Broken Bones and Treatment

Overview of Fractures

A fracture means a break in a bone. If the broken bone pierces the skin, it is called an open or compound fracture; otherwise, it is considered a closed fracture. Fractures, commonly, occur secondary to car accidents, fal low bone density, osteoporosis or tumors near bones. Overuse of an extremity can also produce stress fractures. Stress fractures are minute cracks in the bone.

A displaced fractures must be aligned and maintained in position during the healing process so the end result shows both a cosmetically and a functionally normal bone. If the fracture enters a joint, the joint surface must line up perfectly or overtime, arthritis begins and progresses to limited function and pain.

What are symptoms of fractures ?

One can suspect a fracture if the limb or joint is out-of-place or misshapen, swelling, bruising or bleeding occurs over a bony site, severe pain transpires in the area over a bone, numbness or tingling appear, limited mobility occurs or the limb cannot be moved. If one suspects a fracture, the person needs to seek medical care right away.

What are the different types of fractures ?

With simple fractures, the bone breaks in only one place.
With comminuted fractures, the bone breaks in multiple places with at least three bone fragments at the fracture site.
With open fractures, a skin injury occurs and the bone protrudes through the skin (it is also called a "compound” fracture.
With closed fractures, the skin remains intact over the broken bone.
With undisplaced fractures, the broken bone pieces remain aligned or perfectly adjacent to the original bone.
With displaced fractures, the broken bone pieces scatter from the original bone site.

How is the type of fracture diagnosed ?

A bone x-ray is used to make images of any bone in the body. It can diagnose fractured bones or joint dislocations, identify the presence of bony fragments, and guide orthopedic surgery after fracture reductions. X-ray images provide the clearest, most thorough view of bones, but these images fail to provide information about muscles, tendons or joints.

An MRI may be more useful in identifying bone and joint injuries (such as ligament tears in the foot, rotator cuff tears in the shoulder) and in taking images of the spine. Since the MRI will show the spinal bones and the spinal cord, both areas can be evaluated at once if a spinal cord injury is suspected.

A CT scan provides better assessment of trauma patients in emergency room settings. The CT scan shows images of complicated fractures, subtle fractures or dislocation that x-ray may not detect. In the elderly patient or individuals with osteoporosis, a hip fracture shows up clearly on a CT scan, but may be barely perceptible on a plain hip x-ray.

A nuclear medicine bone scan provides another imaging test to aid in diagnosing bone fractures. Bone scan can detect bone injury or fracture not perceptible by routine x-ray.

Types of Fractures Specific to Body Site :

Broken Wrist

When a person tumbles onto an outstretched hand, it can cause one or more bones in the wrist to buckle and produce a wrist fracture. A Colles’ fracture refers to a situation where the broken distal radius becomes displaced. A displaced fracture must be aligned or problems with arthritis will occur later on.

Broken Hip

Hip fractures remain the most common fracture over the age of 75. The hip breaks either due to a fall or osteoporosis creates a spontaneous fracture that subsequently causes a fall. Even though, not all hip fractures are alike, the treatment, always surgery depends on the location of the fracture on the femur bone. The common sites on the femur bone include subcapital, femoral neck, intertrochanteric and subtrochanteric.

Broken Leg

Leg fractures may entail the femur (thigh bone), the knee, the tibia, the fibula, the ankle or the bones of the feet. The severity of the fracture depends upon the site of injury, whether the bones are displaced, and the stability of the fracture. A number of fractures present with instability and require surgery; whereas, other fractures remain relatively stable and can be observed and not need surgery.

Broken Upper Extremity

While hip fractures routinely require surgery for repair, shoulder fracture usually require no surgical treatment. Fractures of the humerus, elbow, forearm and wrist each require different treatment plans.

Broken hand or fingers

Crush injuries often injure the hands. The hand examination focuses on the bones, tendons, arteries and nerves, because of the functionality of the hand. The alignment of the bones in the hands and fingers becomes extremely important in order ensure that the range of motion, strength and sensation all stay intact.

Compression Fracture of the Spine

As people get older, their bones may develop osteoporosis, a condition causing the bone to lose their calcium content and making the bone susceptible to fractures. The compression fracture of the spinal bones is caused by osteoporosis. Compression fractures often occur in the thoracic or lumbar spine. The bones crumple from compression fractures resulting in complaints of pain. No event like a fall needs to occur as the fractures happen spontaneously.

Nerve or spinal cord injury may or may not transpire with compression fractures of the back. Performing a CT scan or MRI reveals if no damage happened to the spinal cord. Treatment usually entails pain medication and a back brace.

Broken Ribs

Ribs break easily if hit with a direct blow. A chest x-ray helps determine that no collapse or bruising to the lungs took place. With lower rib fractures, concern arises about the liver or spleen being punctured. Ultrasound or CT scan may be ordered to rule out injuries in the abdomen. Rib fractures are treated non-surgically.

Skull Fractures

Skull fractures almost always require a CT scan examination to assess the head bones and the underlying brain at the same time. Fractures of the base of the skull can produce hemotympanum (blood behind the ear drum), Battle’s sign (bruising behind the ear), or raccoon eyes (bruising surrounding the orbits of the eyes). Since the skull, a flat, compact bone, requires significant force to break, the presence of fractures indicates a high probably of bleeding into the brain.

DR. NAME MD'S ORTHOPEDICS CLINIC