Fractures - symptoms, description and treatment

Definition of fracture

A fracture (also called a fracture) is an injury to a bone that results in its complete or partial rupture. Fractures usually involve bones in the limbs. They can also occur in other parts of the body (for example, the spine, pelvis or shoulder) ^[4 ] Bone fractures 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. It can also be caused by osteoporosis, a disease in which bones thin. ^[6 ] Older age and an unhealthy lifestyle contribute to fractures. ^[7]

They divide into several groups according to what the fracture point looks like. Where parts of the bone will shift or whether the bone will penetrate 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.
• Fatigue fracture
  It occurs, for example, due to long-term or unilateral stress. The typical patient with a fatigue fracture are athletes.^[8]

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

Risk factor for fractures is osteoporosis (thinning of the bones). It mainly affects people over 50 years of age and menopausal women.

• 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]

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

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

A broken leg or arm cannot go without treatment. The key is strengthening (fixation), which will provide rest for healing. Resting and elevated positioning also contribute to reducing swelling. In some cases, it is necessary to first put the broken bones in the correct position – either by manipulating the limb in the doctor’s office or surgically in the operating room.

• A cast, splint or brace is used to fix the fracture.
• Various metallic materials are used in the surgical immobilisation of the fracture. It is reinforced either from the outside or from the inside using screws, wires and other metal tools. ^[16]

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

• A broken ankle usually requires 6 to 8 weeks of treatment.^[17]
• A fracture of the femoral neck usually cannot be treated in hospital without surgery. Treatment can take up to several months. ^[18]
• A fractured collarbone is a common injury and in many cases is treated with just a sling on the arm. More complicated requires surgery. ^[19]
• Broken ribs usually heal spontaneously within 6 weeks. Patients must observe a resting regime and take care to breathe properly. Painkillers help with this.^[20]
• Distal radius fracture is very common, especially in the elderly. This is a type of bone fracture that is located in the lower part of the forearm and attaches to the wrist bone. 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 significantly longer.^[21]
• Less common fractures include pelvic fractures. Uncomplicated ones heal without surgery within a few weeks, while serious pelvic fractures are a reason for urgent surgery. ^[22]

Broken ankle – What is the Weber classification ?

Patients often ask about Weber’s 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 where exactly it is located in relation to the so-called. syndesmosis – which is a joint connection between two bones in the lower leg.

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: undergoes 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 as it may be associated with joint injury and require surgery.^[23]

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

The goal of rehabilitation is to fully restore mobility and momentum. 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]