Fractures

Bones make up the skeleton of the body. They allow us the ability to interact with our environment and lift our body against gravity. Bones are attachment points for muscles, which will enable us to run, jump, sit, kneel, grasp, and lift. Bones also protect organs from potential damage. The bone marrow (tissue inside of bones) is responsible for blood cell production.

Bones are the body’s storage area for calcium. On a cellular level, calcium is always entering and exiting bone under the influence of the body’s hormones. Parathyroid hormone increases calcium levels in the bloodstream, meaning that it regulates its release by bone and decreasing bone density. Calcitonin decreases blood calcium levels and helps restore calcium to bone. Calcium is needed in the bloodstream to allow muscle cells, including the heart, to function. Hormone levels will sacrifice calcium in the bone to maintain blood calcium levels in a normal range. For that reason, calcium and Vitamin D are essential to maintain calcium stores in the body.

Causes of Broken Bones

When a bone has an outside force exerted upon it, like a blow or a fall, there is potential that it cannot withstand the amount of pressure, and it breaks. That loss of integrity results in a fracture. It is important to remember that a fracture, break, or crack all describe the same situation, an injury to the bone where it has been damaged. One term is not more severe than another. Fracture, break and crack all mean the same thing.

Depending upon the situation, the amount of force required may not be very significant. For people with osteoporosis, the bones lack calcium and are brittle; a minor injury or even gravity may create enough force to cause a vertebral compression fracture of the back of a hip fracture.

Fracture

What are the three common causes of bone fractures?

  • Trauma: This includes falls, twisting injuries, sports injuries, car accidents, or even fights.
  • Medical conditions that weaken the bone include osteoporosis, infections, osteogenesis imperfecta, chronic steroid use, or tumors that occur in bones.
  • Overuse injuries: Commonly seen in athletes, stress fractures (non-displaced hairline cracks in the bone) result from repetitive motions and repeated stresses on the bone.

Most common types of Broken Bones

Bone Fractures Illustration – Fracture of Bone

Fractures are usually described by their location, how the bones are aligned, whether associated complications with blood and nerve function, and whether the skin is intact at the injury site.

The terms and definitions used in medicine to describe fractures allow health care professionals to precisely explain where the fracture is located in the bone. For a reference point, the heart is considered the center of the body. The anatomic descriptions are based on their location about the heart. When describing a place on or in the body, imagine standing straight up, looking forward with the arms slightly away from your side, and the palms turned forward.

Standard anatomic terms used to describe fractures include the following:

  • Proximal (closer to the center of the body) and Distal (further from the center): the elbow is proximal to the wrist, and the wrist is distal to the elbow.
  • Anterior (toward the front of the body) and Posterior (toward the back): The chest is anterior to the back, and the back is posterior to the chest.
  • Medial (toward the middle of the body) and Lateral (to the outer edge of the body): The ears are lateral to the nose, and the nose is medial to the ears.

By thinking of the body in the anatomic position, fractures can be described by their bone location and how the parts are aligned and related to each other. Fractures are either displaced or non-displaced, meaning that they are adequately aligned or not. Some physicians suggest that all fractures have some displacement and prefer the term “minimally displaced.”

The description of the fracture also includes the direction it takes within the bones.

  • Transverse: the fracture travels across the bone
  • Oblique: the fracture occurs at an angle
  • Spiral: –the fracture spirals or extends down the length of the bone
  • Comminuted: the fracture has more than two parts; multiple fragments are present.

Special terms:

  • Greenstick: In young children, the bones are not yet stable, and when force is applied, it tends to bow and not break completely through. The term comes from a similar situation when trying to break a young branch off a tree.
  • Torus: In children, when only one part of bone buckles, it is called a torus or incomplete fracture.
  • Open fracture: An open fracture describes the situation where the bone penetrates through the skin.
  • The skin is significant in protecting the inside of the body from infection. Suppose the skin overlying a broken bone is damaged. In that case, whether it is cut, torn, or scraped, there is potential for bacteria from the outside world to invade the broken bone and cause an infection.

Fractures are classified as open (if the skin is damaged) or closed (if the skin is intact). An open fracture may require an orthopedic surgeon to wash out the fracture site to prevent osteomyelitis (bone infection). Depending upon circumstances, the type of fracture, the amount of contamination to the skin and wound, and the person’s condition, this procedure may occur in the operating room.