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Fractures

Overview

A break or discontinuity in the bone structure is referred to as a bone fracture in medical terms. It is a very common condition that occurs to thousands of people across the world on a daily basis. Fractures usually happen as a consequence of falls or high-impact injuries, but there are other causes as well. Bones hold up our skeletal system and are a vital component of movement. This is why fracture of any bone can limit the mobility of that region. There are multiple options available for the treatment of fractures. 

Causes

The bones of a healthy adult are very strong and can withstand high-impact forces. But in certain cases, such as a road traffic accident or sports injury, they may break under pressure. Fall from a height, physical abuse, or a direct blow to a bone are other causes. Fractures may also occur if a bone is put under repetitive stress, such as weightlifting.

There are some medical conditions as well that can weaken the bone structure. Among these, osteoporosis is one of the leading causes of bone fractures. Your bones begin to lose their density in this condition and become more prone to fractures. Other conditions include osteomyelitis and certain cancers. Some medications, such as ibandronate, pantoprazole, isotretinoin, etc., may also weaken the bone structure, increasing the risk of bone fractures.

Types

Fractures are divided into multiple types based on different factors. Some of the common types are as follows:

·         Closed fracture: A fracture in which the continuity of the overlying skin remains intact.

·         Open fracture: A fracture that involves a break or wound in the skin.

·         Simple fracture: A fracture that occurs along one line and breaks the bone into two pieces.

·         Comminuted fracture: A fracture that breaks the bone into multiple fragments.

·         Complete fracture: A fracture that separates the bone fragments completely.

·         Incomplete fracture: A fracture in which bone fragments remain partially intact.

·         Linear fracture: A fracture line that is parallel to the bone axis.

·         Transverse fracture: A fracture line that is at a 90° angle to the long axis of the bone.

·         Oblique fracture: A fracture that is at a diagonal angle to the long axis of the bone.

·         Spiral fracture: A fracture where a bone has been twisted.  

Risk Factors And Epidemiology

The risk of bone fractures increases with age. Aging is a natural process that affects all your body systems, including the skeletal system. Bones become weaker over time and begin to lose their strength if health is not maintained. The risk of osteoporosis also increases with age, especially in women. Women going through or have been through menopause are at a higher risk of bone fractures due to osteoporosis. Those in sports or heavy physical activities are also more prone to develop fractures at the site of their knees, ankles, and wrists.

According to a study, fractures are more common among young men than young women due to increased exposure to activities that cause physical trauma or injury. With increasing age, women are more prone to get fractures than men. This is associated with changing hormonal levels and the risk of osteoporosis.

Signs And Symptoms

Symptoms of a bone fracture depend upon its location, severity, age, and health of a person. Limb fractures are usually visible as a bump or protrusion in the affected area. Fractures are often associated with intense pain and swelling. If it is an open fracture, you will notice bleeding from skin wounds and inflammation around the fractured area. The particular bone or bones become difficult to move and cannot withstand force. In cases of multiple or severe fractures, you may also experience dizziness, nausea, or faintness. 

Diagnosis

A doctor will require a history in the beginning to determine the cause of the fracture. This is followed by a physical examination of the affected area. The extent of fracture and mobility of the bone is assessed. An accurate diagnosis of a bone fracture can be attained by an x-ray of the affected region. X-rays can help in determining the location and type of fracture as well. If more advanced imaging techniques are required, your doctor may order a bone scan, CT scan, or MRI. 

Differential Diagnosis

Fractures can be diagnosed easily on the basis of their presentation, but sometimes other causes of bone pain may be confused with a fracture. These can include metastatic bone disease, Paget’s disease, osteoporosis, and osteogenesis imperfecta. Diagnosis can be made based on history, physical examination, and imaging tests. 

Treatment

There are different options available for treating fractures depending on their type and severity. Reduction of the fracture is the first step towards bone healing, which is followed by fixation. In case of minor fractures, your doctor may be able to align the bone by manual manipulation. For large or comminuted fractures, open reduction by surgery may be required. Fixation can be done by multiple methods. Limb fractures are often fixated using a splint or cast. The primary purpose is to immobilize the bone and hold it steady in a place so the fractured ends can heal and join again. This can also be done using traction, in which pulleys or weights are used to align the bone in a particular position. Surgical fixation is required in severe cases. This can be done using metal screws, rods, plates, or frames.

Medications are required for supportive care to reduce pain and promote better healing. Analgesics such as ibuprofen, naproxen, aspirin etc. are prescribed for pain. In cases of open fractures, antibiotics can also be prescribed to reduce the risk of infection. 

Prognosis

The prognosis of bone healing depends on age, type, the severity of a fracture, and health of a person. Bones heal faster in young adults compared to elders. The process of bone healing can take 2 months to 6 months if appropriate treatment measures are followed. 

Prevention

Fractures can be prevented by taking some precautionary measures and maintaining a healthy lifestyle. If you are a sportsperson or engage in heavy physical activities, make sure to wear protective gear such as helmets and knee caps to avoid common fractures. Bike riders should also wear helmets to prevent skull fractures and brain injury. Include food substances in your diet rich in calcium and vitamin D. Exercise regularly as it promotes strong and healthy bones but make sure to get proper training before starting a vigorous routine. 

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 06, 2023.

 

References

https://medlineplus.gov/fractures.html#:~:text=A%20fracture%20is%20a%20break,cause%20weakening%20of%20the%20bones.

https://www.medicalnewstoday.com/articles/173312

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