A fracture is a complete or incomplete break in a bone resulting from the application of excessive force. A bone fracture is a medical condition in which there is a break in the continuity of the bone. They are injuries of bone tissue, which compromise their ability to support the body. It can be the result of high force impact or stress, or trivial injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture.
BONE FRACTURE PHYSIOLOGY
Bone tissue is structurally very hard, but when it is subjected to forces higher than its capacity it responds in two ways. When the forces are applied in one instant, like a sudden fall, it results in a bone fracture. But if it is applied slowly over a period of time, it results in remodeling of the bone to a shape that balances the forces e.g. bowing of legs in rickets. Thus, the bone has a dynamic nature and adjusts to the changing loads of weight bearing and physical stress. This ability of bones is due to the constant erosion of bone by osteoclasts and deposition of new bone by osteoblasts (Picture 1).
Picture 1: Bone Fracture Physiology A delicate balance between these cells is responsible for thickening or thinning of bones, depending on the activity performed by a person. Hence, a manual laborer has a much sturdy skeleton than a sedentary working clerk in an office. Thus, after a bone fracture, the bones have an intrinsic ability to heal themselves due to the deposition of bone by osteoblasts. It also indicates that pressure acting on a particular bone tends to increase the thickness of the bone over time and helps better healing of bone fractures.
CAUSES OF BONE FRACTURES
Individuals with high activity levels appear to be at greater risk for fractures. This group includes children and athletes participating in contact sports. Because of an increase in bone brittleness with aging, elderly persons are also included in this high-risk population. Up to the age of 50, more men suffer from fractures than women due to occupational hazards. However, after the age of 50, women are more prone to fractures than men. Specific diseases causing an increased risk for fractures include Paget's disease, rickets, osteogenesis imperfecta, osteoporosis, bone cancer and tumors, and prolonged disuse of a nonfunctional body part such as after a stroke.
SYMPTOMS OF BONE FRACTURES
Each individual may experience different symptoms depending on the location and impact of fracture. Following are some of the common symptoms of any fracture. •Swelling of the affected area
•Inability to carry out functions of the injured area
•Deformity of limb
•Bruising around the affected area
Symptoms of fractures usually begin with pain that increases with attempted movement or use of the area and swelling at the involved site. The skin in the area may be pale and an obvious deformity may be present. In more severe cases, there may be a loss of pulse below the fracture site, such as in the extremities, accompanied by numbness, tingling, or paralysis below the fracture. An open or compound fracture is often accompanied by bleeding or bruising. If the lower limbs or pelvis are fractured, pain and resistance to movement usually accompany the injury causing difficulty with weight bearing.
TYPES OF FRACTURES
They are broadly classified as Open and Closed fractures:
* OPEN (COMPOUND) FRACTURE: An open fracture is a fracture where the broken bone is exposed. That is dangerous because of increased chances of infection. * CLOSED (SIMPLE) FRACTURE : A closed fracture is a fracture where the bone is broken, but the skin is intact.
ON THE BASIS OF AETIOLOGY:
* TRAUMATIC FRACTURE: A fracture sustained due to trauma is called a traumatic fracture. eg: fractures caused by a fall, road traffic accident...