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Fractures - symptoms, description and treatment

Author MUDr. Peter Bednarčík CSc.

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Image: Fractures
Fractures

All of us have probably had the experience of suffering a fracture. A sharp pain after the injury, which increases is typical. Swelling, tingling, deformation or even bleeding are other symptoms. A fracture is painful. It brings many limitations and treatment is lasts weeks.

What to do when a it occurs and what to do to treat and heal it properly? What are the options for controlling symptoms such as pain, swelling or inflammation that accompany this condition? Read more here.

Fracture symptoms

The 6 most common symptoms or how to recognize it:

  • Pain
  • Swelling
  • Bruise
  • Limited mobility
  • Deformity and abnormal position of the limb
  • Bleeding (with open fracture) [1][2]

A patient with a fracture may also experience nausea and dizziness.[3]

Notice

Only a doctor can make a correct diagnosis. Do not use this or any other article on the internet to make a diagnosis. Do not delay seeing  a physician and address your condition early.

Description and causes of fracture

Definition of fracture: disruption of the integrity of a bone
Definition of fracture: disruption of the integrity of a bone

Defining a fracture

It is an injury to a bone that results in its complete or partial rupture. Fractures usually involve bones in the extremities. They can also occur in other parts of the body (for example, the spine, pelvis, or shoulder).[4] The disruption of the integrity of the bone can take many forms – the types of fracture vary depending on where and how the bone broke. [5]

Fractures occur most often in falls, injuries and accidents. Osteoporosis, a disease in which bones thin, can also be a cause. [6] Older age and an unhealthy lifestyle contribute to fractures. [7]

Fracture symptoms - photogallery

Types of fractures

Types of fractures
Types of fractures

Fractures are divided into several groups according to what the fracture site looks like. Where parts of the bone are displaced or whether the bone penetrates through the skin.

  • Closed
    The bone stays under the skin and does not come out of the wound.
  • Open fracture
    The bone penetrates the skin.
  • Dislocated fracture
    Parts of the bone may shift in some fractures – for example, sideways or lengthways.
  • Stess fracture
    It occurs, for example, due to long-term or unilateral stress. Athletes are typical patients with a fatigue fracture.[8]

Fractures can have different fracture lines. The bone may fracture transversely, obliquely or in a spiral. A splinter fracture can also occur.[9]

Risk factors

Densitometry will show the density of bone tissue.
Densitometry will show the density of bone tissue. Picture description: 1 - healthy bone. 2- bone affected by osteoporosis

Osteoporosis (thinning of the bones) is a risk factor for fractures. It mainly affects people over 50 and women in the menopause.

  • Osteoporosis makes bones brittle and more prone to fractures.
  • Regular checking of bone density by densitometry will show the level of risk. Depending on the results of the examination, the doctor can recommend appropriate treatment. [10]

Fracture diagnostics

Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)

Diagnosis begins with a physical examination, during which the doctor examines and palpates the affected area.

  • An X-ray will provide an accurate picture of the fracture.
  • In some cases, magnetic resonance imaging (MRI) or computed tomography (CT) is also used.
  • With these examinations, the doctor gets a detailed overview of the condition of the bone and surrounding tissues. [11]

Did you know?

  • On average, each person suffers two fractures in a lifetime.[12]
  • Most common fracture during working age is a wrist fracture..[13]
  • Fracture of the femur (the longest bone in the body) affects up to 20 people per 100,000 population each year.[14]

Fracture complications

If treatment is not effective, it can cause a number of complications.

  • Setting the bone in the wrong position: Can lead to deformity and limited mobility of the affected body part.
  • Nerve and vascular damage: the nervous or vascular system may be damaged, leading to prolonged pain, numbness .
  • Infection: open fracture  can be a source of infection, which can lead to serious complications leading to sepsis (blood poisoning).
  • Necrosis: If the blood circulation in the affected area is disrupted, bone tissue can be damaged and necrosis (death) of the tissue may occur.
  • Functional limitations: mobility in the affected part of the body may be restricted, which may affect the patient’s overall quality of life.[15]
Limited mobility

Limited mobility

Long-term pain and numbness

Long-term pain and numbness

Infection

Infection

Necrosis

Necrosis

Notice

We recommend not delaying treatment of fractures

Do not delay treatment for a fracture and see a specialist if you have any health problems or doubts about your health. This will prevent unnecessary health complications.

Fracture treatment

External fixation of a broken lower limb
External fixation of a broken lower limb

A broken leg or arm cannot go without treatment. The key is to fixate the fracture to provide rest for healing. Rest and elevated positioning also help to reduce swelling. In some cases, it is necessary to first set the broken bone in the correct position – either by manipulating the limb in the doctor’s office or surgically in the operating room.

  • A plaster cast, splint or brace is used for basic fixation of the fracture.
  • Various metallic materials are used in the surgical immobilisation of the fracture. It is reinforced either externally or internally using screws, wires and other metal devices. [16]
Notice

Beware

Treatment of the fracture can only be determined by your physician after considering your overall health. Therefore, do not use this article as a guide to treatment, which can only be determined by a physician.

Length of fracture healing

Fractured femoral neck
Fractured femoral neck

Each fracture has its own specific procedures for treatment. They also have different healing times.

  • Broken ankle usually requires 6 to 8 weeks of treatment.
  • Fracture of the femoral neck usually cannot be treated without hospital stay and surgery. Treatment can extend for up to several months. [18]
  • Fracture of the clavicle is a common injury and in many cases is treated only with a sling on the arm. More complicated cases requires surgery. [19]
  • Broken ribs usually heal spontaneously within 6 weeks. Patients must observe a resting regime and take care to breathe properly. Analgesics help.[20]
  • Distal radius fracture is very common, especially in the elderly. This is a type of fracture of the bone that is located in the lower part of the forearm and attaches to the bone of the wrist. It can occur as a result of an injury such as a fall on the wrist. Its healing time can generally take 4-6 weeks. If it requires surgical treatment, the healing time is considerably longer.21]
  • Less common fractures include pelvic fractures. Uncomplicated fractures heal without surgery within a few weeks, while serious pelvic fractures are a reason for urgent surgery. [22]

Broken Ankle  – What is Weber Classification?

Patients often ask about Weber classification if they want to better understand their injury. This is used to assess the severity of the ankle fracture and how much the ankle has moved from its original location. It focuses on exactly where it is in relation to the syndesmosis – which is the articulation between two bones in the lower limb.

Ankle fractures according to the Weber classification are divided into three categories, depending on where they are located:
Type A: located below the syndesmosis.
Type B: passes through the syndesmosis.
Type C: located above the syndesmosis.

These three types of fractures can have different consequences and require different treatments. For example, a type C fracture may be the most severe because it may be associated with joint injury and require surgery.[23]

Medication

Analgesics and anti-inflammatory drugs are most commonly used in the treatment of fractures. Analgesics are commonly used drugs to relieve mild to moderate pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are another type of medication that can be used to relieve pain and inflammation.
In some cases, stronger analgesics such as opioids may need to be used if analgesics and NSAIDs are not effective.

First aid for fractures

The principles of first aid for a fracture include:

  • Immobilization of the injured area (do not, however, try to set the broken bones to their original position),
  • stopping bleeding in an open fracture (ideally with a sterile dressing),
  • applying a cold compress to reduce swelling and relieve pain,
  • checking the general condition of the injured person – after a fracture, shock may develop. [24]

If a fractured vertebra is suspected, do not move the injured person. It could cause irreversible changes to the spine and permanent damage to health. [25]

Physical therapy & rehabilitation

Rehabilitation for fractures
Rehabilitation for fractures

Treatment of the fracture is usually followed by physiotherapy. Properly selected exercises will ensure that the weakened muscles in the affected area become strong again.

The goal of rehabilitation is to fully restore mobility and movement. Specific exercises and type of physical therapy will be recommended by the physiotherapist. The length of rehabilitation depends on the type of fracture and the age of the patient. [26]

Nutrition in case of fractures

Treatment of fractures can be supported by a balanced diet rich in calcium, protein and vitamin D.
[27]
On the other hand, you should avoid smoking and excessive alcohol consumption – both of which have a negative impact on bone quality. [28]

Treatment of fractures can be supported by a balanced diet rich in calcium, protein and vitamin D. [27] On the other hand, you should avoid smoking and excessive alcohol consumption, both of which have a negative impact on bone quality. [28]

Fracture prevention

How to prevent fractures? The risk can be reduced primarily by lifestyle choices.

  • Eat foods rich in calcium and protein.
  • Don’t forget the importance of vitamin D, which promotes calcium absorption.
  • Support bone quality and muscle mass with regular physical activity[29]
  • Create a safe home environment to minimise the risk of falls. This advice is especially important for the elderly. [30]
Notice

Important cautions when dealing with a fracture

When treating a fracture, it is necessary to provide immobilization of the broken bone and a resting regimen.

Treatment usually lasts several weeks and is followed by rehabilitation.

Adhere to all recommendations for fracture care, including any check-ups and X-rays.

Summary and recommendations for fractures

1.

See a physician

The treatment of a fracture is always determined by a doctor based on a general examination, an assessment of your condition and an accurate diagnosis.

2.

Causal treatment of fractures

After a general examination, your doctor will recommend treatment for the fracture. In connection with this, they will also recommend possible lifestyle modification and further treatment.

3.

Reducing pain, swelling and promoting healing

Symptomatic treatment focuses on the manifestations or symptoms of the disease. Such treatment can significantly improve your quality of life and support comprehensive treatment as the disease progresses.

Sources, references and literature

[1] Brazier Y. What is a fracture? Medical News Today, 24. August 2021. Available at: https://www.medicalnewstoday.com/articles/173312

[2] Broken bone. MedLine Plus Medical Encyclopedia, 1. January 2022. Available at: https://medlineplus.gov/ency/article/000001.htm

[3] Brazier Y. What is a fracture? Medical News Today, 24. August 2021. Available at: https://www.medicalnewstoday.com/articles/173312

[4] Bone X-ray. RadiologyInfo.org. 15. April 2022. Available at: https://www.radiologyinfo.org/en/info/bonerad

[5] Brazier Y. What is a fracture? Medical News Today, 24. August 2021. Available at: https://www.medicalnewstoday.com/articles/173312

[6] Broken bone. MedLine Plus Medical Encyclopedia, 1. January 2022. Available at: https://medlineplus.gov/ency/article/000001.htm

[7] Once Is Enough: A Guide to Preventing Future Fractures. National Institutes of Health – Osteoporosis and Related Bone Diseases National Resource Center December 2018. Available at: https://www.bones.nih.gov/health-info/bone/osteoporosis/fracture

[8] Brazier Y. What is a fracture? Medical News Today, 24. August 2021. Available at: https://www.medicalnewstoday.com/articles/173312

[9] Fractures. Johns Hopkins Medicine. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/fractures

[10] Once Is Enough: A Guide to Preventing Future Fractures. National Institutes of Health – Osteoporosis and Related Bone Diseases National Resource Center December 2018. Available at: https://www.bones.nih.gov/health-info/bone/osteoporosis/fracture

[11] Fractures. Johns Hopkins Medicine. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/fractures

[12] Arm Injury Statistics. The Ohio State University. Available at: https://u.osu.edu/productdesigngroup3/sample-page/

[13] Arm Injury Statistics. The Ohio State University. Available at: https://u.osu.edu/productdesigngroup3/sample-page/

[14] Denisiuk M., Afsari A. Femoral Shaft Fractures. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK556057/

[15] Brazier Y. What is a fracture? Medical News Today, 24. August 2021. Available at: https://www.medicalnewstoday.com/articles/173312

[16] Brazier Y. What is a fracture? Medical News Today, 24. August 2021. Available at: https://www.medicalnewstoday.com/articles/173312

[17] Broken ankle. NHS, 11. March 2022. Available at: https://www.nhs.uk/conditions/broken-ankle/

[18] Broken hip. NHS, 8. February 2023. Available at: https://www.nhs.uk/conditions/broken-hip/

[19] Clavicle Fracture (Broken Collarbone). OrthoInfo, April 2022. Available at: https://orthoinfo.aaos.org/en/diseases–conditions/clavicle-fracture-broken-collarbone/

[20] Broken ribs. Mayo Clinic, 15. February 2023. Available at: https://www.mayoclinic.org/diseases-conditions/broken-ribs/diagnosis-treatment/drc-20350769

[21] Fractures of the distal end of the forearm. MUDr. Vlastimil Volf SANQUIS No.25/2003, p. 28. Available at: https://www.sanquis.cz/index2.php?linkID=art654

[22] Pelvic Fracture. Cedars-Sinai. Available at: https://www.cedars-sinai.org/health-library/diseases-and-conditions/p/pelvic-fracture.html

[23] How to recognize a broken ankle and what are the treatment options? MUDr. Michal Vilímovský, August 2022. Available at: https://cs.medlicker.com/2137-zlomeny-kotnik

[24] Fractures (broken bones): First aid. Mayo Clinic, 22. March 2022. Available at: https://www.mayoclinic.org/first-aid/first-aid-fractures/basics/ART-20056641?p=1

[25] Spinal Injury: First aid. Mayo Clinic, 2. February 2023. Available at: https://www.mayoclinic.org/first-aid/first-aid-spinal-injury/basics/art-20056677

[26] Brazier Y. What is a fracture? Medical News Today, 24. August 2021. Available at: https://www.medicalnewstoday.com/articles/173312

[27] Once Is Enough: A Guide to Preventing Future Fractures. National Institutes of Health – Osteoporosis and Related Bone Diseases National Resource Center December 2018. Available at: https://www.bones.nih.gov/health-info/bone/osteoporosis/fracture

[28] Brazier Y. What is a fracture? Medical News Today, 24. August 2021. Available at: https://www.medicalnewstoday.com/articles/173312

[29]Brazier Y. What is a fracture? Medical News Today, 24. August 2021. Available at: https://www.medicalnewstoday.com/articles/173312

[30] Once Is Enough: A Guide to Preventing Future Fractures. National Institutes of Health – Osteoporosis and Related Bone Diseases National Resource Center December 2018. Available at: https://www.bones.nih.gov/health-info/bone/osteoporosis/fracture

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