Fracture forms in bone fracture
Bones are hard, but when an external force is applied, they have to yield a little to absorb the blow.
However, if the force is so great that the threshold of flexibility is exceeded, the bone will snap (just like a plastic ruler if bent too far).
The severity of a fracture usually depends on the intensity of the trauma; in a car accident or a pistol shot, for example, the bone can shatter.
If the bone breaks in such a way that some fragments protrude through the skin or if the wound is so deep that it reaches the bone, this is called an “open” fracture. Such a fracture is a very serious injury because of the risk of infection of the wound and bone through the wounding of the skin.
Overview of fracture types:
- Avulsion fracture (avulsion fracture) – a bone fragment is torn out of the bone due to strong tension in a muscle or ligament.
- Fragmentation fracture – the bone shatters into many pieces.
- Compression fracture (compression fracture) – occurs primarily in the area of the spine, especially when the vertebra is weakened due to diseases such as osteoporosis.
- Dislocated fracture – a joint is dislocated and one of the bones is fractured.
- Incomplete fracture – the bone is broken on one side but not completely severed because the rest of the bone has not been bent. It occurs mostly in children, who have softer and more pliable bones.
- Partial detachment fracture – the bone is broken and a fragment is positioned elsewhere.
- Longitudinal fracture – the fracture line runs along the long axis of the bone.
- Oblique fracture – the fracture divides the axis of the bone diagonally.
- Pathologic fracture – the bone is weakened by disease (see below) and breaks.
- Spiral fracture (torsion fracture, twist fracture) – a fracture in which at least part of the bone has been rotated.
- Stress fracture (fatigue fracture) – typical in athletes. The bone breaks due to permanent overuse.
- Greenstick fracture – the bone deforms but does not break through; occurs mainly in children. Such a fracture is painful but stable.
- Transverse fracture – the fracture line is transverse to the long axis of the bone.
Causes of broken bones
Most broken bones result from a serious fall or car accident. Bones are extremely hard and resilient and can withstand surprisingly large amounts of violence. Bones weaken with age and the risk of falling increases.
Children, who typically lead more active lives than adults, are more likely to break bones.
People who suffer from diseases and conditions that weaken bones are at increased risk of fractures. These diseases include, for example, osteoporosis, infections and tumors. As already mentioned, this form of fracture is referred to as a “pathological fracture”.
The most common cause of broken bones is direct trauma. However, especially in older people, fractures often occur where the bone has been weakened by another problem (such as osteoporosis). In such a pathological fracture, then, there is a disease that weakens the bone structure and makes it prone to fracture; Osteoporosis and tumors in particular play an important role here.
Stress fractures are caused by permanent overuse and mainly occur in professional athletes.
Signs and symptoms of broken bones
The symptom is the patient’s sensation, while the sign is identified by the doctor during the physical examination. For example, pain is a symptom while redness is a fracture sign. Signs and symptoms of a fracture vary depending on several factors: which bone is broken, the patient’s age and general health, and the severity of the injury. Often encountered are:
- pale skin around the affected area
- Unnatural position (the affected area may be abnormally angled).
- The patient cannot bear normal weight on the injured limb.
- The patient cannot move the affected section.
- Bone rubbing sensation (crepitus)
- Patient is pale and sweats
- dizziness and nausea (feeling faint)
If possible, a person with a bone fracture should not be moved until emergency services arrive on site to assess the situation. Possibly can be splinted. If the patient is in a dangerous place, such as a busy road, they must be evacuated before emergency services arrive.
Pelvic or rib fractures can cause serious injury to internal organs and even death; a broken rib, for example, can cause a pneumothorax.
Bone fracture diagnosis
With the help of an X-ray and by examining the injury, the doctor can identify the majority of fractures.
Sometimes fractures are not visible on the x-ray. This usually happens with certain fractures of the wrist , hip (especially in older people), and stress fractures. Then the doctor can perform further examinations, such as computed tomography (CT), magnetic resonance imaging (MRI) or bone scintigraphy.
In some cases, such as a wrist fracture, the X-ray can
look normal at first. The doctor can apply a splint for immobilization and schedule a second x-ray after 10-15 days.
Once a fracture has been diagnosed, additional tests (CT, MRI, or an angiogram, which takes x-rays of blood vessels) may sometimes be needed to determine if there is tissue damage around the bone.
If there is a suspicion of a fractured skull, a more thorough examination procedure (e.g. CT) can be used directly, in which injuries to the brain can also be evaluated.