Call for appointments
Hospital Location:
101-102, Manisha Heights
Balrajeshwar Road
Mulund - West
Mumbai 400080

A fracture is a break (crack) in the continuity of any bone in the body.

Fractures
What is a fracture?

A fracture is a break (crack) in the continuity of any bone in the body. The different kinds of fracture are:

  1. Closed – When the fractured bones ends do not penetrate or protrude through the overlying skin
  2. Open (Compound) – When the fractured bone ends penetrate or protrude through the overlying skin, or there is some wound which exposes the fractured bone ends to outside air and atmosphere.

Common types of Fractures

  • Greenstick fracture: When only one side of the tubular bone is broken and the other side is intact or bent but not broken. Like when we try to break a green plant twig. It is seen in children.
  • Transverse fracture: When the bone is broken into two large pieces in a horizontal line that is perpendicular to the surface of the bone cortex and also the length of the bone.
  • Oblique fracture: When the bone is broken into two large pieces in a line that is less than a 90° angle to the surface of the bone cortex and the length of the bone
  • Spiral fracture: When the line of the fracture forms a spiral line along the surface of the bone cortex and the length of the bone.
  • Comminuted fracture: When the bone is in broken in multiple pieces in multiple directions and does not conform to transverse, oblique or spiral fracture.
  • Avulsion or Chip fracture: When a small piece of bone is broken away from the main bone and stays close to the main bone by means of surrounding soft tissues like muscles, ligaments or tendons.
  • Compression fracture: When the bone ends after fracturing impact into each other and the bone seems compressed as compared to its original architecture.
  • Intra-articular fracture: When the fracture line and fractured bone extends into the joint and disrupts the joint line. These fractures necessitate operative treatment.
  • Growth plate fracture (Physeal injury): When fracture occurs through the growing end (Growth plate) in a child.
  • Stress fracture: When fracture occurs due to overuse rather than a single traumatic incident.
  • Pathological fracture: When fracture occurs in an already diseased or weakened bone even after a trivial force or injury. It is seen in old age ad several medical conditions specially cancer.

Causes

Fractures are caused by trauma to the bone. Trauma is a physical force applied to the bone. Fracture occurs when the traumatic force (physical force) that is applied to the bone exceeds the forces that the bone can withstand. Different types of traumatic forces are – falls, twists, sprains, direct hit with objects, collisions, vehicular accidents.
Several factors increase the risk of fracture namely:

  • Increased age. Osteoporosis —decreased bone mass which weakens bones and affects both men and women is the most common cause in aged adults.
  • Postmenopause
  • Decreased muscle mass
  • Certain medication used to treat type 2 diabetes and some cardiac conditions ( heart ailments)
  • Accidents or violence
  • Overzealous sporting activities
  • Malnutrition
  • Certain chronic diseases. This also includes metastatic cancer (cancer spreading to bones).
  • Child abuse, also known as battered baby syndrome
  • Conditions that increase the risk of falls, such as nerve or muscle disorders
  • Some congenital bone conditions which weaken the bone.
  • Infections or tumours affecting the bone.

Symptoms

Symptoms of a fracture include:

  • Pain, often severe
  • Deformity (Instability) of the area around the break
  • Inability to use the limb or affected area normally
  • Swelling or bruising
  • Numbness
  • Fainting when the pain is severe and in some cases it occurs with blackouts

Diagnosis

The doctor will ask about your symptoms and how you injured yourself. The doctor will examine the injured area. Images shall be taken of the affected structures. This can be done with:

  1. X-rays
  2. CT scan
  3. MRI scan

Treatment

Treatment involves:

  1. First Aid: the doctor shall splint the fracture area using appropriate devices as the case may be so that relative movement between two fractured bone ends does not occur. This is a very important step in management and alleviates pain substantially often to a negligible level.
  2. Goal: the goal of treatment is union of the fractured bone.
  3. Methodology: This is achieved by keeping the bone pieces in close proximity to each other in such a way that they do not rub against each other causing pain and providing healthy atmosphere and nutrition around the fracture so that the fractured bone heals and unites. This can be achieved either by surgery (Open Reduction and Internal Fixation) or non surgically by applying plaster casts or synthetic tapes (Closed reduction and casting). Anaesthesia is usually deployed to achieve optimum results. However, in some cases casts can be applied without anesthesia and optimum results achieved. Devices used to hold the bone together after surgery include – metal pins, metal wires, screw plate construct, rod screw construct, etc.Please discuss with your doctor before making appropriate decisions.
  4. Healing: the average healing time ranges from 3 to 6 or 8 weeks. During this time the bone heals reasonably to carry out activites of daily living and undergo rehabilitation and physiotherapy. However, the process of strengthening and remodeling continues upto 9 months and during such time it is important to prevent the bone from excessive use, heavy weights and un natural forces or loading.
  5. Physiotherapy and Rehabilitation: exercises are designed to regain muscle strength and joint motion with return to full activity in the shortest possible time.

Complications

With modern day medical care complications occur very rarely. A possible list includes -

  1. Delayed union — the fracture takes longer than usual to heal (unite), but does heal with protracted treatment.
  2. Nonunion — the fractured bone does not heal (unite) and needs some special treatment to induce healing. Usually surgery in the form of adding bone at the fracture area – Bone Grafting from elsewhere in the body with or without additional procedures is needed.
  3. Infection — this is more likely to happen after an open fracture or surgery. The fracture generally does not heal. Infection needs to be managed appropriately along with Non Union or delayed union.
  4. Nerve or artery damage — this usually occurs as a result of severe crushing or penetrating injury or trauma. Rarely it occurs after surgery for fractures.
  5. Compartment syndrome — it is a condition when the traumatized limb develops massive and severe swelling in the muscle spaces of the limbs causing damage to body tissues – muscles, blood vessels and nerves. This is usually a result of severe crushing trauma I closed fractures like the limb getting entrapped under heavy loads at the time of injury.
  6. Late arthritis — this happens when the surface of a joint is so badly damaged in intra articular fractures that surgery cannot restore the congruency of the joint surfaces.

Prevention

As such fractures occurs due to accidents and trauma or overzealous sports, so only one should avoid indulging in such activities and avoiding potentially dangerous situation which predispose one to trauma or injury.. Fractures that are pathological (occur in diseased bones) would need concomitant treatment for the co morbid medical condition appropriately.

As such fractures occurs due to accidents and trauma or overzealous sports, so only one should avoid indulging in such activities and avoiding potentially dangerous situation which predispose one to trauma or injury.. Fractures that are pathological (occur in diseased bones) would need concomitant treatment for the co morbid medical condition appropriately.

Upcoming Events!

  • Coming Soon Restoring Mobility Camp
  • Coming Soon Restoring Sight Camp