Fractures (Open and Closed fracture)

A fracture is the medical term for a broken bone.

Fractures are common; the average person has two during a lifetime. They occur when the physical force exerted on the bone is stronger than the bone itself.

Your risk of fracture depends, in part, on your age. Broken bones are very common in childhood, although children's fractures are generally less complicated than fractures in adults. As you age, your bones become more brittle and you are more likely to suffer fractures from falls that would not occur when you were young. 

There are many types of fractures, but the main categories are displaced, non-displaced, open, and closed. Displaced and non-displaced fractures refer to the alignment of the fractured bone.

In a displaced fracture, the bone snaps into two or more parts and moves so that the two ends are not lined up straight. If the bone is in many pieces, it is called a comminuted fracture. In a non-displaced fracture, the bone cracks either part or all of the way through, but does move and maintains its proper alignment.

A closed fracture is when the bone breaks but there is no puncture or open wound in the skin. An open fracture is one in which the bone breaks through the skin; it may then recede back into the wound and not be visible through the skin. This is an important difference from a closed fracture because with an open fracture there is a risk of a deep bone infection.

Because of the unique properties of their bones, there are some defined fracture subtypes that present only in children. For example:

A greenstick fracture in which the bone is bent, but not broken all the way through

A buckle fracture results from compression of two bones driven into each other.

A growth plate fracture at the joint that can result in shorter bone length

These fracture subtypes can present in children and adults:

A comminuted fracture is when the bone breaks into several pieces

A transverse fracture is when the fracture line is perpendicular to the shaft (long part) of the bone.

An oblique fracture is when the break is on an angle through the bone

A pathologic fracture is caused by a disease that weakens the bone

A stress fracture is a hairline crack

The severity of a fracture depends upon the fracture subtype and location. Serious fractures can have dangerous complications if not treated promptly; possible complications include damage to blood vessels or nerves and infection of the bone (osteomyelitis) or surrounding tissue. Recuperation time varies depending on the age and health of the patient and the type of fracture. A minor fracture in a child may heal within a few weeks; a serious fracture in an older person may take months to heal.

The symptoms of a fracture depend on which bone breaks. For example, you’ll likely know right away if you have a problem with your arm, leg or finger. If you’re not sure, consider these possible symptoms:

Difficulty using the limb.

Noticeable and unusual bump, bend or twist.

Severe pain.

Swelling.

Healthy bones are extremely resilient and can withstand surprisingly powerful impacts. However, under enough force, they may crack or break.

Physical trauma, overuse, and health conditions that weaken the bones, such as osteoporosis, are the leading causes of bone fractures. Other factors can also increase an individual’s risk of sustaining fractures.

A person’s bones will typicallyTrusted Source weaken with age, which increases the risk of them breaking. As a person ages, the likelihood of their developing a condition that weakens the bones is also greater.

Infection. This is the most common complication of open fractures. Infection is the result of bacteria entering the wound at the time of the injury. Infection can occur early on during healing or much later after both the wound and fracture have healed.

While bone fractures typically heal well with appropriate treatment, there can be complications, such as:

Bone heals in the wrong position: A fracture may heal in the wrong position, or the bones may shift during the healing process.

Disruption of bone growth: If a childhood bone fracture becomes disrupted during healing, this may affect the typical development of that bone. This can raise the risk of future deformity in the bone.

Bone or bone marrow infection: In a compound fracture, bacteria can enter through a break in the skin and infect the bone or bone marrow. This can become a persistent infection.

Bone death (avascular necrosis): If the bone loses its essential supply of blood, it may die.

Delayed unions and non-unions

Non-unions are fractures that fail to heal, while delayed unions are those that take longer to heal.

Treatments for non-unions and delayed unions include:

Ultrasound therapy: A medical professional will apply low intensity ultrasound to the affected area. This may help fractures heal.

Bone graft: If the fracture does not heal, a surgeon will transplant a natural or synthetic bone to stimulate the broken bone.

Stem cell therapy: Stem cell-derived therapies may assistTrusted Source in the healing of bone fractures.

A person can reduce their risk of bone fractures through a number of remedies and lifestyle changes.

A person’s diet can affect their risk of fractures. The human body needs adequate supplies of calcium for healthy bones. Milk, cheese, yogurt, and dark green leafy vegetables are good sources of calcium.

The body also requires vitamin D to absorb calcium. Exposure to sunlight and eating eggs and oily fish are good ways of getting vitamin D.

Engaging in weight-bearing exercise can help improve muscle mass and bone density. Both of these can reduce the risk of bone fractures.

ResearchTrusted Source has shown that regular exercise and a balanced diet can reduce the risk of a fracture in people with osteoporosis.

Moreover, levels of estrogen, which plays a role in bone health, drop substantially during menopause. This makes calcium regulation more difficult and increases the risk of osteoporosis and fractures.

Consequently, people need to be particularly careful about the density and strength of their bones during and after menopause.