Different Types of Bone Fractures

Though our bones are very strong, the wrong amount of pressure applied on a bone can cause it to snap like a twig! Here is an account of the different types of bone fractures.

One of the most important systems of the human body is the skeletal system. It provides a strong and sturdy framework to the body, giving it strength and proper shape. The main component of the skeletal system are the bones. The human body has 206 bones. Our bones are very strong; there are many daily activities that put a lot of pressure on different bones in the body. However, a bone is still susceptible to injury, which may cause a bone to fracture. A bone fracture is medically defined as loss of continuity of the bone. The continuity of bones may be lost on account of a minor crack, or major breakage of the bone. A fracture is often caused when undue or excessive pressure is applied on the bone. This immediately makes you wonder - how much is too much pressure? There isn't one correct answer to this question. Different bones in the body have different tolerance levels and capacity to endure stress. Each bone has its own threshold value. When the pressure applied on a particular bone crosses it's threshold value, it results in a fracture. Factors that Affect Bone Fractures Before we learn about the types of bone fractures, let us consider different factors that affect bone fractures.
y y y y y

Age: Old people are more susceptible to fractures, since their bones are brittle; children rarely suffer from fractures, since their bones are flexible Health: Diet habits can greatly affect the health of your bones, and hence make you more or less susceptible to bone fractures Occupation: Athletes, sportsperson are more prone than people with sedentary jobs, housewives, etc. Which bone: Different bones in the body have different capacities to bear impact and hence vary in degree of susceptibility to fractures Nature of impact: The amount and direction of force or pressure that the bone was subjected to (in other words, the momentum)

http://www.buzzle.com/articles/different-types-of-bone-fractures.html

All these factors affect the degree of fracture (minor or acute), as well as the type of bone fracture caused. Types of Bone Fractures ~ Ordinary and Pathologic Fractures ~ Normally, people suffer from a fracture as a result of them having performed an activity that subjected the bone to excessive pressure, stress, or a deep impact. For example, a fall, a car accident, etc. Any normal person, with average health and body constitution can suffer from such a fracture. Of the above factors, those of age, occupation, which bone and nature of impact play a greater role in this case. However, certain medical conditions such as osteopenia, osteoporosis, bone marrow cancer, bone cyst, or inherited bone disorders etc. weaken the bones to such an extent that trivial impact can also cause the bones to fracture. These fractures are different from normal fractures, in that the impact involved in causing the fracture is rather trivial, of less severity. These fractures are also known as pathologic fractures. ~ Types of Bone Fractures ~ The most common way to classify bone fractures is on the basis of different features of a fracture. This is known as orthopedic classification. Here is a list of the different types of bone fractures according to the orthopedic classification.
y y y y

y y

Open fracture: An open fracture is a fracture where the broken bone is exposed. That is dangerous because of increased chances of infection. It is also called compound fracture. Closed fracture: Also known as simple fracture, a closed fracture is a fracture where the bone is broken, but the skin is intact. Complete fracture: The two pieces of the bone, resulting from the fracture, completely separate from each other. Incomplete fracture: In this, the two pieces of bone, resulting from the fracture do not completely separate from each other; the bone pieces are still joined to some extent. This happens when the crack (or fracture) does not traverse along the entire width of the bone. Multi-fragmentary fracture: In this the bone splits into multiple pieces. Compression fracture: A compression fracture is a closed fracture that occurs when two or more bones are forced against each other. It commonly occurs to the bones of the spine and may be caused by falling into a standing or sitting position, or a result of advanced osteoporosis. Avulsion fracture: An avulsion fracture is a closed fracture where a piece of bone is broken off by a sudden, forceful contraction of a muscle. This type of fracture is common in athletes and can occur when muscles are not properly stretched before activity. This fracture can also because of an injury. Impacted fracture: An impacted fracture is similar to a compression fracture, yet it occurs within the same bone. It is a closed fracture which occurs when pressure is applied to

http://www.buzzle.com/articles/different-types-of-bone-fractures.html

y y y y y y y

both ends of the bone, causing it to split into two fragments that jam into each other. This type of fracture is common in car accidents and falls. Stress fracture: It is a common overuse injury. It is most often seen in athletes who run and jump on hard surfaces such as runners, ballet dancers and basketball players. Linear fracture: In this the fracture is parallel to the bone's long axis. Transverse fracture: In this the fracture is at a right angle to the bone's long axis. Oblique fracture: In this the fracture is diagonal to a bone's long axis. Spiral fracture: In this at least one part of the bone has been twisted. Comminuted fracture: In this the fracture results in several fragments. Compacted fracture: In this the fracture is caused when bone fragments are driven into each other.

Similarly, bone fractures maybe classified anatomically as well, i.e. based on which bone of the body has suffered from the fracture. This is commonly known as anatomical classification. Anatomically, fractures maybe identified as follows y y y y y y y y y y y y

Skull fracture Spinal fracture Rib fracture Sternal fracture Shoulder fracture Arm fracture Hand fracture Pelvic fracture Femoral fracture (affecting the femur bone, i.e. upper leg; also known as hip fracture) Patellar fracture Crus fracture (affecting the tibia and/or fibula bones, i.e. lower leg) Foot fracture

So those were the different types of fractures. Apart from the two systems of classification of bone fracture types given above, many other systems also exist, such as OTA classification, Dennis classification, Neer Classification, etc. These methods are, however, less common and also often confusing; hence they have not been discussed here. Depending on the type of bone fracture, the healing time of the fracture, as well as the treatment suggested may vary greatly. One general thumb rule, however, is to give the fractured bone complete rest and to prevent it from experiencing any kind of pressure or stress.

http://www.buzzle.com/articles/different-types-of-bone-fractures.html

What are Bone Fractures ?

Bone Fractures are are injuries of bone tissue, which compromise their ability to support the body. A bone fracture can occur in several situations, like a car accident, an assault, a fall in the bathroom or from a height, due to a pre-existing bone disease, like osteoporosis, rickets, and so on. The symptoms of bone fracture may vary depending on the types of bone fractures, their location, as well as their severity. However, every fracture results more or less from an unbalanced force, which overcomes the strength of the bone.

Bone Fracture Physiology

Bone tissue is structurally very hard, but when it is subjected to forces higher than its capacity it responds in two ways. When the forces are applied in one instant, like a sudden fall, it results in a bone fracture. But if it is applied slowly over a period of time, it results in remodeling of the bone to a shape that balances the forces e.g. bowing of legs in rickets. Thus, the bone has a dynamic nature and adjusts to the changing loads of weight bearing and physical stress. This ability of bones is due to the constant erosion of bone by osteoclasts and deposition of new bone by osteoblasts (Picture 1).

Picture 1: Bone Fracture Physiology A delicate balance between these cells is responsible for thickening or thinning of bones, depending on the activity performed by a person. Hence, a manual laborer has a much sturdy skeleton than a sedentary working clerk in an office. Thus, after a bone fracture, the bones have an intrinsic ability to heal themselves due to the deposition of bone by osteoblasts. It also indicates that pressure acting on a particular bone tends to increase the thickness of the bone over time and helps better healing of bone fractures.

http://www.buzzle.com/articles/different-types-of-bone-fractures.html

Types of Bone Fractures

There are several ways to classify a bone fracture, which satisfies specific motives. Each of the bone fracture types, gives us certain information about the fracture, which influences the type of treatment given to a person. Hence, it is very important to understand which of the several types of bone fractures, does one actually have. Displaced Bone Fracture is when the broken ends of a fracture move away from each other and there is a significant gap between them, when seen on an x-ray. The significant gap is different for different types of bone fractures, for example, a gap of 3-4 mm may be insignificant in a humerus bone fracture, but can be significant in a finger phalanx fracture. Undisplaced Bone Fracture or Hairline Fracture is when a bone develops a crack or breaks through and through, but the broken ends remain in place, without any displacement or gap. These bone fractures, are best treated with a simple fiberglass or plaster cast and generally do not require surgical treatment. Pathological Bone Fracture is when a bone has been weakened by a disease, like cancer, osteoporosis, etc., and develops a fracture. Such bone fractures do not require a lot of force and are possible after trivial falls or even without any traumatic incident. Compound Bone Fracture is when the broken bones pierce the skin and create an external wound. These bone fractures are associated with higher rates of infection, due to exposure of the bone to the surrounding dirt and also cause profuse bleeding from the wound.

Long Bone Fracture Types

Long bones, like femur (thigh bone), tibia & fibula (leg bones), humerus (arm bone), radius & ulna (forearm bones) or clavicle (collar bone), have particular types of bone fractures, where the edges of broken bones have a characteristic shape. This not only influences the outcome of the bone fracture, but also dictates the bone fracture repair method which can be used for treatment. Spiral Fracture is when a twisting force is applied to a bone, resulting in long curvy edges of the broken bones, like a spiral. Due to the zig-zag nature of the fractured ends of bone, it is slightly easier to treat a spiral fracture of long bones. Comminuted Fracture is when a bone breaks into several small pieces and is the result of high velocity injuries, like car accidents, or falls from a height. Such bone fractures generally are very difficult to treat, and result in a deformity of the injured part even after treatment.

Bone Fracture Symptoms

Symptoms of bone fractures can range from a mild bone pain to severe bruising, bleeding, and inability to move the part of the body.
y

Pain is due to pain signals from the injured bone in response to pressure on the bone fracture.

http://www.buzzle.com/articles/different-types-of-bone-fractures.html

y y y y

Swelling is due to injury to local blood vessels and also the action of the cells of immune system of the body. Inability to walk - is after an injury to the weight bearing bones of the body, mainly the bones of the leg or thigh. Instability - is when the bone fracture is near a joint and causes the joint to dislocate. Inability to breath - is in the case of rib fractures, where a sharp stabbing pain can be felt at each breath.

Bone Fracture Treatment

Treatment for bone fractures consist of immobilization of the injured part in most of the cases. This is accomplished with the help of a cast moulded on to the injured part. Plaster of Paris (cheap) or Fiberglass (expensive) may be used for the cast depending on the requirement and availability. Several splints are also available for the same purpose, are more comfortable than a cast and provide similar results. Generally, such an immobilization has to be retained for 4-6 weeks, to allow sufficient time for bone fracture healing. Prior to immobilization, it is essential to ensure that the displacements between the fractured ends of bones are reversed and the bones are brought into their natural anatomical alignment. This procedure is called fracture reduction and involves manipulation of the ends of the broken bones. Reduction can be accomplished under x-ray guidance with the help of a C-Arm. Due to the painful nature of fracture reduction procedure, it is essential to give the patient adequate analgesic cover or iv sedation. By reducing bone pain a person is able to relax the muscles of the injured part, which helps greatly in fracture reduction.

Bone Fracture Surgery

Surgical treatment for bone fractures is reserved for displaced fractures and primary management of compound fractures. Displaced bone fractures have a higher propensity of developing nonunion or mal-union. Hence, surgery has to be performed, preferably within a week after injury to bring the broken ends of the bones together. The broken edges are approximated as neatly as possible and secured in that position with the help of orthopedic screws and plates. This provides temporary support, which is sufficient to maintain the position of the bones, until bone fracture healing.

http://www.buzzle.com/articles/different-types-of-bone-fractures.html