Bone Fractures: Causes and Symptoms

'Fracture' is a medical term for a broken bone. According to an estimate, an average person has two fractures within their lifetime. When a force exerted is stronger than the bone itself, it can lead to a fracture. The risk and chance of fracture depend on your age. With age, bones tend to become brittle and, hence, a fall that would have been potentially harmless years ago can lead to a broken bone at a later age.

There are many types of bone fractures, but the main types are:

Closed fracture: A fracture in which the bone breaks but does not tear through the skin

Open fracture: Where the broken bone punctures through the skin and protrudes out. There's a greater chance of bone infection in an open fracture

Displaced fracture: In this type of fracture the bone snaps into more than two parts

Nondisplaced fracture: The bone cracks partly or wholly but it does continue to move

Some of the common signs and symptoms of a fracture are:

- Bruising and swelling of the bones
- Open fractures marked by protruding bones from the skin
- Loss of locomotive and functional ability of the injured area
- Deformity of the injured area
- Pain in the event of movement of the injured area

A fracture can be caused by a number of reasons, and they are:

- Injuries and accidents
- Falls and slips
- Wear and tear through overuse
- Sport injuries
- Fist fights and brawls
- Osteoporosis (a disease which causes bones to weaken in adults)
- Osteomalacia ( a disease caused due to softening of your bones, which is caused by a vitamin D deficiency.) Soft bones are more likely to bow and fracture than are harder, healthy bones.

Note:

Osteomalacia is not the same as osteoporosis. Osteomalacia occurs due to a defect in the bone-building process while osteoporosis develops due to a weakening of existing bones.



Bone Fractures: Causes and Symptoms

A small piece of bone is known as a fragment and it is very common that an avulsion fracture also tends to damage the protrusions of bone to which the tendons attach. This basically means that the tendon or ligament will come away from the bone and it will take a small piece of bone with it. It is sometimes very hard to find out what type of injury you have and this is why knowing the causes and symptoms of an avulsion fracture are very helpful in determining exactly how severe the injury is. 

Here are the causes of an avulsion fracture:

Explosive landing: Athletes who tend to jump or land with great impact tend to get these most commonly. Therefore, it is crucial for your health that if you participate in such sports, you do follow the correct method of jumping.
Explosive extension: Similar to how an athlete landing ferociously can get an avulsion fracture, someone who is extending the legs very violently and explosively during an exercise can also get an avulsion fracture. This is because the bone getting extended could very well damage the protrusions to which the tendons are attached. 
Symptoms
These are the two main causes of an avulsion fracture. There are not many symptoms of an avulsion fracture. This is because an avulsion fracture can only be determined by an MRI or by an X-ray scan. Therefore it is nearly impossible to diagnose that you have an avulsion fracture without looking at the results of the tests performed on the part of your body. However, the way you got the fracture and especially the details of it are very good indications of whether you have an avulsion fracture or not.

Avulsion Fracture - Common Causes Behind it

Breaking a bone is, needless to say, a painful experience. But, when people have their broken bone put in a cast, they tend to forget about it until it comes out. This is quite wrong! A person would want to be up and running but does not find that the hand or the leg as it has been cast up. For weeks, the person's hand or leg barely moves and also shrinks up quite a lot!

There is a lot of pain, not only due to shrinkage when a fracture occurs. The occurrence itself causes what is known as acute pain. Then, for some weeks, the sub-acute pain just seems to persist, to the person having the fracture. The reason for this is the fact that the bone and the soft tissue are in the process of healing.

Chronic pain is a worry as it does not go away even after the healing process has ended. In order to make sure that there is a quick recovery and there is no chronic pain which is experienced at all, some of the proverbial leaves need to be taken out of the book of physiotherapy.

To start with, sometime between a fortnight and a month after the injury or the bone break has taken place, the doctor will wish to see some movement in the soft tissue that has broken around the bone. The great advantage of this is that while it may be a little bit of effort and time involved, there are great benefits by the way of less pain and swelling as the blood flows as normally as is possible.

If such movements are not done, a person can have related soreness, which can be even more of a pain! An example of this would be a broken foot or ankle causing the stiffness of the knee. When a person is already in pain, adding to his or her trouble makes no sense at all, does it?

Post one month mark, the physiotherapist would want to see more functioning so that the normal levels can be attained. A person who has a fracture should not despair as if he or she is willing to stick to the schedule given by the physiotherapist and perform all the exercises that have been set out, he or she will be back at the normal level much sooner than would have been expected!

Also, getting active again will reduce the risk of a repeat injury, and that is enough justification to do so!

What To Expect When Recovering From Broken Bones?

Stress fractures are small cracks that may appear in a bone. It occurs due to repetitive application of force in the same area. It is very common among various sports such as running, tennis and football. It may also occur due to osteoporosis as this disorder weakens the bones and allows stress fractures to occur easily.


The majority of stress fractures occur due to overuse of a specific muscle. The bones and the muscles used in a specific movement do not get time to recover, thus leading to stress fracture.


Causes
The major cause of stress fracture is change in physical activity, such as a sudden increase in exercise. The other factors that may lead to stress fracture are -


1. Poor conditioning: if you are starting an exercise regimen without proper preparation, then it may cause stress on the muscles. It is important that you condition your body before doing any intense activity to prevent injuries.


2. Bone insufficiency: various disorders such as osteoporosis reduces bone strength and increases the likelihood of a stress fracture. If you have low bone density then you are at a higher risk of having stress fractures.


3. Change in surface: change in surface like shifting from running on grass to road tends to cause more stress on the legs, thus increasing the likelihood of a fracture.


4. Improper form: performing any exercise with improper form may lead to a number of injuries. It is recommended to learn the correct technique before exercising, so you may use a spotter or a trainer to guide you.


Symptoms
The symptoms of a stress fracture are: 


1. Pain: you may experience dull to severe pain if you have stress fractures. The severity of pain will depend on the severity of the fracture.


2. Swelling: pain may be accompanied by swelling on the sides and the top of the foot.


3. Tenderness: stress fractures may cause tenderness in the muscles around the affected area.

Causes and Symptoms of Stress Fracture

Fractures are simply a break in a bone. They can be caused due to injury, (traumatic fractures) or a pre-existing condition like osteoporosis that causes weakening of bones (pathologic fractures). There are many ways to classify fractures. All fractures fall into the major categories of simple and compound fractures. Simple fractures are fractures where bones remain inside the skin and don t jut out. They are also called closed fractures.

Compound fractures, also called open fractures, are broken bones that penetrate through the skin. These types expose the bone and deep tissues to the environment. Compound fractures are more serious of the two. The healing here may be affected due to deep infections for which antibiotics need to be used. There are many different sub types of fractures and we re only going to skim through them here.

Comminuted fractures: Severe fractures in which a bone breaks into several smaller pieces.
Avulsion fractures: A small piece of bone is completely torn off from the main bone due to fierce pulling off a part of the body.
Other types of fractures are characterised by the many different angles the bone breaks into like transverse, oblique and spiral fractures.

Diagnosis
When a bone is broken there are symptoms like swelling that doesn t subside on its own and pain. In such a case it s imperative that one goes to a doctor for a diagnosis. Doctors can usually recognise most fractures by examining the injury and taking an X-ray. The X-ray also provides a clear idea about the type of fracture and the degree of displacement of the bone. And, it s important that the patient doesn t wait too long before approaching a doctor. This is because bones begin to heal very quickly after a fracture and the bone tissue will heal using any tissue available. This can lead to a misalignment of broken pieces of bone and cause disability and loss of function.

There are cases when X-ray may not show a fracture. This is especially common in fractures in the hip and wrist in older people. For diagnosing these, doctors will get some other tests done such as a computed tomography (CT) scan, magnetic resonance imaging (MRI), or a bone scan.

Treatments
Fractures have to be treated by doctors. The doctors set the fractured bones in their proper place and hold them there so that they can heal. Setting a bone is called "reduction." Reduction without surgery is called "closed reduction." But if the fracture is serious, it s going to require surgery with bone repositioning, called open reduction.

In extreme cases, pins, plates, screws, rods, or glue are used to hold the fractured bones in place, inside the body. Once the bone abutment has been treated, the bone is immobilised to allow the broken pieces to heal. In most cases, the fractured part is set in a rigid cast. The fractured ends of the bone can be fixed into place using metal pins connected to an external frame. This is removed after the bone has healed.

Fractures - How To Diagnose Them?

The human body allows for movement through the complex system of bones, muscles and joints. A break in the bone is medically known as a fracture and can be caused by constant stress, pressure or impact. It is common knowledge that with age, the bone strength decreases and incidence of fractures (osteoporotic fracture) increases. Based on the affected bone and impact, different types of fractures are commonly identified as:

Complete: When the breakage of the bone is complete, producing two or more pieces, it is referred to as a complete fracture.
Incomplete: When the breakage is incomplete, where the bone has cracked, but does not break into pieces, it is known as an incomplete fracture.
Another type would be the open or closed fracture:
Open fracture: When the skin is exposed and the bone breaks through this exposed skin, it is known as compound or open fracture.
Simple or closed fracture: The bone breaks, but the skin continuity is maintained. Again, here are different types including hairline, greenstick, oblique, etc.
What is the reason behind a fracture?
A bone will fracture when force is applied to it that is stronger than the bone itself. A key factor in a bone s susceptibility to fracturing is age. Both children and older people are prone to bone fractures. Children s bones are constantly growing and have not reached their full strength. Elderly people have brittle bones with old age and are prone to develop bone diseases, making them susceptible to fractures.

How they are treated?
Splint and pain medications are commonly used. Closed reduction where the fracture is reduced without opening up the tissues and open reduction, where the tissues are opened up are common approaches to managing fractures.

Can they be prevented?
Especially with children and in the elderly, extra precaution should be taken to avoid any kind of injury and fracture.

Develop an exercise routine to strengthen the muscles
Manage weight
Use the right footwear and exercise gear
Watch your medications (avoid sleep inducing ones)
Increase lighting in the room/home to improve clarity of vision for elderly
Make the home/living area fall-proof by reducing clutter, using railing in the bathroom and bedroom, using rubber mat, etc.
While a fall may seem inevitable, taking the above steps can help reduce the incidence and severity of a fall, thereby minimizing damage.

Bone Fracture - Common Types and How They Can be Prevented?

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