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Bone Fractures and Broken Bones

Breaks, or fractures, are common injuries to bones. Every year, broken bones cause people to miss work, school, sports, and fun activities.

But a fracture may not feel common when it happens to you.

Fortunately, there are many ways to treat fractures, as casting technology has improved. Some broken bones require surgery. Other less severe fractures may heal with rest.

You can't always know if you have a broken bone. That's why it's important to seek care if you have symptoms of a fracture.

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What Is a Bone Fracture?

A fracture is a broken bone. It can be anything from a small crack to a bone that has separated and moves out of place.

Bone fracture symptoms include:

  • Sharp pain.
  • Swelling.
  • Bruising.

Doctors can often treat bone fractures with a cast or splint. Severe breaks may need surgery.

Fractures are one of the most common injuries to bones. A Lancet study found that there are about 178 million fractures a year worldwide. About 18.3 million of those are in the U.S., according to the U.S. Bone and Joint Initiative.

By the time they're 65, about half of all Americans will have broken a bone. These fractures range in severity and treatment.

What are the types of bone fractures?

Bones can break in different ways. The angle and degree of the crack matter when doctors are deciding how to treat the fracture.

Types of bone breaks include:

  • Stress fracture: A tiny crack in the bone, usually caused by a repetitive motion or force.
  • Stable fracture: A "clean break" where the broken ends of the bone are still in alignment. This means the bones aren't displaced.
  • Compound fracture: Also known as an "open" fracture, this is when the bone has broken the skin. (You may or may not be able to see the bone.)
  • Oblique fracture: The bone breaks in an angled pattern and has a curve or slope in the break. Sometimes oblique fractures are also displaced, meaning the bone is out of alignment.
  • Transverse fracture: The bone has a horizontal fracture line and may or may not be out of place.
  • Comminuted fracture: The bone breaks into three or more pieces, meaning there's more than one fracture in the bone.

Causes of fractures and breaks

Common causes of bone fractures and breaks include:

  • Falls.
  • Sports injuries.
  • Car accidents.

Children are at a high risk of breaks and fractures since their developing bones have weaker spots (growth plates) that expand as they grow.

As we age, our bones become less dense and weaker. This puts older adults at an increased risk of broken bones.

What Are Risk Factors and Complications of Bone Fractures and Breaks?

People of all ages can break a bone. Children, especially those who play sports, are at risk of fractures because they are so active.

But your risk for fractures goes up as you age. Half of adults over 50 — 54 million Americans — are at risk for breaking a bone because of low bone density.

Severe low bone density leads to osteoporosis. About one in two women and one in four men will break a bone during their life because of this disease.

In terms of complications, a broken bone or fracture can put you at risk of getting arthritis later.

If a bone isn't realigned (put back into place) or repaired perfectly, it can cause more wear on a nearby joint. This increases your odds of getting arthritis in that joint.

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Broken Bone and Fracture Symptoms and Diagnosis

Fractures and breaks aren't always plain to see.

For instance, if you break a bone in your arm, the cracked bone may be sore but not look broken.

What are the symptoms of a broken or fractured bone?

Some symptoms of a break or fracture include:

  • Sharp, stabbing pain that gets worse when you move the bone or with pressure.
  • Swelling, bruising, or tenderness at the injury site.
  • Not able to put weight on the area.
  • The arm or leg bends in an odd way or the bone sticks out through the skin. (If you ever see a bone sticking through the skin, go to the emergency room right away.)

How do you diagnose a broken bone or fracture?

Your doctor will first examine the injured area, assessing symptoms and things like range of motion. Your doctor will also ask questions about your medical history, including if you've broken bones before.

The standard way to diagnose fractures is through X-rays.

X-rays give a clear image of the bone. They can show where the break is and what type of break it is. Doctors who have trained to read X-rays can even spot tiny breaks on an X-ray.

But X-rays don't show soft tissues, like ligaments, tendons, or cartilage. They also can't show blood vessels or nerves. If your doctor thinks you might have other injuries related to the fracture, you may need an MRI.

If you've broken bones before, your doctor may look for clues about whether you have a health problem that causes weak bones.

Broken Bone and Fracture Treatment

A bone that is only cracked may need a splint or cast. If your bone is severely broken, doctors will pull it back into place before they put on a splint or cast. Your doctor may also prescribe pain medicine while you heal.

If you have a severe break, you can expect to have X-rays before and after treatment. You may even need follow-up X-rays.

Casts

Casts are the most common treatment for fractures. A cast helps keep the bone in the right position while it heals. Casts can be plaster or fiberglass, or made from waterproof materials.

Functional cast or brace

A functional case or brace, like a walking boot, allows some movement, but still helps support the fracture.

Rest

Rest is a treatment for fractures like rib fractures, which are harder to treat. Doctors often let these types of fractures heal on their own unless they cause other problems.

Bone fracture repair surgery

You may need surgery — or even “external fixation" — to repair:

  • Severe fractures.
  • Shattered bones.
  • Broken and deformed bones that go through the skin.

During external fixation surgery, your orthopaedic surgeon will attach a metal structure — similar to a cage — to the bone. After your bone heals, your surgeon will remove it.

Fractured and broken bone healing process

Your doctor will need to see you a few times for several weeks to check your broken bone or replace your cast. How long a cast stays on varies but can be anywhere from three to eight weeks (or longer for complex breaks).

After your doctor removes the splint or cast, you may feel some pain as you begin to move your joints again. This will improve over time. You may have swelling and bruising for several weeks after the cast or splint is off.

Your doctor may also prescribe exercises to help you regain the strength you lost while your bone was in a cast. Physical therapy is often helpful, especially for severe breaks.

Make an appointment for fractured or broken bone care

Request an appointment with a UPMC orthopaedic surgeon:

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