyroid or endocrine disorders

  • Vitamin deficiencies

Reducing your risk of fractures

You can reduce your risk of a fracture, though it is impossible to completely eliminate any chance of a fracture.

You may be able to lower your risk of fracture by:

  • Following your treatment plan for treatment or prevention of osteoporosis (which may involve calcium and vitamin D supplementation and medications)

  • Living a healthy lifestyle with a good diet and lots of physical activity

  • Watching young children closely

  • Wearing a seat belt any time you are in a car

  • Wearing protective equipment when participating in sports

Treatments

How are fractures treated?

Most broken bone treatments involve realigning the fractured bones in their original orientation and then eliminating movement so the bones can heal. Realignment of the bone pieces in a fracture is known as reduction of the fracture. Treatment can vary from using ice and pain relievers (for a mild broken nose) to immediate emergency surgery.

Because an untreated fracture can have serious complications, it is important to always discuss a suspected fracture with your health care provider, even if the fracture seems mild.

Nonsurgical treatment of fractures

Many broken bones can be treated without surgery. Treatment for these fractures includes casts or splints that can be applied around a fractured limb after the fracture is reduced to limit movement and encourage healing. Reduction without surgery is a closed reduction. Casts are very commonly used for mild or moderately severe breaks of the extremities. Once in place, a cast is usually left on for several weeks.

Surgical treatment of fractures

Many fractures require surgery to repair. Surgical realignment of a broken bone is open reduction. Though surgery comes with its own risks, modern orthopedic techniques can lead to improved outcomes. The surgical technique used will depend on the nature of the specific fracture. Some of these techniques include:

  • Metal plates may be screwed onto your broken bone to prevent it from moving and to promote healing

  • Metal rod may be placed inside the center of a long bone to help reattach two ends of a fracture and to maintain alignment. This technique is called intramedullary fixation.

  • Pins and rods may be placed in your bones and continue outside your skin, where they can be attached to a metal cage. This technique is known as external fixation and allows for slight adjustments to be made to the orientation and position of a bone as it heals.

What you can do to improve your fracture

Your health care provider almost always must treat a fracture. The way you treat a fracture immediately after it happens and before you can get to a hospital is important. You can improve the outcome of your fracture by following these rules:

  • Apply ice to a fracture to reduce swelling

  • Prevent any movement of a victim if a head, neck, or back fracture is suspected

  • Try to immobilize the broken bone if a person must be moved or carried to safety

What are the potential complications of fractures?

Fractures can range from mild to severe and can result in almost no complications or can result in serious complications. The cause of the fracture, the location of the fracture, and the way the fracture is treated will all affect the potential complications.

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Broken bone complications include:

  • Infection that can be local or can spread systemically

  • Loss of a limb

  • Osteomyelitis (bone infection)

  • Paralysis resulting from a neck or back fracture

  • Permanent deformity

  • Permanent loss of sensation

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 28
  1. Broken bone. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000001.htm
  2. Thighbone (femur) fracture. AAOS: American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00364
  3. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy.Philadelphia: Saunders, 2013
  4. Bucholz RW, Heckman JD, Court-Brown CH, et al. (Eds). Rockwood and Green's Fractures in Adults, 6th Ed., Philadelphia: Lippincott Williams & Wilkins, 2005
  5. Femur Shaft Fractures (Broken Thighbone. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00521
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