A fracture, also known as a broken bone, can occur from a traumatic event such as a motor vehicle accident, a fall, from overuse, and from weakening of bones associated with osteoporosis. In fact, fractures are one of the most common reasons for an emergency room visit. Nearly 7 million seek medical attention for a broken bone each year in the U.S.
Fractures can either be classified as closed or open. In a closed fracture, the bone(s) can be broken into a number of pieces, but does not penetrate through the skin. Open fractures are more serious injuries that require immediate attention such as emergent surgery to minimize the risk of further complications.
Further classification of fractures is based on fracture pattern and stability. For example, a non-displaced fracture means that a crack has been identified in the bone in which the edges of the fracture still line up. This is a stable fracture. A comminuted fracture is one in which the bone breaks into multiple pieces, usually from a high energy injury. This can result in an unstable type of injury.
A fracture can cause significant pain, swelling, skin bruising, loss of joint mobility, and deformity. Following a physical examination, an x-ray may be ordered to identify the presence and details of a fracture.
Various treatment options exist based on type of fracture (open vs. closed) and relatively stability. The goal of treatment is to align the bony edges of the fracture back to the original position. In some cases, this is not possible due to the nature of some injuries.
Stable, closed fractures can often be treated in a brace or cast. Other unstable fractures require either external fixation or internal fixation. External fixation refers to the insertion of pins or screws into the fracture that protrude outside the edges of the skin. In open reduction of a fracture, surgery is performed to bring the edges of the fracture back together to achieve anatomic alignment. This involves manipulating the bones and placing screws, pins, wires, plates, or rods into the fracture to hold them in place.
In many cases, fractures can take several months to heal. Certain medical conditions such as uncontrolled diabetes and osteoporosis can delay or prevent healing from taking place. Based on the nature of the original injury, some may always notice a deformed appearance even after healing has completed. Physical therapy may be required after immobilization with a cast or splint has been completed to restore range of motion and strength of the affect joint(s).