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Fracture (Broken Bone) – Causes, Symptoms & Treatment

A fracture is a break in the continuity of a bone, most commonly caused by trauma or excessive force. Prompt medical evaluation and treatment are essential for proper healing.

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Things worth knowing about "Fracture"

A fracture is a break in the continuity of a bone, most commonly caused by trauma or excessive force. Prompt medical evaluation and treatment are essential for proper healing.

What Is a Fracture?

A fracture is a medical term for a broken bone – a condition in which the structural integrity of a bone is partially or completely disrupted. Fractures are among the most common injuries treated in emergency medicine and affect people of all ages. They range from hairline cracks to complex breaks involving multiple bone fragments.

Causes

Most fractures result from a force that exceeds the load-bearing capacity of a bone. Common causes include:

Traumatic fractures: Caused by falls, road traffic accidents, sports injuries, or direct impact.
Stress fractures (fatigue fractures): Occur due to repetitive mechanical stress, commonly seen in athletes and military recruits.
Pathological fractures: Occur in bones weakened by underlying disease such as osteoporosis, bone metastases, or bone infections – often from minimal force.

Types of Fractures

Fractures are classified in several ways:

Closed fracture: The skin over the fracture remains intact.
Open (compound) fracture: The bone breaks through the skin, significantly increasing the risk of infection.
Complete fracture: The bone is broken all the way through.
Incomplete fracture (greenstick fracture): Common in children; the bone bends and cracks without breaking completely.
Comminuted fracture: The bone is shattered into multiple fragments.
Compression fracture: Typically affects vertebrae, often due to osteoporosis.

Symptoms

The hallmark signs of a fracture include:

Intense, localized pain that worsens with movement or pressure
Swelling and bruising (hematoma) around the injury site
Visible deformity or abnormal positioning of the limb or joint
Reduced or complete loss of range of motion
Crepitus: A grating or grinding sensation when the fracture site is moved
In open fractures: visible bone protruding through the skin

Diagnosis

Diagnosis is based on a combination of clinical examination and imaging:

Physical examination: Assessment of pain, swelling, deformity, and function.
X-ray (radiograph): The primary imaging tool for fracture detection; typically taken in two planes (anteroposterior and lateral).
Computed tomography (CT scan): Used for complex fractures of the spine, skull, or joints.
Magnetic resonance imaging (MRI): Useful for stress fractures not visible on X-ray and for evaluating soft tissue damage.

Treatment

Treatment depends on the type, location, and severity of the fracture. The two main approaches are conservative (non-surgical) and operative (surgical) management:

Conservative Treatment

Stable, non-displaced fractures are often managed without surgery:

Immobilization with a plaster cast, splint, or functional brace
Pain management using analgesics such as ibuprofen or paracetamol
Elevation of the injured limb to reduce swelling

Surgical Treatment

Displaced, unstable, or intra-articular fractures often require surgical intervention:

Osteosynthesis: Internal fixation using screws, plates, intramedullary nails, or wires
Joint replacement (arthroplasty): Indicated in severe hip or joint fractures
External fixation: Used for open or severely comminuted fractures as a temporary or definitive measure

Rehabilitation

After initial treatment, physiotherapy is essential to restore strength, mobility, and function. Healing time varies depending on the patient age, bone involved, and fracture type – ranging from a few weeks to several months.

Complications

If inadequately treated, fractures can lead to serious complications:

Malunion: The bone heals in an incorrect position
Non-union (pseudarthrosis): Failure of the bone to heal
Infection: Particularly in open fractures (osteomyelitis)
Nerve or vascular injury adjacent to the fracture site
Compartment syndrome: Dangerous pressure build-up within a muscle compartment
Long-term joint stiffness or chronic pain

References

Buckwalter, J.A., Einhorn, T.A., Simon, S.R. (eds.) - Orthopaedic Basic Science: Biology and Biomechanics of the Musculoskeletal System. American Academy of Orthopaedic Surgeons, 2000.
Court-Brown, C.M., Heckman, J.D., McQueen, M.M. et al. - Rockwood and Green's Fractures in Adults. 8th Edition. Wolters Kluwer, 2015.
World Health Organization (WHO) - Global status report on road safety 2023. Available at: https://www.who.int

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