Fractures

Fracture Diagnosis and Care

A fracture is a break or crack in a bone that occurs when the bone cannot withstand the amount of force being placed on it. A fracture is usually the result of trauma, a fall or a direct blow to the body. The severity of a fracture usually depends on the force that caused the break. A bone may be completely fractured or partially fractured in several different ways. Treatment for fractures may include a splint, cast or surgery, depending on the severity and location of the break.

Types of Fractures

Fractures vary based on the type of injury that was sustained, the way the bone was fractured and the location of the fracture. Fractures may be categorized by the type of injury, which may include:

  • A transverse fracture is a straight line across the bone
  • An oblique fracture is an angled line or break
  • A spiral fracture is a fracture that encircles the bone
  • A comminuted fracture occurs when the bone has broken into several pieces
  • A displaced fracture occurs when the bone fragments on each side of the break are not aligned

An open or compound fracture occurs when bone fragments puncture the skin, possibly damaging surrounding muscles and tendons. This is often the most serious type of fracture because if the skin is broken, infection in both the wound and the bone can occur.

Symptoms of Fractures

A fractured bone is usually painful and an individual may experience:

  • Swelling
  • Tenderness
  • Physical deformity
  • Difficulty moving
  • Bruising

The injured limb is often difficult or impossible to move, and in severe cases the bone may have broken through the skin.

Diagnosis of Fractures

A fracture is diagnosed after a physical examination as well as imaging tests that may include X-rays or CT scans. Imaging tests allow the physician to identify the exact location and type of fracture.

Treatment of a Fracture

Initial treatment of a fracture may include managing pain and any swelling of the injured area. Treatment for most fractures focuses on repositioning the bone and preventing it from moving out of place until it has healed. Treatment may include:

  • Pain medication
  • Immobilization through a splint or cast
  • Functional cast or brace which allows limited movement of nearby joints

A displaced fracture may require the broken bones to be realigned, prior to splinting or casting. Patients with severe fractures may be referred to an orthopedic specialist in a hospital setting for treatment. Severe or multiple fractures may require external fixation, which uses an outer metal rod and pins to hold the bone or bones in place until they heal. Internal fixation devices, including plates, rods or screws, may also be used to maintain proper position of the bone during healing.

Fractures may take several weeks to several months to heal, depending on the extent of the injury. During the healing phase, physical therapy is often recommended to restore normal muscle strength, range of motion, and flexibility.

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Mass General - North Shore

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