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Home » Diseases starting with Letter F » Fracture

Fracture:

A break or crack in a bone usually caused by injury. Less often a fracture may be the result of repeated stress to a bone (fatigue) or weakening by disease (a pathological fracture). The more common fractures are described below according to site and illustrated according to type. A fracture is 'simple' or 'closed' if the skin above the break is not broken, and 'compound' or 'open' if the bone is exposed, in which case there is greater risk of infection. The healing process varies greatly according to the site and age of the patient. In children a break may heal in four to six weeks, in adults it may take three or four months.
It is usually clear when a bone has been broken, but occasionally a fracture goes unsuspected because the patient can still use the injured part. Consult the doctor after any injury—especially one caused by a fall or severe blow—which causes pain or a large bruise for more than a day or so.

Fractured Ankle

The three bones that form the ankle (fibula, tibia and talus) are fractured more often than any bone, apart from the radius in the forearm.

Symptoms

  • Immediate pain, which is often severe.
  • The ankle soon becomes swollen or bruised.
  • Pain when moving the ankle.
  • It may be impossible to stand on the affected leg.

Duration

  • The ankle is usually in plaster for about six weeks.

Causes

  • An awkward fall or stumble that makes the foot bend excessively.
  • Falling on the foot from a height.

Complications

  • Osteoarthritis may follow several years after if the joint is injured.

Treatment in the home

  • Rest the ankle. Do not place weight on it.
  • Apply a cold compress to help reduce swelling.

When to consult the doctor

  • As soon as a fracture is suspected.

What the doctor may do

  • Send the patient to the nearest hospital.
  • At the hospital the type and extent of the fracture will be determined by examination and X-rays.
  • In the case of a simple fracture, a plaster will be applied to the leg below the knee.
  • If the fracture is severe, the ankle may be manipulated with the patient under a general anaesthetic, or an operation may be necessary to pin the fractured bone together. Then a plaster is applied.
  • Arrange intensive exercises before and after the plaster is removed to restore the strength of the muscles in the foot and leg.

Outlook

  • With a straightforward fracture of the ankle, normal function of the joint nearly always returns with treatment in two or three months.
  • If a fracture is severe, there may be permanent stiffness in the ankle after healing.

Fractured Collar-Bone

A common fracture that usually follows sporting injuries. There is a partial or complete breakage of one of the two bones that extend from the top of the breastbone to the shoulder-blades.

Symptoms

  • Pain, often severe, over the collar-bone.
  • A tender swelling, usually in the middle of the bone.
  • Inability to lift the arm on the affected side,

Duration

  • With treatment, the bone usually heals within four weeks.

Causes

  • The fracture is almost always caused indirectly by an impact elsewhere: a fall on the hand or on the point of the shoulder.

Treatment in the home

  • Putting the arm on the affected side in a sling often relieves the pain in the injured area.

When to consult the doctor

  • Immediately a fracture is suspected.

What the doctor may do

  • Send the patient to hospital.
  • At the hospital the collar-bone will be examined and X-rayed in order to discover the type and the extent of the fracture. brings the fractured parts of the bone into line so that the bone can heal.
  • If there is excessive pain, the arm may be put in a sling.
  • Elderly patients will be given shoulder exercises to do after the bone has healed. This is to prevent stiffness in the shoulder joint.

Outlook

  • The bone usually heals completely with no aftereffects, other than a bump in the bone at the site of the fracture.

Greenstick Fracture The bone bends and half breaks. This results in the covering of the bone (periosteum) tearing, with the possibility of a blood clot forming under it. Small cracks may also occur at the surface of the bone. Greenstick fractures are most often seen in children but can occur in adults. They are usually caused by a fall or a blow. A common site, is the clavicle I collar-bone), shown here with the shoulder-blade.
Collar-Bone Part of the structure which supports the arms.

Colles' Fracture

A partial or complete breakage of the lower end of the radius (one of the two bones of the forearm) just above the wrist. It is the most common fracture and occurs most often in elderly women, in whom the radius is particularly brittle.

Symptoms

  • Pain, deformity and swelling at the wrist follow the injury immediately.
  • The affected hand cannot be used.

Duration

  • Recovery of the full use of wrist and hand usually takes about ten weeks.

Causes

  • Falling on an "outstretched hand is the most common cause.

Treatment in the home

  • A cold compress helps to immobilise the wrist or reduce swelling while waiting to see a doctor.

When to consult the doctor

  • Immediately the symptoms occur.

What the doctor may do

  • Put the arm in a sling for support and reduction of pain.
  • Send the patient to a hospital accident and emergency department.
  • At the hospital the wrist will be X-rayed to determine the extent of the fracture. Then the displaced ends of the broken bone will be realigned after the patient has been given a general or local anaesthetic: a doctor manipulates the bone ends into position, feeling through the skin with his fingers. Afterwards a back slab is applied to immobilise the wrist and is kept in position by firm bandaging. The arm is then supported in a sling for two or three days until the swelling has died down. From time to time the sling is removed and the patient does elbow and shoulder exercises. Finger movements are also performed to encourage the return of full use of the hand.
  • When the swelling has subsided, the forearm is put in plaster for six weeks.
  • Some fractures may still become displaced and require further immobilisation or an operation.

Prevention

  • Elderly people should make sure there are no loose-fitting carpets or dangerous stair treads in the house. When walking outside they should take care and use shorter steps in the dark and in icy conditions.

Outlook

  • The recovery of wrist movement and use of the hand takes about ten weeks. Complications are rare.

Fractured Hand

Five metacarpal bones support the palm of the hand and join the wrist (carpal) bones to the finger bones (phalanges). One or more of these metacarpal bones may be partly or completely fractured by crushing or punching.

Symptoms

  • Acute pain and tenderness following injury are felt in the palm and back of the hand at the site of the fractured metacarpal bone. Several bones may be fractured.
  • Swelling of the hand.
  • The knuckles of affected bones become less prominent than usual.

Duration

  • According to the extent of the injury, the hand will be out of action for about ten days to a month.

Causes

  • The commonest causes are a fall on the hand or a blow on the knuckles, as may happen, for example, during fist fighting or skiing.

Treatment in the home

• Apply a firm cold compress to support the hand and reduce swelling.

When to consult the doctor

  • As soon as a fracture is suspected.

What the doctor may do

  • Send the patient to a hospital accident and emergency department.
  • At the hospital, the hand will be examined and X-rayed to determine the type and severity of the fracture.
  • Most cases are mild, and after a period of rest exercise of the hand will be encouraged.
  • If splinting is required, then a light plaster on the back of the arm can be applied for several weeks.
  • If the ends of the broken bones are displaced (out of alignment), they will either need to be manipulated into place with the patient under a general anaesthetic, or require an operation to pin them together.

Outlook

  • The hand usually returns to full use after most fractures.

Fractured Bone in the Lower Leg

Partial or complete breakage of the shafts of the tibia (shin bone) and the fibula, which run from knee to ankle. Often both bones are fractured.

Symptoms

  • Immediate severe pain.
  • Sometimes a 'crack' is heard on injury.
  • Swelling and deformity of the leg.
  • An inability to place weight on the leg.
  • The ends of the broken bones often pierce the skin (compound fracture).

Duration

  • If the bones are not displaced out of alignment, the fracture usually takes at least four to six weeks to heal. If they are displaced, it can take 12-20 weeks for them to mend.

Causes

  • A road accident is the most common cause. There is a high incidence of the fracture among motor-cyclists who crash.

Complications

  • Road traffic accidents often cause severe fractures, including multiple and open breaks, which give rise to complications. These may include damage to blood vessels and nerves, infection, difficulty in setting the bones and difficulty in immobilising the bones—all of which may mean that the bones--fail to knit and recovery is delayed. If this happens, it may be necessary to operate in order to fix the break.

Treatment in the home

  • The patient must be handled with great care, otherwise a simple fracture can be turned into a compound one or a compound fracture made worse.
  • When there is an obvious fracture of this type, the patient should be made comfortable and warm where he is—in the open or on the roadside—until emergency medical help is available.

When to consult the doctor

  • Immediately.

What the doctor may do

  • Send the patient to the nearest hospital accident and emergency department.
  • At the hospital the leg will be X-rayed. If the bones are not displaced the leg is put in a plaster that immobilises the bones and allows the patient to walk. It is applied above the knee if both bones or the tibia alone is fractured, below the knee if the fibula is fractured. Weight-bearing and walking in a suitable plaster will be encouraged as early as is feasible.
  • If displacement of the bones has occurred, the patient is given a general anaesthetic and the doctor manipulates the separated parts of the bone together by feeling through the skin of the leg. Sometimes the bones need pinning. Then a plaster is applied to immobilise the leg. After two weeks this plaster is replaced by an above-the-knee plaster that allows the patient to walk.
  • A compound fracture may become infected and require antibiotics which may delay healing.

Prevention

  • During icy or wet conditions on the road motor-cyclists in particular should take great care. The leg guards of motor-cycles should never be removed for the sake of speed. Seat belts should always be worn in cars.

Outlook

  • For undisplaced fractures and displaced fractures that are successfully manipulated, the outlook is good.

Fractured (Neck of) Thigh Bone

The neck of the thigh bone (femur) is at the top of the bone, where it joins the pelvis. It is commonly fractured in elderly people, especially women, whose bones have become brittle.

Symptoms

  • Pain, which is usually made worse by movement of the leg.
  • In cases when the ends of the broken bone are displaced (out of alignment), the person cannot put any weight on the affected leg and if, the fracture was caused by a fall, cannot stand up unaided.
  • When the bones are impacted (wedged together), walking is not affected but there is pain in the knee.
  • The affected leg (and foot) is turned outwards when the patient lies on a bed or sits in a chair.

Duration

  • The fracture generally takes about three months to heal, but the patient may not be fully mobile until several months after that.

Causes

  • The most common cause is a fall, but often a fracture in an elderly person is simply the result of a slight knock.

Complications

  • Pneumonia and respiratory complications can occur.

Treatment in the home

  • All attempts to move the leg (or patient) should be avoided.

When to consult the doctor

  • Immediately if a fracture is suspected.

What the doctor may do

  • Arrange for the patient to be taken to a hospital accident and emergency department. In the meantime he may tie the patient's ankles and knees together, so that the unaffected leg provides a splint for the injured one; this prevents further movement of a displaced fracture.
  • At the hospital, several X-rays will be taken to determine the nature of the fracture.
  • An impacted fracture will usually heal of its own accord and will need no treatment. The patient will be allowed to walk on the affected leg with the aid of sticks.
  • For a displaced fracture an operation will be needed to pin the broken bones together. After that the patient will not be allowed to put weight on the affected leg for two or three months.

Prevention

  • Elderly people should make sure there are no loose-fitting carpets or unsafe stair treads in the home. They should also take care and shorten their steps when walking outside, especially after dark and on icy pavements.

Outlook

  • Pinning together displaced bone ends is successful in 70 per cent of cases. In the rest a further operation will be needed.
  • The mobility after most treatment, including pinning, is usually excellent.

Fractured Spine

The spine may be fractured in the neck (cervical spine), the back (thoracic spine) or waist (lumbar spine). All are potentially serious fractures because the spinal cord may be injured either by the original injury or by subsequent moving of the patient. The spinal cord carries the nerves which control breathing, the bladder, bowels and movements of the limbs. These and many other bodily functions can be permanently paralysed. Do not attempt to move a casualty after an accident if there is pain on moving or twisting the spine (neck, back or waist).

Symptoms

  • Pain on moving or twisting any part of the spine.
  • Paralysis or numbness of the limbs or trunk.
  • Difficulty in breathing or passing water.

Duration

  • Three months, if there is no injury to the spinal cord.

Causes

  • Falls, accidents in vehicles, at work or in sport.
  • Impact injuries such as those from fast-moving traffic
     

Thigh Bone  

The largest and strongest bone in the body.

Kneecap 

A flat round bone in front of the knee joint.

Shin Bone 

The larger of the two bones in the lower leg

Transverse Fracture

The bone breaks straight across at right-angles to its Song axis. Transverse fractures may be caused by a blow or a fall. Illustrated here is a transverse fracture of the neck of the femur (thigh bone). Fractures of this kind are common in elderly people.

Oblique Fracture

The line of the break is oblique to the • long axis of the bone. This common type of fracture is usually caused by a fall accompanied by pressure from the side and twisting, such as a fall from a ladder or a slip on ice. The fracture shown here has occurred in the lower third of the left tibia (shin bone).

Comminuted Fracture

The bone breaks into several pieces. A comminuted fracture may be caused by a direct blow and is shown
here in the left patella (the kneecap). This particular injury can occur in car accidents, when the collision
bangs the driver's knees against the glove shelf.

Compression Fracture

The bone is squashed and the resulting deformation causes a fracture. Compression fractures may be caused by the impact force, of a vertical drop, such as a jump from a high window to escape fire. In this illustration the force transmitted up the spine as a result of jumping from a height has caused the fourth lumbar vertebra to be compressed and fractured.

Spine

The five lumbar, vertebrae form the inwards curve in the lower back at waist level
 

List of Diseases Starting Letter F

The List of Diseases Starting Letter F

Faecal Impaction Fainting Attack Falls Family Planning
Fibroadenoma of the Breast Fibroids, Uterine Fibrositis Fistula In Ano
Flat Feet Floaters Foot Strain Foot Care
Foreign Bodies in the Ear, Nose or Throat Fracture

 

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