Continuity of the Bone is Broken

Overview

Illustrated comparison of different types of bone fractures — Bone fractures are classified by their pattern, cause and where they happen in your body.

What is a bone fracture?

A bone fracture is the medical definition for a broken bone.

Fractures are usually caused by traumas like falls, car accidents or sports injuries. But some medical conditions and repetitive forces (like running) can increase your risk for experiencing certain types of fractures.

If you break a bone, you might need surgery to repair it. Some people only need a splint, cast, brace or sling for their bone to heal. How long it takes to recover fully depends on which of your bones are fractured, where the fracture is and what caused it.

Bone fracture vs. break

Bone fractures and broken bones are the same injury and mean the same thing. You might see them used interchangeably. A fracture is the medical term for a broken bone, so your healthcare provider will probably refer to your broken bone as a certain type of fracture after they diagnose it.

Bone fracture vs. bone bruise

Bone fractures and bone bruises are both painful injuries caused by a strong force hitting your body — usually a fall, car accident or sports injury. The difference is how damaged your bone is.

Your bones are living tissue that can get bruised in lots of the same ways your skin can. It takes much more force to bruise a bone than it does your skin, but the injury is very similar. If something hits your bones with enough force, they can bleed without being broken. Blood trapped under the surface of your bone after an injury is a bone bruise.

A bone fracture happens when something hits your bone with enough force not only to damage it, but to break it in at least one place. Fractures are more serious injuries and can take much longer to heal than bone bruises.

If you've experienced a trauma and have pain on or near a bone, go to the emergency room or visit your provider as soon as possible. No matter which injury you have, it's important to get your bone examined right away.

Bone fractures vs. sprains

Bone fractures and sprains are common sports injuries.

If you experience a bone fracture, you've broken one or more of your bones. You can't sprain a bone. A sprain happens when one of your ligaments is stretched or torn.

It's possible to experience a bone fracture and a ligament sprain during the same injury, especially if you damage a joint like your knee or elbow.

What are the different types of bone fractures?

There are many different types of fractures. Your provider will diagnose a specific fracture type depending on a few criteria, including its:

Pattern: A fracture pattern is the medical term for the shape of a break or what it looks like.
Cause: Some fractures are classified by how they happen.
Body part: Where in your body your broke a bone.

Fractures diagnosed by pattern or shape

Some fractures are classified by their pattern. This can either be the direction a break goes (if it's a straight light across your bone) or its shape (if it's more than a single line break).

Fractures that have a single straight-line break include:

Oblique fractures.
Transverse fractures.
Longitudinal fractures (breaks that happen along the length of the bone).

Fracture patterns that don't break your bone in a single straight line include:

Greenstick fractures.
Comminuted fractures.
Segmental fractures.
Spiral fractures.

Fractures diagnosed by cause

A few types of fractures are named or classified by what causes them. These include:

Stress fractures (sometimes referred to as hairline fractures).
Avulsion fractures.
Buckle fractures (sometimes referred to as torus or impacted fractures).

Fractures diagnosed by location

Lots of fractures are specific to where they happen in your body. In some cases, it's possible to experience a location-based fracture that's also one of the other types listed above. For example, someone who experiences a severe fall might have a comminuted tibia (shin bone) fracture.

Fractures that affect people's chest, arms and upper body include:

Clavicle fractures (broken collarbones).
Shoulder fractures.
Humerus (upper arm bone) fractures.
Elbow fractures.
Rib fractures.
Compression fractures.
Facial fractures.

Some fractures that can affect your hands or wrists include:

Barton fractures.
Chauffeur fractures.
Colles fractures.
Smith fractures.
Scaphoid fractures.
Metacarpal fractures (breaking any of the bones in your hand that connect your wrist to your fingers).

Fractures that damage the bones in your lower body and legs include:

Pelvic fractures.
Acetabular fractures.
Hip fractures.
Femur fractures.
Patella fractures.
Growth plate fractures.
Tibia (your shin bone) and fibula (your calf bone) fractures.

Fractures that affect your feet and ankles are more likely to have complications like nonunion. They include:

Calcaneal stress fractures.
Fifth metatarsal fractures.
Jones fractures.
Lisfranc fractures.
Talus fractures.
Trimalleolar fractures.
Pilon fractures.

Open vs. closed fractures

Your provider will classify your fracture as either open or closed. If you have an open fracture, your bone breaks through your skin. Open fractures are sometimes referred to as compound fractures. Open fractures usually take longer to heal and have an increased risk of infections and other complications. Closed fractures are still serious, but your bone doesn't push through your skin.

Displaced vs. non displaced fractures

Displaced or non-displaced are more words your provider will use to describe your fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke. Non-displaced fractures are still broken bones, but the pieces weren't moved far enough during the break to be out of alignment. Displaced fractures are much more likely to require surgery to repair.

Who gets bone fractures?

Bone fractures can affect anyone. Because they're usually caused by traumas like falls, car accidents or sports injuries, it's hard to know when someone will break a bone.

You're more likely to experience a fracture if your bones are weakened by osteoporosis.

Osteoporosis

Osteoporosis weakens bones, making them more susceptible to sudden and unexpected fractures. Many people don't know they have osteoporosis until after it causes them to break a bone. There usually aren't obvious symptoms.

People assigned female at birth and adults older than 50 have an increased risk for developing osteoporosis. Talk to your provider about a bone density screening that can catch osteoporosis before it causes a fracture.

How common are bone fractures?

Bone fractures are a common injury. Millions of people break a bone every year.

Symptoms and Causes

What are the symptoms of a bone fracture?

Symptoms of bone fractures include:

Pain.
Swelling.
Tenderness.
Inability to move a part of your body like you usually can.
Bruising or discoloration.
A deformity or bump that's not usually on your body.

What causes bone fractures?

Bone fractures are almost always caused by traumas. Anything that hits one of your bones with enough force can break it. Some of the most common causes include:

Car accidents.
Falls.
Sports injuries.

Sometimes you can fracture a bone without experiencing a trauma. Repetitive forces — like running or practicing a sport — can cause stress fractures. Similarly, repeating one movement or motion constantly over a long period of time can lead to overuse syndrome in your hands and arms. If you play an instrument or use your hands in the same way every day at work you're more likely to develop a stress fracture.

Your risk of experiencing a fracture is greatly increased if you have osteoporosis. Osteoporosis causes more than one million fractures each year.

Diagnosis and Tests

How are bone fractures diagnosed?

Your provider will diagnose a bone fracture with a physical exam and imaging tests. In some cases, this may be done in the emergency room if you're admitted after a trauma.

If you're taken to the ER, a team of providers stabilize you and treat your injuries in the order of severity, especially if some are life-threatening. After you're stabilized, you will need imaging tests to confirm any fractures.

What tests are done to diagnose bone fractures?

You'll need at least one of a few imaging tests to take pictures of your fracture:

X-rays: An X-ray will confirm any fractures, and show how damaged your bones are.
Magnetic Resonance Imaging (MRI) : Your provider might use an MRI to get a complete picture of the damage to your bones and the area around them. An MRI will show tissue like cartilage and ligaments around your bones too.
CT scan : A CT scan will give your provider or surgeon a more detailed picture of your bones and the surrounding tissue than an X-ray.
Bone scan: Healthcare providers use a bone scan to find fractures that don't show up on an X-ray. This scan takes longer — usually two visits four hours apart — but it can help find some fractures.

Management and Treatment

How are bone fractures treated?

How your fracture is treated depends on which type it is, what caused it and how damaged your bones are.

Immobilization

If your fracture is mild and your bones did not move far out of place (if it's non-displaced), you might only need a splint or cast. Splinting usually lasts for three to five weeks. If you need a cast, it will likely be for longer, typically six to eight weeks. In both cases you'll likely need follow up X-rays to make sure your bones are healing correctly.

Closed reduction

More severe breaks require a closed reduction to set (realign) your bones. During this non-surgical procedure, your provider will physically push and pull your body on the outside to line up your broken bones inside you. To prevent you from feeling pain during the procedure you'll receive one of the following:

Local anesthetic to numb the area around your fracture.
Sedatives to relax your whole body.
General anesthesia to make you sleep through the procedure.

After the closed reduction, your provider will put you in a splint or cast.

Bone fracture surgery

Some bone fractures require surgery. Depending on which type of fracture you have — and how badly your bones are damaged — there are few techniques your surgeon might use.

Internal fixation

Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what's called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. You'll need to limit how much you use that part of your body to make sure your bone can fully heal.

Internal fixation techniques include:

Rods: A rod inserted through the center of your bone that runs from top-to-bottom.
Plates and screws: Metal plates screwed into your bone to hold the pieces together in place.
Pins and wires: Pins and wires hold pieces of bone in place that are too small for other fasteners. They're typically used at the same time as either rods or plates.

Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.

External fixation

You might need an external fixation. Your surgeon will put screws in your bone on either side of the fracture inside your body then connect them to a brace or bracket around the bone outside your body. This is usually a temporary way to stabilize your fracture and give it time to begin healing before you have an internal fixation.

Arthroplasty

If you fracture a joint (like your shoulder, elbow or knee) you might need an arthroplasty (joint replacement). Your surgeon will remove the damaged joint and replace it with an artificial joint. The artificial joint (prosthesis) can be metal, ceramic or heavy-duty plastic. The new joint will look like your natural joint and move in a similar way.

Bone grafting

You might need bone grafting if your fracture is severely displaced or if your bone isn't healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they'll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:

Internally from somewhere else in your body — usually the top of your hip bone.
An external donor.
An artificial replacement piece.

After your surgery, your bone will be immobilized. You'll need some combination of a splint, cast, brace or sling before you can start using it like you did before your fracture.

Complications of bone fracture treatment

Fracture surgery complications include:

Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.
Malunion: This happens when your broken bones don't line up correctly while they heal.
Nonunion: Your bones may not grow back together fully or at all.
Bone infection (osteomyelitis): If you have an open fracture (the bone breaks through your skin) you have an increased risk of bacterial infection.
Other internal damage: Fractures can damage the area around the injury including your muscles, nerves, blood vessels, tendons and ligaments.

What medications are used to treat bone fractures?

Over-the-counter NSAIDs like aspirin or ibuprofen can lead to bleeding and other complications after a surgery. Your surgeon will talk to you about the medications you can take to reduce pain after your surgery.

NSAID side effects

Side effects of NSAIDs include:

Bleeding.
Ulcers.
Stomach pain.
Bowel complications.

How long does it take bone fractures to heal?

How long it takes a bone fracture to heal depends on a few factors, including:

What caused it.
Which bone is broken.
Which type of fracture it is.
Which treatment(s) you need.
Any other injuries you experienced.

Depending on which type of immobilization or surgery you needed to repair your fracture, you should be able to start moving again in a few weeks. More severe fractures can take a year or more to heal.

Talk to your provider or surgeon about what to expect while you're recovering.

Contact your provider right away if you experience intense pain that doesn't get better.

Prevention

How can I reduce my risk for bone fractures?

Follow these general safety tips to reduce your risk of an injury:

Always wear your seatbelt.
Wear the right protective equipment for all activities and sports.
Make sure your home and workspace are free from clutter that could trip you or others.
Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
Follow a diet and exercise plan that will help you maintain good bone health.
Talk to your provider about a bone density test if you're older than 50 or if you have a family history of osteoporosis.
Use your cane or walker if you have difficulty walking or have an increased risk for falls.

Outlook / Prognosis

What can I expect if I have a bone fracture?

Most people who break a bone make a full recovery and can resume their typical routine after their bone heals. Some fractures can have a long-term impact on your life, especially if you experienced other injuries. Talk to your surgeon or provider before resuming any physical activities or playing sports while you're recovering.

Living With

When should I go to the emergency room?

Go to the emergency room right away if you've experienced a trauma.

If you think you have a bone fracture, you need to see a healthcare provider as soon as possible. Go to the emergency room if you experience any of the following:

Intense pain.
You can't move a part of your body like you usually can.
A part of your body is noticeably different looking or out of its usual place.
You can see your bone through your skin.
Swelling.
New bruising that appears at the same time as any of these other symptoms.

Can bone fractures cause fevers?

Bone fractures themselves don't cause fevers. However, if you have a fever, or the area around your broken bone feels warm or hot go to the emergency room. This can be a sign of a serious infection that needs to be examined by a provider right away.

What questions should I ask my doctor?

What type of fracture do I have?
Will I need surgery?
How long will it take to recover?
When can I resume physical activities or play sports?

A note from Cleveland Clinic

Even though bone fractures are common injuries, they're still scary to experience. If you break a bone, talk to your provider or surgeon about what to expect. Most people who break a bone make full recoveries and can return to their pre-injury routine and activities with no long-term impacts.

Don't rush your recovery. Giving your body the time it needs to get better can be frustrating, but it's the best way to make sure you don't re-injure your bone while it heals.

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Source: https://my.clevelandclinic.org/health/diseases/15241-bone-fractures