Types of Fractures
Even minor broken bones and fractures cause pain, require restrictions on the use of the affected bone, result in lost work or school time, and sometimes result in more serious complications. They can happen in falls, motor vehicle accidents, or on the job. In many cases, these are preventable accidents that occur because of someone else’s negligence, in which case the victim may have legal recourse against the responsible party.
Different types of fractures include:
- Open versus closed fractures: In open fractures, the broken bone is no longer covered by the skin; the bone may have broken through the skin, or the skin may have been damaged by the same force which broke the bone. Open fractures are serious injuries.
- Complete versus incomplete fractures: Complete fractures involve total separation of the two segments of the bone; the segments remain partially attached in incomplete fractures
- Pattern of the break: Many different break patterns are recognized, including:
- Comminuted—the bone has 3 or more fragments
- Spiral—the fracture twists around the bone’s axis
- Oblique—the fracture runs diagonally to the bone’ axis
- Transverse—the fracture runs perpendicular to the bone’s axis
- Displaced—the broken ends are no longer aligned
Common Accompanying Injuries
Many people with fractured bones also have injuries to nearby soft tissues like muscles, nerves, and blood vessels.
The soft tissue injuries can be caused by either or both of the following:
- The injury was inflicted with so much force that it damaged the soft tissue it encountered before reaching the bone
- The broken end of the bone contacted the soft tissue around it
In either case, the soft tissue injuries often lead to longer healing times and can leave permanent functional problems even if the fractured bone heals completely.
Factors Affecting Recovery
While all fractures are similar to a degree and heal by the same process, recovery from a fracture varies considerably from case to case.
The most significant factors that affect the time needed for recovery and the likely long term consequences include:
- Which bone is affected; fracturing a hip is a far different than fracturing a small bone in the pinky finger; fracturing a bone in the spine is far different than fracturing a bone in the foot
- Whether an upper limb fracture affects the victim’s dominant hand (left vs. right)
- The type of fracture; a bone broken into several pieces is different than a fracture that involves a single, straight line break
- Whether repair requires surgery
- The severity of accompanying injuries; recovery from a fracture alone is far different than recovery from a fracture that has broken completely through the skin, damaging the soft tissues on its path
- Any complications that occur during recovery, especially osteonecrosis (the death of bone tissue), blood clots, and the failure of the fracture to heal normally
- How important the fractured bone is to the victim’s work; collarbone fractures keep you away from jobs involving overhead reaching, while leg fractures keep you out of a job where you stand all day longer than out of a job which you can do sitting down
- The age of the victim
Fractures in Kids
The unique concern with fractures in children is the potential for damage to the growth plate at the end of the bones. If the growth plate injury is not adequately repaired, the damaged bone may not grow at the same rate as the uninjured bone on the other side. Serious growth plate injuries call for periodic medical follow-ups until it is clear that the growth is proceeding normally. If not, further repair is needed.
Fractures in Seniors
Seniors are especially at risk of fractures. The elderly are very prone to breaking bones because they are prone both to falling and to thinning bones (osteoporosis). The immobility required for fracture healing is especially hard on older people, many of whom already suffer from mobility problems, reduced activity, and other health problems. All in all, fractures in the elderly are far more serious than in other age groups. In fact, the five-year survival rate for elderly people who suffer an osteoporotic hip fracture has been said to resemble that of cancer patients. Osteoporosis is also believed to impair the normal fracture healing process.
