Common Fractures
Common Fractures
A bone fracture may indicate that a bone is cracked or completely broken through. Fractures can be caused by:
- An impact, such as a car accident or a fall (one of the most common causes)
- A torsion with extreme pressure (planting one foot and pivoting sharply around it at speed)
- Overuse or repetitive motions (typically seen in athletes)
- As the result of osteoporosis which causes thinning bones (associated with aging)
The steps to follow in case of a fracture include:
- Control any bleeding
- Prevent bone (ischemic) death
- Remove foreign bodies and dead tissue
- Treat to reduce the risk of infection
- Reduce the fracture (put bones back in proper alignment)
- Immobilize the fracture
The type of fracture will dictate treatment. There are several different types of fractures.
Greenstick fractures
Children’s bones are flexible, and can sometimes bend without breaking like a green twig on a tree. Splinting and casting can usually encourage the bone to return to its former straightness.
Simple fractures
If pieces of a fractured bone are stable and well aligned, minimal intervention is needed. Casting is the typical treatment for simple fractures, followed by a sling and brace if necessary during rehabilitation.
Unstable fractures
If fragments of the broken bone have been shifted out of position or moved significantly out of place, more intervention is necessary. A closed reduction may be used to help the bones shift into place. Realignment of the bones is followed by splinting and casting.
Compound fractures
If bone is sticking through the skin, the risk of infection is significantly increased, and immediate medical intervention is required. An open reduction allows access to the fracture, and internal fixation can be applied with wires, screws, nails, and metal plates to stabilize the break. Traction may be required before or after surgery
- Skin traction is achieved with the use of special tape applied and tensioned below the break to gently move the bone
- Skeletal traction involves the insertion of a pin, and the limb being suspended so the body’s weight moves the bone (typically used for thighbone fractures)
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Fracture healing
When a bone is broken, the body immediately works to form a clot and prevent leakage from the fracture. Callus of fibrous tissue is also formed to protect the ends of the bone while they grow back together. Each end of the broken bone creates new cells which grow from the fractured ends towards the meeting point to heal the fracture.
If the bone broken is difficult to stabilize, or there is soft tissue injury to work around, external fixation may be used. This helps immobilize the joint from a short distance away from the fracture, so the fixation doesn’t cause unnecessary trauma to injured tissue.
Depending on the severity of the fracture and damage to the surrounding tissues, a fracture can take anywhere from a few weeks to a few months to heal completely. Dr. Strasburger will lay out a recovery plan that is designed to restore your mobility, flexibility, and strength. Total rehabilitation can be attained with strict adherence to restriction on activity until healing is complete.