The word “fracture” simply means a broken bone. A bone may break (fracture) in a number of ways. Commonly fractures are caused by trauma such as falls, impact during sports or as a result of road traffic accidents.
Elderly patients with osteoporosis are at risk of fracture relatively easily as they have thinning of their bones.
Athletes can be at risk of stress fractures, which are an overuse type injury from activity.
Types of Fractures
Open fractures (also called compound fractures) where the broken bone comes through the skin, these are very high risk for infection and need immediate emergency care.
Closed fractures contained by the skin but the break can produce visible deformity and will be seen on x-ray.
Stable fractures the bone ends are well aligned
Unstable fractures may be in many pieces and the bone fragments are often displaced.
Greenstick fractures only occur in children, this type of break doesn’t go all the way through the bone.
The human body reacts to fractures by forming a blood clot, then callus (a fibrous tissue) forms over the broken bone ends. Bone forming cells then gradually replace the callus with new bone.
The aim of fracture treatment is to reduce the fracture and maintain it in this position to allow healing to take place. The treatment may be operative or non-operative depending upon the type of fracture and patient specific considerations.
Non-operative fracture treatment includes splints and casting to hold the fracture in a satisfactory position and immobilise the affected body part. Traction (skin and skeletal traction) is another technique that can be used; this method uses weights to pull the broken bone against the pull of muscles to allow healing to take place.
Surgical fracture treatment can range from closed manipulation and pinning with wires through the skin (k-wires) to open reduction and internal fixation where plates, screws and intramedullary nails might be used to stabilise the fracture. In some circumstances external fixators (metal frames outside the body) are required.
If surgical treatment of a fracture is recommended, the trauma surgeon will discuss and explain the type of surgery needed.
Fractures may take many weeks to months to heal completely. The advice will vary in accordance with the type of fracture and the type of treatment. Physiotherapy exercises and a gradual increase in activity levels are recommended until the fracture has healed fully. All patients are advised not to smoke to allow the fractureto heal.
Surrey Orthopaedic Clinic