Reviewed by Dr. Clement J. Cheng
Fractures, or broken bones, are often the result of injury or accident. Whenever stress on a bone is stronger than the bone, the bone breaks. Around 5.6 million fractures happen in the United States every year.
Bone fracture may be suggested if the person is unable to move or put weight on an injured area; if it looks misshapen; or if it is very painful. Without an X-ray, diagnosis of a bone fracture is difficult. In case of doubt, the injury should be treated as if it is a fracture until a test determines otherwise.
If there is no pulse below the injury, or the area below the injury is numb, tingly, or paralyzed, CALL 911 IMMEDIATELY! These are symptoms of a rare emergency that needs immediate medical attention.
Symptoms of a fracture include: a recent injury (within the last 24 hours), pain, swelling, bruising, and the inability to move or put weight on the area that was injured. Also, any “sprain” that doesn’t get better in 2-3 days may be a fracture.
Fractures are categorized as either open or closed. An open fracture means that the broken bone breaks through the skin. If a wound is visible over a fracture, it may be an open fracture. A closed fracture means the bone does not show through the skin; this means less damage to the muscles and other tissues.
FIRST AID:
- Call the doctor immediately!
- NEVER try to force back a dislocated bone yourself.
- Learn how to splint a fracture properly.
- Do not move the person if s/he has severe pain in the neck or spine, tingling or loss of feeling in the arms or legs, or loss of bowel or bladder control. These are signs that the spine may be injured.
- Move the person as little as possible. Any time a person with a fracture moves, the broken bones may also move out of place.
- Cover any open wounds with clean dressing.
- Splint the break in place, then go to the hospital. If the injury makes it difficult for the person to walk, call 911.
- Don’t give the injured person anything to eat or drink. It may delay treatment. Any treatment needing surgery is safer on an empty stomach to prevent anesthetic complications.
While most broken bones are the result of an accident or injury, there are less obvious causes.
A stress fracture results from either repeated stress on one bone or too much stress on one bone for too long. These can happen in the spine of women with osteoporosis, the hands of golfers, or the long bones of active people. Repeated stress may lead to compression fractures.
Avulsion fractures happen when strong muscle contractions pull off a section of the bone to which the muscle is attached. These are most common in the shoulder, knee, leg, and heel.
Aging, osteoporosis, and cancer can make the bones increasingly weak and brittle until they break very easily.
Proper treatment of a fracture is imperative. Otherwise, the bone may rejoin out of alignment. If a bone fragment is separated from its blood supply, it may die. In some open fractures, the bone may get infected. All open fractures require the attention of an orthopedic surgeon. Moreover, broken bones can affect everything around them. Bone fragments can compress or sever nearby blood vessels or nerves. A broken rib can puncture a lung. Some of this damage to soft tissues requires surgery.
Doctors diagnose fractures using X-ray. In the rare case where the fracture does not show up on X-ray, a doctor will order a CT test or an MRI.
Injuries will happen. They are difficult to prevent. Bone loss associated with aging can be prevented, however. A balanced diet that includes 100% of the U.S. Recommended Daily Allowances, especially of calcium and Vitamin D, can lower the risk of bone loss. Regular exercise is very important to keep bones strong. Post-menopausal women should ask their doctor about hormone therapy.
The first thing the doctor will do is ensure the broken pieces of bone are in the proper alignment. Putting them back into the right alignment is called reduction, and may in some cases require surgery.
Once the bones are properly aligned, they are immobilized so they can be held in the right position while they heal. (Click here for pictures of the healing process.)
Several treatment options are available to heal fractures, depending on the placement of the injury:
- A cast of firm plastic or plaster is wrapped around the area to support the broken bone.
- A splint is a firm object or “brace” that is sometimes attached to the area surrounding the bone.
- A finger or toe can be bandaged to the one next to it to hold it in place.
- Sometimes the doctor will perform surgery to insert a pin, rod, or plate inside the bone to hold it in place. This means the injured limb can be used much sooner.
- Certain bones, like the ribs, are naturally held in place by other bones. They don’t require any other support.
If an area is kept motionless for a long time, the muscles get weak and tight. Often the injured area must be rehabilitated. It is important to follow the doctor’s advice about how to move and exercise the area. A fracture may require physical therapy, beginning while the bone is still immobilized. The goal is to keep the nearby joints as active as possible without disturbing the healing process. Following the doctor’s plan will help keep down swelling and increase the blood flow to the bone, which helps it heal.
Fractures can take anywhere from 2 weeks to 3 months to heal, depending on the severity of the injury and the age of the injured. Prolonged healing may require additional treatment from your doctor.
