Fracture

ON THIS PAGE:

• Common causes of fracture
• Types of Fracture: how the bone breaks
• Special note about stress fractures
• Types of Fracture: what bone is affected
• Special consideration of children and fractures
• Special consideration of seniors and fractures
• Diagnosing fractures
• Treatment of fractures
• Recovering from fractures
• Fractures and liability

A fracture is a break of one of the bones in the body. Fractures are common; the average individual experiences a fracture twice in their lifetime. While fractures can occur at any time throughout a person’s life, young children and older individuals experience fractures more commonly than adults do. Fractures occur when trauma or force exerted on the bone is stronger than the bone itself. A bone can be fractured in many ways, as discussed below, which determines the severity of the injury, the treatment necessary, and the time it will take for the bone to heal.

Common Causes of Fractures

Fractures can happen in many ways, the three most common of which include:

1. Trauma: Most fractures are the result of trauma. Vehicle accidents, falls, sports injuries and violence are common trauma-related causes of fracture. For many fractures, such as jaw fractures, vehicle accidents are the cause of trauma nearly 50 percent of the time.
   
2. Overuse: repetitive stress on a bone or bones can result in stress fractures. These are common among athletes and workers who frequently perform intense physical labor.
   
3. Osteoporosis: This medical condition weakens the bones, causing them to be more fragile and prone to fracture. This contributing factor to fractures is more prevalent in older individuals.

In cases where another party caused or contributed to your traumatic accident, resulting in fracture or other serious injury, you may be able to recover compensation for your losses. Please contact us to learn more about your legal rights and options.

Types of Fractures: how the bone breaks

A bone can fracture in many ways. The main categories of fractures include incomplete, complete, simple, and compound. In an incomplete fracture, the bone cracks but does not break all the way through. Recovery from such a fracture typically takes less time than recovery from a complete fracture. In a complete fracture, the bone breaks all the way through, fracturing into two or more parts.

In a simple fracture (also called a closed fracture) the bone breaks but does not pierce through the skin, whereas a compound fracture causes the bone to break through the skin. A compound fracture (also called an open fracture) may result in a protruding bone or the bone may recede back into the wound and no longer be visible.

Fractures are further classified by how the bone breaks. The following are specific types of fractures, which can affect various bones throughout the body, though some types are more common in certain bones.

• Greenstick fracture – this is an incomplete fracture, affecting only one side of the bone, which causes the bone to bend. Greenstick fractures are most common in children.
• Transverse fracture – in this fracture, the bone breaks or fissures at a right angle. A transverse fracture, typically a stable fracture, is most common in traumatic injuries.
• Impacted fracture – this is a complete fracture wherein the two broken edges of the bone become wedged together. This is typically a stable fracture, unless the bones are pulled apart. It can be difficult to diagnose this type of fracture without careful examination of x-rays.
• Buckle fracture (also called Torus fracture) – this is an incomplete fracture caused by compression of a long bone. Buckle fractures are extremely common in children, often the result of falling on an outstretched hand. These fractures tend to heal more quickly than similar greenstick fractures.
• Oblique fracture – this is an uncommon type of fracture, characterized by a sloped break of the bone, which is unstable. This type of fracture may be diagnosed as a spiral fracture.
• Spiral fracture – (also called a torsion fracture) occurs when the bone has been twisted apart. These are commonly unstable fractures caused by a traumatic twisting of the limbs (as in a skiing accident).
• Comminuted fracture – this is a complete fracture wherein the bone breaks into three or more pieces.
• Displaced fracture – is a complete fracture in which the bone segments are not aligned, yet they are not at an angle to one another.
• Avulsion fracture – this type of fracture occurs when trauma causes a ligament or tendon to tear from the bone it is attached to.
• Occult fracture – In this type of fracture, the bone does not appear to be broken on x-rays, yet the bone shows signs of re-growth weeks later.
• Hairline fracture (also called fissure fracture) - is an incomplete fracture whereby the bone is finely cracked, with no significant displacement. This stable fracture does not typically cause trauma to surrounding tissues.

Special note about Stress Fractures

Stress fractures are tiny hairline or fissure fractures, which are commonly the result of overuse or sports-related injuries. Stress fractures most commonly affect weight-bearing bones in the legs or foot. Stress fractures typically occur when a fatigued muscle is no longer able absorb the shock of impact. Impact with an unfamiliar surface, extreme physical stress and improper equipment use are common culprits in stress fractures.

Types of Fracture: what bone is affected

The following is a list of fractures based on where the bone is located in the body.

Fractures of the skull

• skull fracture
• radial head fracture
• basal skull fracture
• basilar skull fracture

Facial Fractures

• facial fracture
• jaw fracture
• cheekbone fracture
• mandibular fracture
• nose fracture

Fractures of the shoulder, arms, wrists, hands and fingers

• clavicle fracture
• shoulder fracture
• arm fracture
• humerus fracture
          - supracondylar fracture
• elbow fracture
• radius fracture
          - distal radius fracture
• colles fracture (wrist fracture)
• scaphoid fracture (wrist bone fracture)
• smiths fracture (wrist fracture)
• hand fracture 
• navicular fracture (hand)
• thumb fracture
• finger fracture
          - metacarpal fracture
          - bennetts fracture ( carpometacarpal joint: finger)
          - boxer fracture (small finger metacarpal bone)

Fractures of the spine

• compression fracture (of the spine)
• spinal fracture (fractured spine)
• vertebral fracture
• cervical fracture

Fractures of the hips and pelvis

• hip fracture
• femoral neck fracture (leg bone connecting to hip)
• pelvic fracture (pelvis fracture)

Fractures of the legs, knees, and feet

• leg fracture
• femur fracture
• fibula fracture
          - potts fracture
• patella fracture (kneecap)
• knee fracture
• tibia fibula fracture (tib-fib fracture)
• tibia fracture (tibial fracture)
          - pilon fracture (comminuted fracture of the distal tibia)
          - tibial plateau fracture
          - trimalleolar fracture (tibia)
          - bimalleolar fracture
• ankle fracture
• heel fracture/ calcaneus fracture (heel bone fracture)
• foot fracture
• toe fracture
• metatarsal fracture
          - jones fracture - fifth metatarsal of the foot 
          - sesamoid fracture (located under the first metatarsal bone in the foot)
          - lis franc fracture - tarsometatarsal (Lisfranc's) joint
          - metatarsal stress fracture

Special consideration of children and fractures

Because children’s bones are still developing, they are more prone to greenstick and buckle fractures, whereby the bone bows instead of completely breaking. This is good because the bone’s cortex is not typically disrupted. However, fractures in children carry unique risks. Growth plate injuries and plastic deformation are two possible complications of fracture in children.

When the growth plate is affected by fracture, there is a risk of abnormal growth of the bones. Careful treatment and accurate reduction are necessary to make sure the bone continues to grow properly. Plastic deformation, whereby the bone permanently bends but doesn’t break, is another risk with fractures in children. This complication may require a surgery called osteotomy, in which the bone is cut for realignment, when closed realignment strategies have failed.

Special consideration of seniors and fractures

Because of the effects of aging on the bones, fractures can be particularly serious for older individuals. Falls are one of the most common culprits of fractures in seniors. In fact, among Americans over the age of 65, fall-related fractures and injuries are the leading cause of accidental death. Ninety percent of all hip fractures are the result of falls in older individuals.

Falls, which commonly lead to fractures in seniors, can be caused by a loss of footing or traction on unsafe surfaces or tripping due to hazardous conditions. Medications, alcohol use, changes in muscle mass, bone fragility, changes in vision, and other factors can increase the risk of falls and, in some cases, the severity of subsequent injuries. It is important for seniors to speak with their health provider about ways to reduce the risk of falls, which can lead to fractures and other serious injuries.

Diagnosing fractures

In most cases, a person knows when they have suffered a fracture. A snap or cracking sound in the bone is often enough to know that you have broken a bone. Other signs and symptoms of fractures include swelling, tenderness, deformity, or even part of the bone exposed through the skin. While some fractures can be obvious, others are more difficult to diagnose.

Stress fractures, occult fractures, and impacted fractures can be difficult to detect on an x-ray. In some cases, a fracture can be misdiagnosed as another type of fracture or injury, which is more common with spiral vs. oblique fractures, avulsion, and stress fractures.

Physical examination and x-rays are the common ways of diagnosing fractures.

Treatment of Fractures

Time is often the best treatment for stable fractures, in conjunction with devices that correctly position the bone during healing, such as casts, splits, and pins. Casts, made of either fiberglass or plaster, are external devices used to stabilize the area allowing the bone to heal. Casts, splits and other devices may be requires for weeks to months following fracture. Crutches may be used during this time if the affected bone is a weight-bearing bone.

In some cases, internal fixation is necessary to stabilize the bone as it heals. Metal plates, pins, or screws may be used to hold a bone in the proper position as it heals. These are often permanent.

In cases where complications arise or other tissues are affected by the trauma, additional treatments may be necessary, such as surgery. Pain medications or anti-inflammatory drugs are sometimes administered to help a patient reduce their symptoms of pain, particularly in the early stages of recovery.

Recovering from fractures

After a fracture has occurred, the body starts the work of healing. Initially, the body acts to protect the injured area by creating a protective blood clot and callus/fibrous tissue. Then, new threads of bone tissue begin to develop on both sides of the fracture line, growing towards each other. Once the fracture is closed, the callus/fibrous tissue is re-absorbed by the body. Pain typically stops before healing is complete. This process can take several weeks to many months, depending on the type and severity of the fracture and how well a patient follows medical advice.

Activity may still be limited after a cast or brace is removed until the bone is solid enough and the surrounding tissues have healed and become stronger. The tissues surrounding the bone, such as ligaments and muscles, can become stiff or weak during fracture recovery from lack of use. Rehabilitative exercises, including stretches, weight-bearing activities, and other exercises, may be necessary to bring the body back to full health. It is important not to try to rush the healing process, as this can compromise your progress and lead to further injury.

Fractures and liability

When fractures or other serious injuries are the product of a preventable accident, the responsible party can be held liable and the injured party may be able to seek compensation for their damages, including medical expenses, loss of income, and more. If you believe that your injuries are the result of another party’s negligence or wrongdoing, please contact us to speak with a qualified attorney at Oshman & Mirisola to learn more about your legal rights and options.

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For more information, please see our Fractures Frequently Asked Questions.

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