Understanding Fractures: Types, Causes, and Treatment Options

Understanding Fractures: Types, Causes, and Treatment Options

Trauma surgeons have a lot to do when it is slippery and icy because the number of broken bones, especially in the forearm and femoral neck, often increases rapidly. However, broken bones are not only an issue in winter: In addition to these frequent fractures caused by falls, which usually only affect one bone, significantly more complicated bone fractures can also occur, for example, due to traffic accidents. But how does a broken bone occur, and how long does the healing process take? We answer these and other questions below.

Bones – a rigid framework for the softcore

Our bony body structure accounts for around 20 per cent of our weight, anchors muscles and ligaments and protects our internal organs in the head, chest and pelvic areas. Bones comprise almost 50 per cent inorganic material such as calcium phosphate, 25 per cent connective tissue structures and 25 per cent water.

They are very stable: a fully grown bone can withstand a pressure of up to 15 kilograms per square millimetre – so a femur can carry a good 1.5 tons.

 

How does a bone fracture occur?

Despite the enormous resilience, a bone cannot give way when a strong force is applied to the bony skeleton due to its brittle, hard substance – a bone crack (fissure), a bone fracture (fracture) or even a splintering of the bone into several parts (multiple fractures, complicated fracture). Arises. If the fragments are displaced in a fracture, this is referred to as a dislocation.

A frequent cause of a bone fracture is a sudden and intense impact, for example, by a:

  • accident
  • fall
  • bump
  • blow

However, repeated overload can also cause a bone to break. This is then referred to as a fatigue fracture or a stress fracture.

In addition, there are so-called pathological fractures,  in which a bone breaks without (or with little) external influence. In this case, the bone structure is changed so that the bone cannot cope with any pressure load – for example, in bone-changing metabolic diseases such as severe osteoporosis or brittle bone disease, bone cancer or metastasis in the bone.

Different types of broken bones

How the bone breaks is pure physics. Depending on the force applied, the following types of fractures can occur, for example:

  • a clear breakthrough
  • a perforation with a bone fragment blown out on the opposite side
  • a twisted bone fracture (spiral fracture) or
  • lots of bone debris

The bone is not yet so brittle in childhood and can give way better. This is where so-called greenstick fractures often occur. In the case of greenstick fractures, the bone only breaks on one side, or it is compressed, or the sensitive periosteum is injured, but the bone holds up. A kink is formed, like a young green twig – hence the name.

In addition, the fractures can be associated with other injuries, such as injuries to the skin, nerves, joints or neighbouring organs.

Bone fractures are classified according to various criteria, such as their location, the number of fragments or whether the fracture is open or closed.

 

How long does a bone take to heal?

As a guideline, it usually takes six to twelve weeks after a broken bone before it can bear total weight again. Children can take three to four weeks to heal, while adults can take as many months.

How long it takes for a fracture to heal depends on a variety of factors, such as:

  • Type and extent of the fracture (a compound comminuted fracture heals more slowly than a clean eruption)
  • The age of the affected person (in children, bones grow together faster, and misalignments of the bones can be corrected easily; with increasing age, the healing time increases)
  • The location of the fracture (certain bones heal more quickly than others)
  • the type of healing (direct and indirect fracture healing)
  • The kind of treatment (which mainly depends on the type of fracture)

Localization: How long does each fracture heal?

Which bone is affected affects the healing time. The following rough guide values ​​apply, whereby the influencing factors already mentioned must also be taken into account:

  • For example, a broken collarbone in an adult will heal in six to eight weeks (rest should take three to four weeks).
  • On the other hand, a thigh fracture takes about ten to 14 weeks, but healing can take up to six months.
  • broken nose can heal in as little as two weeks.
  • broken rib heals in about twelve weeks; with simple fractures, it goes faster.
  • A broken wrist takes about five to six weeks to heal.

A joint fracture or a broken bone near a joint usually takes longer to heal.

Indirect and direct fracture healing

There are two different ways in which a broken bone can heal.

In indirect or secondary fracture healing, the so-called callus forms at the broken end of the bone, i.e. scar tissue, which bridges the fracture site and slowly transforms into bone. The development takes a long time, so the corresponding tissue can still be seen in X-ray images even after several months or years. Nevertheless, the bone can typically be loaded again sooner.

Direct or primary fracture healing occurs without such scar tissue. It happens only when the ends of the bone fit together precisely, which is usually only the case with surgical treatment. The bone is fully functional again after about three weeks.

 

Proper treatment is crucial for healing.

When treating a fracture, the separate parts of the bone are usually put back together and fixed in place so they can grow back together. An adequate blood supply must also be ensured.

Various methods are available for treating a fracture, which affects how long it takes to heal or how quickly the affected areas can be put under pressure again. Early treatment contributes to rapid healing. You will learn details about the treatment later in this article.

Rehabilitation promotes the healing process.

The treatment also includes appropriate rehabilitation measures: To avoid consequential damage to the muscles and joints, one does not usually wait for the healing to be complete before the bone is loaded again but begins with the rehabilitation as soon as the fracture has been adequately treated and stabilized:

  • Sufferers should try to use their non-immobilized joints as generally as possible.
  • Isometric exercises (a particular form of strength training) can also help to keep the immobilized muscles fit.
  • Suppose the person concerned has to remain in bed due to other injuries, an illness or other reasons. In that case, early mobilization is usually carried out using physiotherapy exercises in bed.

You should consult your doctor and have him explain which movements and exercises are recommended for your broken bone.

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