Bone Fractures

A fracture is when a bone's continuity is disrupted or broken most commonly due to trauma. It can present a complex challenge in treatment, recovery and rehabilitation.
Bone fractures, though common, present a complex challenge in medical care, involving not just treatment but also recovery and rehabilitation. This article provides an overview of fractures, including causes, risk factors, symptoms, diagnosis, management, and prevention.

Bone fractures, though common, present a complex challenge in medical care, involving not just treatment but also recovery and rehabilitation. This article provides an overview of fractures, including causes, risk factors, symptoms, diagnosis, management, and prevention.

What is a bone fracture?

A bone fracture is a medical condition where a bone's continuity is disrupted or broken. Fractures can vary significantly in their severity and are classified based on whether the skin is broken:

  • Closed fracture: The skin remains intact in this type of fracture.
  • Open fracture: This involves a wound that may expose the bone to the external environment, increasing infection risk.
Diagram illustrating Closed vs. Open fractures

Common types of fractures include:

  • Simple fracture: A fracture where the bone is broken in only one place.
  • Displaced fracture: This occurs when the bone breaks into two or more pieces and moves so that the two ends are not lined up straight.
  • Transverse fracture: A fracture line is horizontal in this type of fracture.
  • Oblique fracture: This type of fracture has an angled pattern and usually occurs due to rotational or twisting forces.
  • Spiral fracture: The fracture line spirals around the bone; often seen with injuries from a twisting force.
  • Stress or hairline fracture: A small crack in the bone that often develops from overuse or repetitive activity.
  • Compression fracture: Commonly seen in spinal bones (vertebrae), where the bone is squashed or collapses, often due to osteoporosis.
  • Greenstick fracture: This occurs mostly in children where one side of the bone is broken and the other side is bent.
  • Comminuted fracture: A complex type where the bone breaks into several fragments.
  • Avulsion fracture: This occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone.
Diagram illustrating some of the different common types of fractures

Causes of fractures

Fractures are typically caused by a variety of factors including:

  • Trauma: The most common cause, trauma can result from falls, accidents, or sports injuries. High-impact or contact sports, such as football or rugby often put players at risk.
  • Overuse or repetitive motion: Repetitive stress on a bone can lead to stress fractures. These are common in athletes who perform the same motions again and again, such as runners or military personnel during intense training.
  • Osteoporosis: This medical condition results in weaker bones, making them more susceptible to fractures. Even minor stresses or falls can lead to fractures in someone with osteoporosis.
  • Certain types of cancer: Some cancers, particularly those that originate in or spread to the bones, can weaken the bone structure, increasing the likelihood of fractures.

Risk factors for fractures

Several factors can increase the risk of fractures. These include:

  • Age: Higher risk in children and older adults.
  • Certain medical conditions: Osteoporosis, specific cancers, and certain genetic disorders.
  • Lifestyle factors: Smoking, excessive alcohol consumption, and poor nutrition.
  • High-risk activities: Participation in contact or extreme sports.
  • Previous fractures: A history of previous fractures.
  • Gender: Women are at higher risk due to a higher incidence of osteoporosis.
  • Family history: Genetic predisposition to bone fragility or specific bone diseases.
  • Low body weight: Being underweight can lead to decreased bone mass.
  • Insufficient calcium and vitamin D: These nutrients are essential for bone health.
  • Certain medications: Prolonged use of some drugs like corticosteroids can weaken bones.
  • Sedentary lifestyle: Lack of physical activity or immobilisation for long periods can affect bone health.


Symptoms of a fractured bone

Symptoms of a fracture can vary, depending on the specific bone involved, the patient's general health, and the severity of the injury. However, common symptoms include:

  • Severe pain, which may worsen with movement or pressure.
  • Swelling and bruising.
  • Deformity of the injured area.
  • Difficulty moving the injured area or bearing weight on it.
  • In severe cases, a bone may be protruding from the skin.

Diagnosis of fractures

Diagnosis of a fracture starts with a detailed medical history and a physical examination. The doctor will ask about the circumstances of the injury, symptoms, and past medical history. Imaging tests like X-rays are the most commonly used to confirm the diagnosis. In some cases, other scans like CT scans, MRIs, or bone scans may be used to provide more detailed assessment, especially for fractures that are difficult to identify on plain X-rays.

Management of fractures

The goal of fracture management is to ensure the best possible function of the injured part after healing. This includes:

Reduction: This process realigns the fractured bone. It can be:

  • Closed Reduction: The bone is realigned without an incision. The procedure is usually performed under anaesthesia.
  • Open Reduction: More severe fractures may require surgery, where an incision is made for realignment and internal fixation devices are used.

Immobilisation: This maintains the bone alignment and aids healing. It can involve casts, splints, or braces, and in some cases, internal fixation with pins or plates.

Pain Management: Patients may be prescribed pain medication to help manage discomfort.

Physical Therapy: This aids in restoring movement, strength, and function to the affected area.

Follow-up Care: Regular check-ups ensure the fracture is healing correctly and help monitor for complications.

Each patient's treatment plan is tailored to their specific needs and the nature of the fracture. If you would like further advice and assistance in management, please contact us and book an appointment to discuss this further.

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