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?


A fracture separates a single solid object into two or more pieces due to pressure. In medical terms, a fracture refers to a broken bone due to some kind of external trauma. A crack in the bone, on the other hand, it does not cause a clean break in the bone, there is only a separation or discontinuity in the bone material.

A crack in the bone caused due to repeated stress is often called as 'hairline fracture'. Here are the basic differences between a crack and a fracture in the bone and how to treat them:

1. A crack or hairline fracture is rarely caused by a single injury. It is usually the result of bone fatigue, which may be caused due to repeated, concentrated stress over a long period of time and thus, it is also called as 'stress fracture'. Other bone fractures are almost always the result of sudden and severe force on the bones.

2. The skeletal system constantly remodels itself. The cells, known as 'osteoblasts' absorb calcium and secrete bone connective tissue. If a particular site is exposed to recurrent bouts of force (which are individually not impactful enough to cause a crack), over time the osteoblasts in that region malfunction and the crack appears.

Muscular exhaustion can also cause cracks in the bone. Fractures are caused due to sudden external single force trauma to the bone. Nutritional problems like deficiencies of Calcium, Phosphorus, vitamin D and excessive smoking decrease the bone mineral density and increase the chance of both cracks and fractures.

3. Symptoms of a crack are swelling, tenderness and sharp pain in the injured region and the symptoms worsen over time. A fracture has similar symptoms and might also exhibit an external physical distortion and makes it impossible to move that part of the body that where the bone is broken.

4. An MRI is often suggested for detecting the crack or crack-prone areas because an X-ray can only detect the crack after it widens somewhat or the bone starts paining because the rays cannot pass through the tiny gap in bone material. A fracture is easily detectable by an X-ray because the rays pass right through the break.

5. Complete rest for six to eight weeks is the most effective way of healing a crack. Using a walking boot in case of cracks in the leg bones in also helpful. Healing fractures require extensive medical intervention. Surgical techniques like bone grafting and the insertion of metal plates are used to reposition the broken bone.

Cracks VS Fractures

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?

Sports injuries are a common problem, where various types of musculoskeletal injuries can occur during the physical activities. These injuries can either be acute or chronic in nature. In athletes, such injuries can pose as a risk to their careers, which makes it essential for the physicians to provide the most appropriate treatment. It is mandatory to provide a prompt, safe and quick treatment that can restore the athlete s preinjury level of participation in sports.

Various treatment approaches are present for treating sports injuries. The use of intra-lesion blood injection is being made for addressing the musculoskeletal injuries. An easy and minimally invasive method of using concentrated autologous growth factors in treating sports injuries is the use of platelet rich plasma (PRP). It is a fraction of the blood plasma that contains a higher concentration of platelets than normal plasma, along with growth factors.

PRP is used in the treatment of both soft tissue and bone injuries. Growth factors have a positively influencing effect on the healing process of connective tissue components.
There is a huge difference between the anatomy and functions of tendons, ligaments, muscles and joint capsules. Hence, the site of injection of PRP also varies.
The cellular tension in the tissue and the collagen structure is affected after the administration of PRP.
Use of PRP is popular in the treatment of an Achilles tendon. For injecting PRP, an ultrasound scan is done, the site of injection is accurately identified and then PRP is administered.
Proper location of the site of injury and deciding the accurate injection zone prior to the injection of PRP makes it easier to facilitate treatment and eliminate discomfort.
Administration of PRP should be considered secondary to physical therapy and other conservative means of treatment.
Enthesopathy is a discomfort in the area where the attachment of tendons, ligaments and the articular capsule is present. The use of PRP is increasing in the treatment of this condition. It has an inflammatory nature and presents as epicondylitis or capsulitis.
Studies have proved that PRP is an effective alternative to injection of steroids for an anti-inflammatory effect. Steroids majorly provide only symptomatic relief, whereas PRP is more definitive.
PRP has also found an increased use in the area of surgical procedures of knees. It is used to increase the efficiency of the healing grafts placed in the knee during reconstructive surgeries.
For treatment of bone injuries, use of PRP has shown an improved quality and rate of bone healing. Even in cases of an infected injury, PRP aids in healing efficiently.
No known side effects or complications after use of PRP have been observed, which makes it a sought after option in management of sports injuries.


Platelet Rich Plasma In Sports Injuries

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

The medical term used to describe a broken wrist is wrist fracture. The fracture might be in the 10 bones, which make up the wrist or in the radius. Some fractures can be serious while others may be tiny. The serious fractures make the bone unstable and these might require surgeries to cure. Open fracture is when the bone breaks and it breaks through the skin. This might cause an infection to the wounded area.

Causes
The most basic cause of a wrist fracture is injury. Any fall on your outstretched hand and you might have to nurse a fractured wrist. This type of fracture is common among sportsmen. If you are suffering from osteoporosis, then you have a high risk of getting a wrist fracture. Traumatic accidents may also cause severe wrist fractures.

Symptoms
The symptoms of a wrist fracture can be extremely painful. The pain escalates whenever you try to move your wrist or flex it, even if you are just flexing your fingers. Sometimes your hand or arm may even become extremely numb when you fracture the wrist. The muscles in the area become tender and swell up. It is almost impossible to move the wrist after it gets fractured. The fracture causes the wrist or rather the hand to appear deformed. The area around the fracture might even get bruise and a fractured wrist also affects the blood flow in the area. You might even injure your ligaments, tendons, muscles or nerves.

Diagnosis
To confirm and check the level of severity, you are generally asked to get an X-ray done. In order to get a more detailed look at the fracture, you might have to undergo CT or MRI scans as well. Usually to treat a fracture, you will have to wear a splint and move your hand as least as possible. But keep moving you're your fingers otherwise they might get stiff. Your doctor will inform you from when you will be able to move your wrist. Until then try to keep your movements to the minimal.

Causes and Symptoms of Wrist Fracture

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