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FracturesPublished by Bupa's health information team, February 2008. This factsheet is for people who would like information about bone fractures. A broken or cracked bone is known as a fracture. This can be a crack or buckle in the structure of the bone or a complete break, producing two or more fragments.
Wrist fracture animation About boneBone is living tissue, made up of cells that produce a hard, crystalline compound of mineral salts, which mainly consist of calcium phosphate. This gives your bones strength and hardness. During childhood and puberty increasing amounts of these minerals are deposited in your bones, progressively increasing their density. Maximum bone density is reached when you are in your 30s. Your bones have nerve and blood supplies. This explains why fractured bones are painful and result in bruising. SymptomsThe most obvious symptom of a fractured bone is pain, especially when you try to move. It may even be impossible to move the fractured part of the body. At the site of the fracture you may:
If you have a bone fracture, you may be pale and clammy, and may feel sick or light-headed due to pain. CausesBones have a tough structure and are normally able to tolerate strong forces. Fractures occur when you are hit by something or if you twist or bend awkwardly. This can happen as a result of a fall or a collision. If you are older you are at increased risk of fractures because you tend to be more prone to falls and your bones are not as strong. Young children are more likely to have falls and accidents which can result in a fracture, partly because they are less aware of hazards. Broken bones in adultsThe bones in your body can break in a number of different ways, so there are many different types of fractures. Simple fracturesGenerally, an injury causes a single fracture, known as a simple fracture. A single crack across the shaft of a bone is called a simple transverse fracture. If it breaks at an angle across the bone it is called an oblique fracture. This is rare.
Complex fracturesIn long bones, such as the thighbone (femur) an injury is more likely to cause a more complex, spiral fracture. This leaves surfaces that are less likely to re-unite easily. Stress fracturesBones can break due to small repeated stresses and strains. This is known as a stress or fatigue fracture, and is most often seen in the lower leg or foot bones of athletes. Avulsion fracturesMuscle or ligament that supports or is attached to bone can also cause a fracture called an avulsion fracture. This happens when the ligament or muscle pulls on the bone causing it to fracture. Hairline fracturesHairline fractures may occur after a trip or a fall. The bone is only partially fractured. They can be difficult to detect. Depressed fracturesA depressed fracture is when part of the bone is pushed out of line with the rest of the bone. This is usually in the skull. Pathological fracturesIf a tumour or other disease causing factor is weakening the bone, it's called a pathological fracture. Complicated fracturesA fracture is described as complicated if there is damage to major structures near the fractured bone, such as an artery. Compound fracturesThe broken end of a bone can break the skin, or protrude through the skin. This is known as an open or compound fracture and it can lead to infection and blood loss. Closed fracturesIf the bone doesn't damage the skin it's called a closed fracture. Comminuted fracturesSometimes, particularly in more serious accidents, the bone can fracture in a way that produces several fragments. This is called a comminuted fracture. Impacted fracturesAfter a fracture, the broken fragments of bone usually separate to some degree. Sometimes one fragment of bone is driven into another. This is called an impacted fracture. Fragility fracturesFrom middle-age onwards, your bones lose density and fractures are more likely. Osteoporosis is a bone disease that speeds up this process and weakens the bones. This makes people with osteoporosis more likely to have fragility fractures, which can occur after a minor fall, such as falling from standing height or less. For further information see Related topics. Broken bones in childrenFractures in children tend to be different to those in adults because bone is softer and more able to bend. When fractures occur, the bone is not always broken completely. The bone can buckle and split and result in what is known as a greenstick fracture. Another type of fracture common in children is a growth plate fracture, called an epiphyseal plate fracture. Bone grows in length from the growth plates near the ends of long bones. These fractures can affect bone growth. DiagnosisAt the hospitalMost fractures are diagnosed using X-ray images but MRI (magnetic resonance imaging) or CT (computerised tomography) scans may be used by your doctor to look at the fracture more closely. TreamentFirst aid for broken bonesIf you fracture a bone, it's important that you limit your movement as much as possible. You may need to use a sling or splint. This helps minimise pain and can also prevent further injuries caused by movement of the sharp ends of broken bone. At the hospitalIf you have had a serious accident, medical professionals will treat your circulation (blood flow), breathing and other injuries before they treat any fractures. Fractures are then usually treated in the following way.
ComplicationsComplications are problems which can occur during or after treatment. Serious fractures can cause ongoing problems such as pain or stiffness in the limb or joint involved. Some fractured bones don't knit together easily and surgery may be needed to help the bones to unite. Fractures can also damage nerves and blood vessels, which may need separate treatment. Infection can also complicate and delay healing. Infection is more common if you had a compund fracture or if you need surgery to fix the bone. This can lead to an infection of the bone marrow which is called osteomyelitis. You should return to the fracture clinic or accident and emergency department at the hospital if:
RecoveryThe repair of a fracture by the body is a gradual process. Fractures in children usually heal quickly. The speed of recovery also depends on the bone you break. It will take longer for fractures in lower limbs, such as the thighbone, to recover than those in smaller bones, such as the finger bones. This is because the thighbone is larger and more difficult to immobilise. After this it's important to begin gentle movements and exercise as this helps to build up strength in the healing bone. You may need to have physiotherapy to promote healing and increase your movement of the affected area. This will be specific to your injury. Ultrasound or pulsed electromagnetic energy may be used for fractures that are not healing or are healing slowly. How long does it take for fractures to completely heal?The time it takes for the broken ends of the bone to knit back together (unite) varies depending on the type of fracture and where the fracture is. Generally during the first two to six weeks after a fracture, a firm mass called a callus forms around the fracture. Then the bone becomes harder and stronger and minerals such as calcium are deposited (this process is called ossification). It can take up to two years for the bone to heal and be back to full strength. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Mr Raj Bhatia MD, MBChB, BSc (Hons), FRCS (Eng), FRCS (Tr&Orth); and BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: February 2008. Expected review date: February 2010.
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