Globally, nearly 10 million cases of fractures are recorded each year, usually resulting from traumatic injury to bones.
The site of fracture is main determinant of how serious it will be. Regardless of location, pain is the main presentation. This happens because the nerves and muscle tissues surrounding the bone will invariably respond to the additional pressure they have to contend with, as the broken bone “bleeds”. Surrounding muscles also spasm as the defence system of the body attempts to fight the fracture. A fracture leads to inability to use the affected area partially or completely and there will also be swelling and discoloration as a result of the bruising.
Entire Body System
- Severe Pain
[…] and the inability to walk Ankle: Severe pain, swelling, tenderness to touch, bruising, deformity, and the inability to walk Foot: Severe pain, swelling, bruising, numbness in toes and foot, decreased range of motion, inability to walk comfortably, and [my.clevelandclinic.org]
Surgery is normally reserved for those with severe pain, weakness, or inability to feel their arms or legs. [emedicinehealth.com]
Severe Pain Burst fractures cause severe pain. Typically, this is pain at the level of the fracture, that is, in the back. However, pain may also be present in the legs following the distribution of the affected nerves. [spineuniverse.com]
- Arm Pain
Here however, we describe the case of a young, amateur athlete presenting with acute right, upper arm pain after throwing a ball. Examination showed right upper arm deformity and tenderness to palpation, without any distal neurovascular deficits. [ncbi.nlm.nih.gov]
Arm: Pain, swelling, abnormal bend, difficulty using or moving arm, warmth, bruising, or redness Elbow: Pain, swelling, bruising, stiffness, a ‘pop’ noise at the time of fracture, or visible deformity Wrist: Pain, swelling, decreased use of hand and wrist [my.clevelandclinic.org]
The tooth strain and fracture resistance data were analyzed using the Tukey test and two-way ANOVA, and the fracture mode was analyzed by the chi-square test (α=0.05). [ncbi.nlm.nih.gov]
[…] junction of the spine Rib fracture Sternal fracture Shoulder fracture Clavicle fracture Scapular fracture Arm fracture Humerus fracture (fracture of upper arm) Supracondylar fracture Holstein-Lewis fracture – a fracture of the distal third of the humerus [en.wikipedia.org]
Two fragments transverse fracture oblique fracture spiral fracture Three fragments bending wedge fracture spiral wedge fracture segmental fracture Multiple fragments segmental fracture fragmented wedge fracture irregular multifragmental fracture comminuted [radiopaedia.org]
The final stages that are unique to this fracture-dislocation are the posterior dislocation and fracture of the fibula and the fracture of the medial malleolus or rupture of the deltoid ligament. [doi.org]
- Hip Pain
At 29 weeks of gestation, the patient complained of sudden pain on walking in both hips. Despite the bed rest, her hip pain increased; consequently, cesarean section was performed at 36 weeks. [ncbi.nlm.nih.gov]
Hip fractures are more common in older persons, and any elderly riders who sustain a fall and complain of hip pain should be suspect for this injury. [whmentors.org]
- Neck Pain
An 82-year-old woman presented with neck pain and bilateral upper limb paraesthesia after sustaining an unwitnessed fall at home the day before. [ncbi.nlm.nih.gov]
- Bone Pain
Broken bones bleed, and the blood and associated swelling (edema) causes pain. Muscles that surround the injured area may go into spasm when they try to hold the broken bone fragments in place, and these spasms cause further pain. [web.archive.org]
Because broken bones can cause significant amounts of pain, pain management is an important aspect of treating broken bones. Pain management is best accomplished with anti-inflammatory medicines and pain relievers. [emedicinehealth.com]
- Bone Disorder
[…] of unspecified bones (disorder), Fracture, cause unspecified (disorder), Fracture (disorder), Fracture - lesion (morphologic abnormality), Fracture of bones NOS (disorder), Fracture, bone, FRACTURE(S), Fracture of Bone, Broken bone, Fracture of bone, [fpnotebook.com]
Clinical diagnosis of a bone fracture is based on the history given as well as physical examination performed . Imaging via X-Ray is performed to get a better view of the bone suspected to have been fractured. When X-ray proves insufficient, a CT or MRI scan can be performed.
In early fracture management, the main aim is to control hemorrhage, provide pain relief and remove potential sources of contamination (both foreign body and nonviable tissues) . As soon as these are accomplished, the fracture will be reduced and reduction maintained. Following maintenance, fracture union is optimised and the chances of complications are reduced greatly.
Again, treatment is also focused on ensuring that following healing, the limb affected will return to its highest level of functioning. It is often accomplished by obtaining and maintenance of a reduction in the fracture with an immobilisation technique that makes it possible for the fracture to heal and also offering the patient decent functional aftercare. Depending on the type situation, non-operative or surgical treatment can be deployed.
The prognosis for most cases of fracture is dependent on the kind of bone injured, the part broken, the direction the breach of continuity faces, and other general complications . When the fracture involves bones with many strong muscles inserted into them, cure becomes a lot more difficult. Prognosis is more positive when the fracture involves bones with little levers attached to them that are capable of displacing the fragments.
The main etiologic factors for bone fractures include fall from a height, commonly seen in children and the elderly, road and sports related accidents and direct impact on the bone. Repetitive force as can be seen with running can also lead to stress induced fracture in bones in some parts of the body such as the foot, ankle, tibia or hip. All of these are external factors that can lead to bone fracture .
There are however, certain internal factors that can bring about fractures. Apart from old age, tumor, infections and osteoporosis can also lead to fractures.
Fractures are relatively common. Every woman aged 50 years and above has a 50% chance of suffering from a fracture. In men, the possibility is reduced to 20% . Around the world, nearly 10 million cases of fractures are recorded each year. Wrist fractures are the most common form of fractures with hip, humeral and symptomatic vertebral fractures being the next most popular fracture types. The highest incidence is seen in Europe and the Americas with 34.8% and 15.7% of cases seen here.
Actual fracture injuries to the bone affect the local soft tissue, the bone marrow, periosteum and the local soft tissues. The fracture destabilises the general structure making it difficult for this part of the body to carry out its normal activities until healing is complete .
The most important stage in the fracture healing is the inflammatory phase as well as subsequent hematoma formation. Around this stage, cellular signalling mechanisms work in line with chemotaxis and an inflammatory mechanism to attract the cells that are necessary to initiate the healing process. In less than 7 days, granulation tissue is formed by the body between the fracture fragments. Different biochemical signalling substances are involved in the formation of the soft callus which takes place over a period of two weeks .
With hard callus formation, cell proliferation and differentiation in the granulation tissue brings about production of osteoblasts and chondroblasts. The extracellular organic matrixes of woven bone and cartilage are synthesised respectively by the osteoblasts and chondroblasts after which a new formed bone is mineralised. The entire stage takes 4 to 16 weeks to complete.
There is no total way of preventing a fracture but these basic steps can help in the reduction of the risk .
- Consistent consumption of bone building meals such as milk, yoghurt, and cheese help in building strong bones. Vitamin supplements (A and D) can also be consumed as long as they do not interfere with other medications being consumed by the individual.
- While engaging in any sport activities, wear the right clothing and gear. Also alternate exercise activities to prevent fractures.
- While working with heavy equipment, adhere to all precautionary instructions and avoid operating heavy equipment if you do not understand how they work.
A fracture occurs when any bone in the body loses its natural characteristics and most especially, its continuity. For a fracture to take place, the perisoteum, the bone marrow and other soft tissues around the bone must be injured. There are three known types of fractures. They include pathologic, stress and greenstick fractures . The characteristic that determines what type of fracture an individual is facing include its anatomy, how the articular surface is involved, the fragmentation, etc.
Treatment and recovery from a fracture is dependent on the location and severity of the injury. A severe fracture may require surgery to implant devices into the bone so as to maintain the right alignment as the healing process plays out. In some cases, cast or splint maybe enough treatment to ensure full recovery. Regardless of type of fracture, early treatment and diagnosis is important to complete healing.
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