Definition

A fracture is a break in any bone in the body. Fractures are usually caused by trauma. This may be falls, twists, blows or collisions. There are different kinds of fracture:

• The bone may be fractured but stable (simple fracture).
• Bone fragments may be sticking through the skin (open).

Fractures may also be described as:

• Chip (avulsion fracture)—A small piece of bone is broken away from the main bone.
• Compression—The bone is compressed together (ie, vertebrae).
• Comminuted—The bone is in pieces.
• Greenstick—One side of the bone is broken and the other side is bent but not broken.
• Intra-articular—The joint is affected.
• Transverse—The bone is broken in a horizontal line that is perpendicular to the surface of the bone cortex.
• Oblique—The bone is broken in a line that is less than a 90° angle to the surface of the bone cortex.
• Spiral—The line of the fracture forms a spiral.
• Stress—A thin fracture line occurs due to overuse rather than a single traumatic incident.

The Bones of the Body

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Causes

Fractures are caused by trauma to the bone. Trauma includes:

• Falls
• Twists
• Blows
• Collisions

The trauma is a physical force applied to the bone that the bone cannot withstand. Stronger bones can withstand more physical force than weaker bones.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for a fracture include:

• Advancing age
• Postmenopause
• Decreased muscle mass
• Osteoporosis —decreased bone mass which weakens bones (This can affect men and women.)
• Certain congenital bone conditions (rare)
• Taking glitazones (medication used to treat type 2 diabetes )
• Accidents or violence

Symptoms

Symptoms of a fracture include:

• Pain, often severe (primary symptom)
• Instability of the area around the break
• Inability to use the limb or affected area normally (There may be full or partial restriction in movement.)
• Swelling or bruising caused by the bleeding from the bone and surrounding tissues
• Numbness caused by damage to a nearby nerve (rare)
• Fainting or even shock (rare–only in a severe trauma)

Diagnosis

The doctor will ask about your symptoms and how you injured yourself, and examine the injured area.

Tests may include:

• X-rays —to look for a break in the bone
• CT scan —uses computerized x-rays to make pictures of structures inside the body
• MRI scan —uses a strong magnetic field and radio waves to make pictures of structures inside the body
• Bone scan —typically used to look for stress fractures

Treatment

Treatment involves:

• Putting the pieces of bone together (may require anesthesia and/or surgery)
• Keeping the pieces together while the bone heals itself

Devices that can hold a bone in place while it heals include:

• A cast (may be used with or without surgery)
• Metal pins across the bone with a frame holding them outside the bone (requires surgery)
• A metal plate with screws (requires surgery)
• Screws alone (requires surgery)
• A rod down the middle of the bone (requires surgery)

If you are diagnosed with a fracture, follow your doctor's instructions .

Prevention

You can reduce your chances of getting a fracture:

• Avoid putting yourself at risk for an accident or other trauma to the bone.
• Eat a diet rich in calcium and vitamin D .
• Do weight-bearing exercise regularly to build and maintain strong bones.
• Do strengthening exercises regularly to build strong muscles and prevent falls.
• Patients with osteoporosis may benefit from bisphosphonate medications.