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Bone fracture

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A bone fracture is a medical condition involving a break in the continuity of a bone. This break can be partial or complete.

612 Types of Fractures
612 Types of Fractures

In severe cases, the bone may shatter into several fragments. This specific type is called a comminuted fracture. If the broken bone pierces through the skin, it is known as an open or compound fracture.

Offene Luxation
Offene Luxation

Open fractures carry a higher risk of infection. While closed fractures have an infection rate of 1-2%, open fractures can reach 30%. Most fractures result from high-force impact or stress. However, some occur due to underlying medical conditions. These are called pathologic fractures. Conditions like osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta can weaken bones enough to cause these breaks.

Even though bone tissue itself lacks pain receptors, a fracture is very painful. This pain occurs for several biological reasons. First, the injury often breaks the periosteum. The periosteum is the layer surrounding the bone, and it contains many pain receptors. Second, bleeding in the bone marrow creates a hematoma. This causes swelling, or edema, which creates pressure pain in nearby soft tissues. Third, the body often undergoes involuntary muscle spasms. These spasms attempt to hold the broken bone fragments in place. Finally, the injury may damage adjacent nerves, muscles, or blood vessels. In severe cases, like skull or spine fractures, damage to the spinal cord or cranial contents can occur.

613 Stages of Fracture Repair
613 Stages of Fracture Repair

The body heals a fracture through a specific sequence of steps. The process begins when the injured bone and tissues bleed. This forms a fracture hematoma, which is a blood clot between the fragments. Within a few days, new blood vessels grow into this jelly-like matrix. These vessels bring phagocytes to remove non-viable material. They also bring fibroblasts, which are cells that produce collagen fibers. These cells create a collagen matrix that has a rubbery consistency. This consistency allows the bone fragments to move only slightly. Eventually, bone crystals called calcium hydroxyapatite are deposited into this matrix. This process is called mineralization, and it turns the soft matrix into hard bone.

Healing occurs in progressive stages of development. It starts with the formation of the fracture hematoma. Next, internal and external calli, or bony growths, form around the break. The cartilage within these calli is then replaced by trabecular bone. The final stage is remodeling, where the bone is reshaped. In adults, this new bone usually appears on an X-ray within 6 weeks.

Xraymachine
Xraymachine

This initial bone is called woven bone, which lacks the strength of mature bone. Through remodeling, woven bone is replaced by mature lamellar bone. The entire process can take up to 18 months. However, the strength of the healing bone is usually 80% of normal by 3 months. Factors like adequate nutrition and calcium intake help, while tobacco smoking can hinder the process.

Doctors classify fractures in many systematic ways. They may categorize them by stability, such as stable or unstable fractures. They also look at the fracture pattern. A transverse fracture occurs at a right angle to the bone's long axis. An oblique fracture is diagonal, at an angle greater than 30 degrees. A spiral fracture happens when a bone is twisted. There are also linear fractures, which run parallel to the bone's axis.

Armbreak - Spiral Fracture
Armbreak - Spiral Fracture

Some fractures involve displacement, where the bone pieces shift out of alignment. This includes angulated, rotated, or shortened fractures. An impacted fracture occurs when bone fragments are driven into each other.

Medical professionals use various tools to diagnose these injuries. Physical examinations and patient history are the first steps. Radiographic imaging, such as X-rays, is commonly used to confirm a break.

Xraymachine
Xraymachine

If X-rays are not clear, doctors may use Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). They may also examine nearby joints to rule out dislocations. Proper diagnosis is vital to prevent complications. Complications can be immediate, occurring at the time of injury. They can also be early, occurring in the first few days, or late, occurring much later. These include systemic issues like hypovolemic shock or local issues like infection.

If fractures are not treated correctly, serious long-term issues can arise. One serious condition is compartment syndrome, which may require amputation if untreated. Other complications include non-union, where the bone fails to heal. There is also malunion, where the bone heals in a deformed position. A common form of malunion is malrotation, often seen in femur or tibia fractures. Other issues include avascular necrosis, joint stiffness, or osteoarthritis. Understanding these risks highlights why urgent medical attention is necessary for most bone breaks.

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🖼️ Images & Media (16)
File:Nonunion2010.JPG
Nonunion2010.JPG
File:613 Stages of Fracture Repair.jpg
613 Stages of Fracture Repair.jpg
File:Xraymachine.JPG
Xraymachine.JPG
File:612 Types of Fractures.jpg
612 Types of Fractures.jpg
File:Offene Luxation.jpg
Offene Luxation.jpg
File:Periprosthetic fracture of left femur, case 1, before treatment.jpg
Periprosthetic fracture of left femur,...
File:Laengsfraktur_D4-Endglied_-_Verlauf_25M_-_CR_ap_-_001.jpg
Laengsfraktur_D4-Endglied_-_Verlauf_25M_-_...
File:Kind_of_fractures_-_Closed_fracture_--_Smart-Servier.png
Kind_of_fractures_-_Closed_fracture_--_Sma...
File:Kind of fractures - Oblique -- Smart-Servier.png
Kind of fractures - Oblique -- Smart-Servier.png
File:Armbreak_-_Spiral_Fracture.jpg
Armbreak_-_Spiral_Fracture.jpg
File:Blausen_0250_CompressionFracture_Vertebrae.png
Blausen_0250_CompressionFracture_Vertebrae.png
File:MalletFinger.PNG
MalletFinger.PNG

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