The term "fracture" means a broken bone. A bone can break completely or just partially, and this usually happens due to an injury from a fall, a car accident, or participation in sports. In older people, bones can become thinner because of a condition called osteoporosis, making them more likely to break. Athletes often suffer from stress fractures, which are caused by overuse of the bones.
Types of fractures include:
- Simple fractures occur when broken bone pieces remain properly aligned, stable, and maintain structural integrity.
- Unstable fractures occur when the pieces of the broken bone are not properly aligned and have moved out of place.
- Open fractures occur when the broken bones pierce through the skin, making them a serious type of injury. These fractures carry a higher risk of infection and need urgent medical care.
- Greenstick fractures: This is a unique fracture in children that involves bending of one side of the bone without any break in the bone.
Fracture Healing
When a bone breaks, the body responds by creating a blood clot and a layer of fibrous tissue to shield the damaged area. Bone-forming cells start developing on both sides of the fracture. These cells gradually move toward each other, eventually bringing the broken parts of the bone together and closing the fracture.
Medical Therapy
The main goal of early fracture treatment is to stop bleeding, avoid damage to the blood supply that can lead to bone death, and eliminate infection sources like foreign objects and dead tissue. After this, the next step is to realign the broken bone and keep it in the correct position. It is crucial to make sure that the affected part of the body can work normally once the fracture has healed. This is done by keeping the bone in place using either a non-surgical or surgical method.
Non-operative (closed) therapy comprises of casting and traction(skin and skeletal traction).
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Casting
Closed reduction is performed on fractures that are displaced, shortened, or angulated. Splints and casts made from fiberglass or plaster of Paris are used to keep the limb in place and prevent movement. -
Traction
Traction is a technique used to manage fractures and dislocations when casting is not a suitable treatment. There are two types of traction: skin traction and skeletal traction.
Skin traction is a method where special tapes are attached to the skin on the part of the limb that is below the broken bone. In skeletal traction, a small pin is placed through the bone that is located further away from the break. A weight is then connected to this pin, and the patient is positioned in a device that helps apply the pulling force. This technique is frequently used when there is a fracture in the thigh bone.
Surgical Therapy
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Open Reduction and Internal Fixation (ORIF)
This is a type of surgery where the broken bone area is properly exposed, and the fractured pieces are realigned. To stabilize the bone, internal fixation is performed using tools like Kirschner wires, plates and screws, or intramedullary nails. -
External fixation
External fixation is a method used to stabilize a broken bone froma location away from the actual break. This technique helps keep the bone properly aligned and maintains its correct length without the need for a cast.
External fixation is performed in the following conditions:
- Open fractures with soft-tissue involvement
- Burns and soft tissue injuries
- Pelvic fractures
- Comminuted and unstable fractures
- Fractures having bony deficits
- Limb-lengthening procedures
- Fractures with infection or nonunion
Rehabilitation
Fractures can take several weeks or even months to fully heal. Even after the cast or brace is removed, you should continue to limit your activities to allow the bone to become strong enough to handle stress. A rehabilitation program includes exercises and a slow increase in physical activity until the healing process is complete.
