Bone fracture treatment
Last updated date: 10-Jul-2023
Originally Written in English
Bone fractures treatment
A fracture is a break in the continuity of bone that might be partial or complete. Trauma is the most prevalent cause, followed by disorders that result in decreased bone structure (e.g., osteoporosis).The latter causes pathologic fractures, which are fractures that would not occur if the bone structure had not been compromised. Open fractures, in which the bone is exposed as a result of extensive soft tissue damage, carry a high risk of infection and poor wound healing.
Fracture management can be conservative (e.g., with a cast or splint) or surgical, and it typically entails anatomic reduction, fixation, and/or immobilization. Acute nerve and vascular damage, compartment syndrome, and long-term problems like as avascular necrosis and nonunion are all possible consequences.
Epidemiology of bone fracture across the age, race and gender
Cumulative incidence of total fracture by age, race and gender:
Through the age of 50, blacks had a greater cumulative incidence of fracture. A crossover occurs between the ages of 50 and 54, when white incidence exceeds that of blacks. When incidence is studied by race and gender, however, significant patterns emerge. Around the age of 62, there is a racial crossover of black and white males.
Women have an oscillating relative fracture incidence until the age of 46, when incidence begins to diverge. Total fracture incidence is greater among adult women and occurs at a younger age in whites than in blacks. Increases in black women were more mild and lag behind all those seen in white women by 5-10 years.
During their adult years, both white and black adult men experience a plateau in fracture incidence, but their female counterparts show a progressive increase in fracture incidence that increases with age.
Cumulative incidence of fracture by anatomic site, gender, race, and age:
Despite significant disparities in cumulative fracture incidence between blacks and whites, the anatomic distribution of fracture showed substantial consistency across age groups, with modest racial variance within age groups.
The proportion of fractures accounted for by upper extremity fractures, as well as skull and facial fractures, decreased with increasing age in both blacks and whites, whereas the proportion of fractures accounted for by neck and trunk and lower extremity fractures increased with age in both blacks and whites.
The proportion of lower extremity fractures was lowest in children, but increased with age, accounting for almost half of hospitalized fractures in black and white adults and nearly two-thirds in black and white elderly.
- Skull and face:
When evaluated by race, the incidence of skull and face fractures in whites and blacks is comparable at ages less than 10 years, with blacks having a greater prevalence between adolescence and adulthood. During adolescence, white men have approximately quadruple the incidence of white girls, while black males have six times the incidence of black females.
Until the age of 50, the incidence among black and white females is similar. Incidence rises in white females between the ages of 55 and 59, and in black females between the ages of 65 and 69, whereas black men fall to their lowest levels.
- Neck and trunk:
Fractures of the neck and trunk are uncommon in young blacks and whites under the age of ten, but rise with age. In adolescence and early adulthood, the incidence of black females doubles, whereas white females, as well as white and black men, rise 6 to 10 times.
Fractures of the neck and trunk are more common in both black and white senior people as they get older. This begins slowly about the age of 30 in white females, and accelerates starting around the age of 40-44. Beginning in the age range of 55 to 59, black females exhibit considerable rises.
White females and white males exhibit two distinct time periods of increased vertebral fracture risk, one in adolescence and one beginning in older adulthood (Figure 3c). After age 55, vertebral fracture patterns are more similar within race than gender with white incidence for males and females increasing exponentially. White women begin to show increases in the 45 to 49 age range with white males and black women showing increases beginning 10 years later in the 55 to 59 age range. Although the increases are relatively more modest, vertebral fracture in black women quadruples after age 55
- Upper extremity:
Prior to the age of 50, the incidence of upper extremity fracture is more comparable by gender than by race, with males having a 2 to 4 times greater incidence than girls in adolescence and young adulthood. Adult white female upper extremity fracture rates continue to rise gradually in the late 30s, with exponential rises beginning in the 40s.
Black females have a ten-year lag behind white females in terms of incidence. Although fracture incidence in black men doubles between the ages of 65 and the end of life, it does not reach the high levels found in early adulthood.
- Lower extremity:
Lower extremity fracture incidence increases begin earlier in both white and black females than in other areas studied in this study. Females have a lower incidence than males during adolescence and early adulthood, thus these increases start from a lower foundation. Lower extremity fractures in males peak in their adolescence and remain there until age-related increases begin in white males between the ages of 45 and 49, and in black males between the ages of 60 and 64.
Types of Bone Fracture
Fractures come in a variety of shapes and sizes, and each one necessitates an unique repair approach and procedure. Here are a few categories of bone fractures:
- Open Fracture: A fracture in which the bone has broken through the skin and is visible outside the leg. Alternatively, there may be a deep wound that exposes the bone through the skin. This is also referred to as a complex fracture.
- Closed Fracture: A fracture that does not cause the skin to break. This is sometimes referred to as a simple fracture.
- Partial Fracture: An incomplete break of the bone.
- Complete Fracture: A complete break of the bone that causes it to be divided into two or more pieces.
- Stable Fracture: The shattered ends of the bone are aligned and have not shifted.
- Displaced Fracture: There is a space between the bone's shattered ends. A displaced fracture may need surgery to repair.
In addition to whether the bone is displaced or non-displaced it will be given a fracture pattern name. Here are several types of fracture patterns:
1. Transverse Fracture:
Transverse fractures are breaks that go across the bone in a straight line. Traumatic occurrences such as falls or car accidents can result in this form of fracture.
2. Spiral Fracture:
This is a kind of fracture that spirals around the bone, as the name implies. Spiral fractures occur in long bones of the body, most commonly in the legs' femur, tibia, or fibula. They can, however, form in the long bones of the arms. Spiral fractures are produced by twisting injuries experienced while participating in sports, during a violent attack, or in an accident.
3. Greenstick Fracture:
This is a kind of incomplete fracture that usually affects children. The bone flexes and cracks, yet it does not shatter into two distinct pieces. Because children's bones are softer and more flexible, they are more prone to sustain this form of fracture.
4. Stress Fracture:
Hairline fractures are another name for stress fractures. This form of fracture resembles a crack and might be difficult to detect with standard X-rays. Running, for example, is a common cause of stress fractures.
5. Compression Fracture:
A compression fracture occurs when bones are squashed. The broken bone will seem larger and flatter than it did before the incident. Compression fractures are the most common type of fracture in the spine and can cause your vertebrae to collapse. The most prevalent cause of compression fractures is osteoporosis, a kind of bone loss.
6. Oblique Fracture:
An oblique fracture occurs when a break occurs diagonally across the bone. This type of fracture is more common in lengthy bones. Oblique fractures can occur as a consequence of a sharp blow delivered at an angle as a result of a fall or other trauma.
7. Impacted Fracture:
When the shattered ends of the bone are forced together, it results in an impacted fracture. The force of the injury that produced the fracture has pressed the fragments together.
8. Segmental Fracture:
The same bone is shattered twice, resulting in a "floating" piece of bone between the two fractures. Long bones, such as those in the legs, are more prone to fractures. This sort of bone fracture may require more time to heal or may create problems.
9. Comminuted Fracture:
A comminuted fracture occurs when the bone is fractured into three or more parts. At the fracture site, there are also bone pieces. These sorts of bone fractures occur as a result of a high-impact trauma, such as a car collision.
10. Avulsion Fracture:
An avulsion fracture occurs when a fragment is pulled off the bone by a tendon or ligament. These types of bone fractures are more common in children than adults. Sometimes a child’s ligaments can pull hard enough to cause a growth plate to fracture.
How do I know if I have a Bone Fracture?
Most fractures may be identified by evaluating the injury and obtaining X-rays.
An X-ray may not always reveal a fracture. This is especially prevalent with certain wrist fractures, hip fractures (particularly in the elderly), and stress fractures. In certain cases, your doctor may order further tests like a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.
In some circumstances, such as a potential wrist fracture with an initially normal X-ray, your doctor may use a splint to immobilize the region and schedule a second X-ray 10 to 14 days later, when healing may reveal the fracture.
Even after a fracture diagnosis has been made, further tests (such as a CT scan, MRI, or angiogram, a specific X-ray of blood vessels) may be required to assess whether any tissues surrounding the bone have been affected.
If your doctor detects a skull fracture, they will most likely bypass X-rays and go straight to a CT scan, which will identify the fracture as well as any more serious connected injuries or secondary injuries inside the skull, such as hemorrhage around the brain.
What are the treatments for a Bone Fracture?
A fracture frequently need emergency care at a hospital. A fracture of the tip of a toe is an example of a small fracture that may not need immediate treatment. If you suspect that a bone in the back, neck, or hip has been fractured, or if a bone is exposed, do not move the individual; instead, call for help.
In other circumstances, you may need to call for help or transfer the individual to an emergency room. Protect the damaged region before moving the person to avoid additional injury. To restrict movement of fractured arm or leg bones, place a splint (made of wood, plastic, metal, or similar stiff material packed with gauze) against the region; loosely wrap the splint to the area using gauze. If bleeding occurs, apply pressure to halt the bleeding before splinting, and then elevate the fracture.
Fractured bones must be placed and kept in place in order to heal properly. The process of setting a bone is known as reduction. Closed reduction refers to bone repositioning without surgery. Closed reduction is used to treat the majority of fractures in children. Serious fractures may necessitate open reduction – surgical repositioning. Pins, plates, screws, rods, or glue may be used to keep the fracture in place in some circumstances. To minimize infection, open fractures must also be carefully cleansed.
Most fractures are immobilized with a cast, splint, or, on rare occasions, traction after they have been set to minimize discomfort and aid healing. In most situations, medicine is confined to pain relievers. Antibiotics are administered to open fractures to avoid infection. Even if the bone is in a cast, rehabilitation should begin as soon as feasible. This increases blood flow, healing, muscular tone maintenance, and aids in the prevention of blood clots and stiffness.
After removing the cast or splint, the region surrounding the fracture is frequently stiff for many weeks, with swelling and bumps. Increased hair on the arms and legs in children might arise as a result of cast irritation of the hair follicles. There may be a limp with shattered legs. Symptoms usually go away after a few weeks.
If you have fractured a bone, you should gradually resume utilizing the region once the cast or splint is removed. It might take another 4 to 6 weeks for the bone to recover its previous strength. In light of your fracture and general health, see your doctor to determine the type and degree of exercise that is appropriate for you. Exercising in a swimming pool is widely regarded as a beneficial method of rehabilitation.
How Bone Fractures can be prevented?
Follow common safety procedures to help avoid fractures, such as:
- Always wear a seat belt when traveling in a motor vehicle.
- When participating in leisure activities such as biking, snowboarding, or contact sports, always use the appropriate safety equipment (helmets and other protective pads).
- Keep anything that might cause you to trip off the pathways and stairs.
- Get frequent exercise if you have osteoporosis to improve your strength and balance, which may help you avoid falling.
- Consult your doctor before beginning bone-building drugs and supplements (such as calcium and vitamin D).
- When using a ladder, avoid utilizing the top step and make sure someone is holding the ladder.
How long does it take a fracture to heal?
The length of time it takes to heal a fractured bone varies from person to person and is determined by the degree of the injury. A broken leg, for example, will take longer to heal than a broken arm or wrist. In addition, as you become older, your healing time slows down. According to healthcare specialists, recovering from a fractured bone takes six to eight weeks on average.
Are there complications with Bone fractures?
A broken bone, like many other injuries, can result in problems. These are some examples:
- Blood clots: A blood vessel blockage that can break loose and travel across the body.
- Cast-wearing complications: Complications from wearing a cast might include pressure ulcers (sores) and joint stiffness.
- Compartment syndrome: There may be bleeding or edema in the muscles around the fracture.
- Hemarthrosis: It is a condition in which blood flows into a joint, causing it to enlarge.
A bone fracture is a break in a bone's continuity. A considerable proportion of bone fractures are caused by a high force impact or stress.
The most prevalent causes of fractures include physical trauma, misuse, and diseases such as osteoporosis. Furthermore, until late adulthood, a person's bones typically weaken. This raises their chances of breaking a bone.
The symptoms of a fracture differ depending on where it is located, a person's age and general health, and the degree of the injury. People who have a bone fracture may experience pain, swelling, bruising, discolored skin around the affected area, protrusion of the affected area at an unusual angle, inability to put weight on the injured area, inability to move the affected area, a grating sensation in the affected bone or joint, or bleeding if it is an open fracture.
Most fractures may be repaired by the body, but medical intervention is frequently required to maintain the shattered bones in place. External casts and splints, as well as surgical screws and plates, are examples of these procedures.