What Are the Types of Fractures?

Symptoms of fractures include: 

• Pain
• Difficulty moving the injured area
• Inability to bear weight on that part of the body
• Swelling and tenderness around the injury
• Bruising
• Numbness in the area of the broken bone
• Deformity
  • The area may look abnormal or not the usual shape 
  • A limb may look out of place
  • A part of the bone may puncture through the skin

Common causes of fractures include:

• Trauma
  • Falls
  • Motor vehicle accidents
  • Sporting accidents 
• Osteoporosis
• Overuse
  • Repetitive motion tires muscles and places additional force on bone, which can result in stress fractures
  • Stress fractures are more common in athletes

Fractures are diagnosed with a patient history including how the injury occurred, and a physical examination of the injured area. 

X-rays are usually used to diagnose a fracture and show the location and type of fracture. 

Other imaging tests may be needed to assess whether damage to tendons, ligaments, or joints occurred, which may include: 

• Computerized tomography (CT) scan
• Bone scan
• Ultrasound

Treatment of fractures involves aligning the bones in place (reduction) so they can heal properly. Depending on the type and severity of the fracture, this may be done medically or surgically. 

Immobilization of a fracture in which the ends already align includes: 

• A plaster or fiberglass cast (most common type of fracture treatment)
• Functional cast, brace, or splint
  • Allows for limited movement of nearby joints
• Traction
  • Not a treatment, but used to align bones by a gentle, steady pulling action so they can be immobilized 

Surgery to treat fractures includes: 

• External fixation
  • Metal pins or screws are placed into the broken bone above and below the fracture site and connected to a metal bar outside the skin which acts as a stabilizing frame to hold bones in the proper position while they heal
• Open reduction and internal fixation
  • The bone fragments are first reduced (repositioned) into proper alignment, and held together with special screws, metal plates attached to the outer surface of the bone, or rods inserted through the center of the bone

For pain, over-the-counter (OTC) pain medicines such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve) may be recommended. For severe fractures, prescription pain medications may be used. 

After the bone has healed, physical therapy may be needed because patients may lose muscle strength and range of motion in the injured area. Exercises will help stretch and strengthen the muscles, improve joint motion, and flexibility. 

There are steps patients can take to help improve the healing process, including: 

• Eat a healthy, balanced diet that includes sufficient calcium, protein, and vitamin D
• Avoid certain sports
• Don’t smoke (this slows healing)
• Keep the cast dry

Fractures can take several weeks to several months to heal, though pain usually goes away long before the fracture is fully healed.

Complications of fractures include:

• Blood vessel damage
• Nerve damage
• Infections
• Joint problems
• Uneven limbs
  • Can affect children if a growth plate in a leg is fractured
  • May occur in adults who fracture a thighbone and require surgery
• Problems with healing
  • Bones grow back together very slowly (delayed union)
  • Bones grow back in the wrong position (malunion)
  • Bones don’t grow back together (nonunion)
• Blood clot in the lung (pulmonary embolism), which can be life threatening 
  • This is often a severe complication of serious fractures of the hip or pelvis
• Death of part of the bone (osteonecrosis)
• Fat embolism (rare)
• Compartment syndrome (rare)

To help prevent fractures: 

• Eat a healthy, balanced diet with adequate amounts of calcium, protein, and vitamin D
• Exercise regularly, including weight bearing exercises to keep bones strong
• Protect your body from injury:
  • Wear safety gear such as helmets, elbow pads, knee pads, and shin pads when playing sports or in any activity in which you could get injured
  • Keep walkways clear of clutter
  • Remove or tack down loose rugs
  • Wear a seatbelt every time you are in a motor vehicle
  • Use a non-slip mat in the bathtub 
  • Install handrails on the stairs (especially for older people)