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.
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 .
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 .
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.
A fracture refers to a crack in any bones in the body. Some of the common causes of fractures include falls, industrial injuries, vehicular accidents and sports related injuries.
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.