Bone Fracture: What is a Fracture?

A fracture (also called bone fracture) is a medical condition where one or more than one bone cracks or breaks. This may happen due to exertion of high force, physical impact or stress or diseases like osteoporosis or osteogenesis imperfecta (a type of cancer). If a fracture occurs due to a medical condition, it is called a pathological fracture. A fracture can occur crosswise, lengthwise, or the bone may break into multiple pieces.

What are the signs & symptoms of a Bone Fracture?

There are many signs and symptoms of a fracture:

The bone fracture may display some kind of swelling or bruising.
An arm or leg may take a deformed shape.
Pain in the injured area may worsen, especially if any kind of pressure is applied there.
The injured area may stop functioning.
A bone may protrude from the skin (Sign of compound fracture).
The skin surrounding the affected area may get discoloured.
The affected area can give you a kind of irritation.
If a large bone like pelvis or femur is affected, bleeding may occur.
The affected person may look pale or feel dizzy. He/she may also suffer from nausea.

How does a fracture occur?

The causes of a fracture can be varied.

Trauma:A traumatic incident, such as a fall, or a vehicle accident or a sporting injury, is one of the most common causes of a bone fracture.
Medical Conditions:Diseases like Osteoporosis weakens the bones as a result of which they become likelier to suffer cracks or breaks. Patients affected by osteogenesis imperfecta can experience bone fractures very frequently. Such fractures are generally termed as pathological fractures.
Repetitive motion:Constant movement can tire the muscles, thus exerting more force on the bones, which may lead to stress fractures. Such fractures are most commonly observed in sports professionals.

What are the basic steps for immediate management?

For open bone fracture the first thing one should do is to control bleeding before going for any further treatment. The wound should be rinsed and dressed properly maintaining hygiene standards.

Besides, it is very important to check the breathing process of the wounded person. In certain cases the person may show irregular breathing due to immense pain or a sudden nervous breakdown. Also, it should be meticulously examined if there are any other minor injuries.

Immediate application of ice in case of closed fractures most often proves immensely helpful. One should not massage the affected area at all or try to straighten the broken/ cracked bone. The joints surrounding the wounded region (above or below the fracture) also should not be moved. The wounded person should not be given any oral liquid or food till the doctor comes.

What are the types of Fracture?

Fractures can be divided into displaced fractures and non-displaced fractures.

Displaced fracture: In this fracture, the bone may break into two or more parts and the broken bones move in a way that they don't remain positioned in a linear order. When the bone breaks into more than two pieces, then it is regarded as a case of comminuted fracture.
Non-displaced fracture: In this bone fracture, the bone may break into several pieces but the alignment is not affected.
Again, fractures can also be divided into open and closed fractures.
Closed fracture: In this fracture there is an internal breakage of bone but it does not display any open wound or external puncture.
Open fracture: In an open fracture the bone becomes visible through the skin but then it may recede back. Open fractures are more critical as they may lead to deep bone infection.

There are some other fracture types that include:

Greenstick fracture:It is a type of incomplete fracture mostly observed in children. In this fracture the bone gets bent.
Transverse fracture: When the fracture occurs at an angle of 90 degree to the bone's axis, it is called transverse fracture.
Oblique fracture: In an oblique bone fracture the break takes a curved pattern or a sloped pattern.
Comminuted fracture:In a comminuted fracture the bone breaks into several pieces.
Impacted fracture: In case of an impacted fracture the ends of two bones drive into each other. Arm fractures in children are examples of impacted fractures. The other name for impacted fracture is buckle fracture.
Pathological fracture: When a bone fracture occurs due to a disease like osteoporosis, it is called a pathological fracture.

Does weak bone predispose to a bone fracture?

Weak bones are prone to having pathologic fractures. A normal activity or a minor trauma may lead a patient to a fracture as a result of his/her weakened bones. Recognition of the underlying condition at the right time and proper diagnosis of ailments like osteoporosis or metastatic bone density as well as treatment of the affected bone can dramatically alter the management of the fracture.

However, recent studies show that many people who do not have osteoporotic bone density get fractures. They mostly have normal bone density or can have osteopenia (lower bone density but not low enough to be classified as osteoporosis) at the most. The striking point is, many people with osteoporotic bone density never get fractures.

Long-term precautions?

Surgery is the best treatment to fix a fracture. And after the surgery, the patient needs to take some long term precautions to experience the best results of the surgery.

After the surgery the patient can take part in quite a few physical activities, which was impossible before.

In case of a hip fracture surgery, the patient can have either polyethylene bearings or metal on metal bearings. After the surgery he or she can go swimming; however undertaking very rigorous activities may shorten the life of the implant. The patient can also wear smooth spike less shoes to curb down any rotational stress on the lead leg or hip. Besides, he/she should not go for bicycling as the rapid pedaling may cause stress in the hip region.

After surgery there is also a risk of infection. If the operated region gets infected somehow, the patient should immediately consult a doctor. Antibiotics are prescribed in most cases. Besides, you need to dress the operated region on a regular basis to rule out any further chance of infection.

Management?

The general principles of fracture management include:

Reduction:Reduction of a bone fracture depends on the type of it. Reduction mainly corrects the deformity of the valgus or varus. (In valgus deformity the distal part of the leg is deviated inward, whereas in case of varus deformity, the same is deviated outward.) Anatomical reduction is performed in case of intra- articular fractures. (In intra articular fractures cracks occur in the surface of the joints). Both in cases of open and closed bone fracture reduction can be performed.

Immobilization:There are two methods of immobilization followed, external and internal. External methods of immobilization include plaster casts, traction and external fixation, whereas, internal methods include implantation of plates, intermedullary nails, or -wires.

Rehabilitation: Rehabilitation mainly increases the flexibility and balance of the fractured bone. It includes strengthening exercises that enable one to increase his/her regular activities gradually. One can also undergo physical therapy to get back into sports safely. If the patient follows rehabilitation instructions properly, his/ her fracture can heal faster. Besides, one should also follow rehab guidelines as they lessen the risk of further injury. Once the bone is completely healed, one can begin muscle building.

How to prevent it in the future?

If a person is diagnosed with osteoporosis, he/she should immediately consult a doctor. The patients are often prescribed medications like bisphosphonates, estrogen agonists/antagonists, parathyroid hormone, estrogen therapy, hormone therapy etc.

Intake of more calcium, sodium, protein and vitamin D increases the bone density thereby preventing future fractures. Exercises are also helpful as they increase the balance, flexibility and strength of the body thus reducing the risk of falling.

Any diet changes?

After a fracture the body needs to produce more bone cells to repair the damage as fast as possible. Diet changes can contribute much to improve the healing of bone fractures. Some of the foods that one must eat regularly after a fracture are as follows:

Foods rich in calcium

Calcium helps to repair and regenerate bone cells rapidly. Thus intake of more calcium will help one's body heal a fracture quickly. One can have dairy products, salmon, broccoli, almonds, tofu, asparagus, alfalfa, sesame seeds, spinach etc. to increase the calcium content in his or her body.

Also Read Top 8 Calcium Rich Indian Food

Foods rich in Vitamin K

Vitamin K enables the body absorb more calcium from food sources, which in turn, helps accelerate the healing of complete and incomplete bone fractures quickly. It also helps strengthen the bone cells thereby reducing the risk of future fractures to a significant extent. The foods rich in vitamin K include kale, broccoli, cauliflower, avocados, egg, rye bread, Brussels sprouts etc.

Foods rich in Lysine

Lysine is considered as a major building block of cellular repair. It helps repair the bone cells and also strengthens the muscles that surround the bone cells. Lysine is actually an amino acid that enhances the absorption of calcium to heal the bone fracture bones faster. Lysine is found in foods like lentils, chickpeas, beef, pork, soy products, dairy products and lima beans.

Bone Fracture: A painful Experience