Bone Fractures

The human body contains 206 bones. (Read about "Skeletal System") They are made of strong material, but even tough stuff can break if enough force is applied. When a bone breaks, it is called a fracture.

Fracture facts

According to the American Academy of Orthopaedic Surgeons (AAOS) fractures are among the most common orthopedic complaints, with approximately 7 million broken bones each year in the U.S. AAOS says men are more likely to experience fractures than women until about age 45. After that, fracture rates are higher among women. (Read about "Age and Bone Loss") AAOS says a type of fracture, called a stress fracture, is more common in women. The most common fracture, according to AAOS, prior to age 75 is called a colles fracture (just above the wrist); in the elderly, hip fractures become the most common. (Read about "Hip Fractures") The Society of Cardiovascular and Interventional Radiology (SCVIR) says that osteoporosis causes 700,000 fractures of the vertebrae each year. (Read about "The Spine")

Breaking bones

Bones are made up of bone cells, proteins and minerals like calcium. Bone strength is related to the age, size and health of a bone. According to the Food and Drug Administration (FDA), fractures are are the result of a number of things including:

• a blow
• a fall
• other trauma
• osteoporosis (Read about "Osteoporosis")
• bone tumors (Read about "Bone Tumors - Benign")
• Paget's disease of bone (Read about "Paget's Disease of Bone")
• osteopetrosis (Read about "Osteopetrosis")

There are five basic types of fractures according to AAOS. They are:

• Simple fracture - when the bone is broken in one place but the skin is not broken
• Compound fracture - when the skin is broken
• Transverse fracture - when the break is at a right angle to the length of the bone
• Greenstick fracture - when the break is only one side of the bone and the bone bends
• Comminuted fracture - when there are at least three bone fragments

Stress fractures are a type of fracture commonly found in athletes. They are often the result of overuse. (Read about "Repetitive Stress") They can also develop when you use the wrong equipment or use an unfamiliar surface (for example, a runner who switches from trails to pavement) AAOS says they are more common in women. Stress fractures often occur in the leg or foot, but can also develop in the spine or elsewhere.

Treatment

Bone is constantly in a state of turnover, even when not damaged or injured. Living bones continually absorb and replace cells, a process known as remodeling. Because of this, the process of healing bone often comes about naturally.

For stress fractures, the treatment involves rest and avoiding the activity that caused the fracture. AAOS says it takes 6-8 weeks for a stress fracture to heal, and if you don't give it the time it needs, the fracture may never heal correctly.

Rest can also benefit more serious fractures. In order for a more serious fracture to heal as quickly as possible, however, without any deformity, the bones must sometimes be first put back in proper position. This is called "reduction" and involves putting the broken bone in a cast, after the doctor manipulates the bone into proper alignment. The use of casts is called external fixation. For some breaks, immobilization through the use of a cast may be enough to facilitate healing.

On the other hand, surgery may be required for more complicated breaks such as comminuted fractures. Surgery has become more common with the advent of new materials. Surgery is known by the term internal fixation. AAOS lists some of the following as internal fixation types:

• Wires - used with other devices or by themselves on small fractures in places like the foot or the hands
• Plates - used to hold two lengths of bone together like an internal splint and held in place by screws
• Nails or rods - are placed in the center of long bones and held in place with screws
• Screws - the most common device used for broken bones; they are used with other methods and by themselves

The time needed for complete healing varies. Healing depends on many factors including the specific bone that was broken and the age of the individual. Some broken bones, especially in children, heal within a couple of weeks. Others may take months or even years. FDA says bones heal more slowly the older we get. Children heal more quickly than adults because of the increased bone turnover associated with growth.

Cast care and rehabilitation

The American Academy of Family Physicians (AAFP) has these recommendations for cast care:

• keep plaster casts dry; wrap them in plastic when bathing. Most medical supply stores sell a plastic sleeve, which fits snugly over a cast for bathing and showering.
• try to keep objects out from the cast; if you have an itch, gently tapping the cast can sometimes make the itchy sensation go away
• inspect the cast regularly and let your doctor know if it cracks, breaks or becomes too tight or too loose

Fiberglass has become the material of choice for many doctors when they set a break and apply a cast. The fiberglass provides more flexibility in terms of getting the cast wet.

In some cases, rehabilitation (Read about "Rehabilitation") may be necessary. Your physician could recommend exercises to prevent atrophy (wasting) of muscles and to speed up healing.

Bone up to help prevent problems

The best way to handle fractures is to prevent them in the first place. Keep safety in mind at work and play. For the elderly, especially women, prevention of osteoporosis is also important. FDA also recommends exercise and a diet with adequate calcium and vitamin D. (Read about "Calcium" "Vitamins & Minerals") Check with your doctor for the recommended dosages and before starting an exercise program.

Related Information:

    Accidental Falls

    Calcium and Osteoporosis

    Menopause and Exercise

    Exercise and Seniors