Fractures Health Article

Definition

A fracture is a crack or break in a bone. It results from the application of excessive force through injuries, such as a fall or a hard blow.

Description

Up to the age of 50, more men suffer from fractures than women because of occupational hazards. However, after the age of 50, more women suffer fractures than men because of osteoperosis. Simple, or closed, fractures are not obvious on the surface because the skin remains intact. Compound, or open, fractures break through the skin, exposing bone. They are generally more serious than closed fractures. When bones are broken, there may be an accompanying soft tissue injury or an infection either in the surrounding tissue or the bone itself. If an artery is damaged, there can be a significant loss of blood. Single and multiple fractures refer to the number of breaks in the same bone. Fractures are termed complete if the break is completely through the bone, and described as incomplete, or green-stick, if the fracture occurs partly across a bone shaft. This latter type of fracture is often the result of bending or crushing on the bone. A stress fracture is usually a small break in the bone due to repeated or prolonged force.

Causes & symptoms

Fractures usually result from an injury to a bone that causes the bone tissue or cartilage to be disrupted or broken. Bones weakened by disease or misuse will be more likely to break. In some women who have gone through menopause, the bones fracture easily due to osteoperosis. This is because the body produces less estrogen at that time of life, and estrogen is a major regulator of bone density through its effects on calcium in the body. Moderate exercise and weight training is helpful in building and maintaining strong bones; so, the bones of an inactive person may also tend to fracture easier than those who are moderately active. However, individuals with a very high activity level have a greater risk of fractures. This group includes children and athletes participating in contact sports. Because bones start to thin out with the aging process, the elderly are also at a high risk of sustaining a fracture. Diseases that may lead to an increased risk of fractures include Paget's disease, rickets, osteogenesis imperfecta, osteoporosis, tumors, deficiencies of vitamins A or D, and stroke induced paralysis.

Fractures usually begin with intense pain and swelling at the site of injury. Obvious deformities, such as a crooked or otherwise misshapen limb, point to a possible fracture. Pain that prevents the use of a limb may also indicate a break. In severe fractures, there may be a loss of pulses below the fracture site and a resultant numbness, tingling, or paralysis in the feet, hands, fingers, or toes below the site. An open fracture is often accompanied by bleeding or bruising. If a leg is fractured, there will usually be difficulty bearing weight on it. If there is dizziness, sweating, disorientation, or thirst, the onset of shock may be indicated.

Diagnosis

Diagnosis begins immediately with the individual's own observation of symptoms. A thorough medical history

and physical exam completed by a physician often provides enough information to determine if further testing is necessary. An x ray of the injured area is most commonly used to determine the presence of a bone fracture. However, it is important to note that not all fractures are apparent on an initial x ray. Rib fractures are often difficult to diagnose and may require several views at different angles. If the fracture is open and occurs in conjunction with soft tissue injury, further laboratory studies may have to be done.

In the event of stress fractures, a tuning fork can provide a simple, inexpensive test. The tuning fork is a metal instrument with a stem and two prongs that vibrate when struck. If a patient has increased pain when the tuning fork is placed on the bone, such as the lower leg bone or shinbone, the likelihood of a stress fracture is high. Bone scans also are helpful in detecting stress fractures or other difficult-to-detect fractures.