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A fracture happens when there is a break in the continuity of a bone. Bones are the body’s supporting tissues, and they are continuous throughout their structure. A break along the body of any bone is called a fracture, and depending on the cause, the pattern may vary. But regardless of the cause, most fractures cause severe pain to the individual.
Fractures often heal over time with some medical treatment. The kind of treatment and attention given to a fracture depends on the cause, the extent of the fracture, as well as the complications that may arise. Some fractures can even heal without medical attention, although there are chances that the limb will be permanently deformed.
Fractures in the upper limb usually heal within 8 to 12 weeks. Lower limb fractures take longer, usually between 12 to 16 weeks. Some other factors determine the speed of healing. For example, the bones of children heal faster than those of adults.
Bones are connective tissues in the body, and they are made up of tiny bone cells (or osteo-cells). There are different kinds of bone cells, and they are all differentiated based on their function. While osteophytes make up the structure of the bone, osteoclasts are responsible for reabsorbing and remodelling the bone.
Any break in the continuity of a bone is a fracture. However, since bones connect at joints, a dislocation, in a sense, is also a break in continuity. The difference is that while fractures apply to a break along the shaft (main body) or end of a bone, dislocations apply to joints. This means that dislocation is the separation of two or more bones at their joints.
Dislocations are equally painful as fractures, and they can be just as deforming if not properly treated. Sometimes, it’s difficult to tell a fracture from a dislocation, especially when the fracture occurs very close to the joint end of the bone. In other cases, a fracture and a dislocation happen at the same time, complicating the condition. X-rays are used to tell these conditions apart from each other.
As mentioned earlier, there are different types of fractures, and they all have slightly different patterns. Fractures can be classified based on the pattern of the break on the bone, based on the cause, and based on the extent of damage to the bone and surrounding tissue.
Classified based on the extent of damage, fractures can be classified into:
A fracture is said to be open when one or more of the bone fragments break the skin and are exposed. This is commonly seen in traumatic fractures where the impact causes the bone to protrude out of the skin. Besides the difficulty in realigning the bony pieces, open fractures can have other complications like infections and slowed healing.
A closed fracture is one in which the broken bone remains within the body. That means that there’s no bone sticking out of the body. These kinds of fractures are considered to be less painful and easier to treat than open fractures. They also have fewer complications.
Traumatic fractures are the most common types of fractures, and they are caused by a severe trauma to the bone in question. Because bones are incredibly strong, the force required to cause a fracture is always significant.
A stress fracture occurs when a bone bears excessive load over time. This is often seen in the elderly. As mentioned earlier, bones are incredibly strong connective tissues, and often require great force to cause a fracture. However, in older people, conditions like osteoporosis weaken the bones, making it easier to sustain a fracture.
A pathological fracture is caused by disease conditions in the body. These are the most troublesome kinds of fractures because until the underlying condition is resolved, the individual is predisposed to sustaining future fractures. A condition that can cause recurrent fractures is Osteogenesis Imperfecta, commonly known as brittle bone disease.
As mentioned earlier, fractures can be caused by a couple of different factors. These factors are often involved in the way the fracture is named. The major cause of fractures is trauma, and it is very common in car accidents and falls from great heights.
The prevalence of fractures varies among younger and older people, and among men and women. In men between the ages of 18 and 49, the incidence of fracture is about 94.8 in 10,000 people or roughly 1%. In women of the same age range, the incidence was 54.3 in 10,000 women or roughly 0.5% In men over the age of 50; the incidence is about 0.7% in men and 1.5% in women.
Older people have a bigger chance of sustaining fractures than younger people. This is because as we age, our bones lose density, and they get more brittle. Also, all the other supporting systems in the body like the joints and the muscles age and lose their strength and elasticity. All of this contributes to the increased likely hood of sustaining fractures.
People who are in high-stress jobs are at risk of getting stress fractures. This is because the repeated impact of the heavy loads on the bones weakens them over time.
Women are more predisposed to sustaining fractures than men. This is because women have lesser bone density and strength than men. Also, women lose more bone density as they grow older, compared to men.
Smoking puts a person at risk for sustaining a fracture because of its influences on hormones. Women who smoke have been shown to go through menopause earlier than women who don’t. It also leads to bone loss.
Symptoms of fractures are quite easy to identify. The most significant of them is an obvious deformity in the affected area. Any break in the continuity at the arms or legs can be easily seen. Other symptoms of fractures include
A fracture can be diagnosed by assessment alone, depending on the area. A fracture of the arm is easily identified. However, further tests like X-rays may be conducted to determine the extent and kind of fracture. It may also be conducted to rule out other suspicious. In some cases, MRIs may also be requested to determine the extent of damage to the surrounding tissues.
However, an X-ray is often all that’s necessary.
The treatment of a fracture depends on the severity of the fracture. Most fracture treatments follow these steps
The most important part of treating a fracture is reducing it. If it is a simple closed fracture, traction may be all that’s necessary. In traction, a force is applied to the distal end of the bone, and that moves it back into place
In other situations, surgery may be needed to reduce the fracture. A plate and screw may then be sued to hold the bones in place
After reduction, the bone pieces are held together, and the affected part is immobilized to allow the bone rest and heal. This may be achieved by the cast alone. In other situations, like an upper limb fracture, an arm sling may be necessary.
Some painkillers may be prescribed to reduce the pain associated with the fracture
https://books.google.com.ng/books?id=KYstDAAAQBAJ&pg=PA462&redir_esc=yKatherine, Abel (2013). Official CPC Certification Study Guide. American Medical Association. p. 108