Bone fracture

A bone fracture is damage to the bone. This can range from a crack in the bone to a complete comminution. Bone fractures are classified by their location and the type of fracture. It is important to determine whether it is a "closed" or "open" bone fracture.

In a closed fracture, the skin is not punctured; in an open bone fracture, it is. The bone protrudes through the skin, which makes an infection more likely.

In the article on different types of bone fractures, you will learn which other classifications exist for fractures.

Determining the location of the fracture is important to investigate whether there is associated injury. Think, for example, of a broken rib that pierces a lung or a broken bone that damages a nerve, muscle, tendon, or blood vessel. Always consult a doctor if a bone fracture is suspected.

Bone fractures by body region

In principle, any bone in the body can break. The symptoms and treatment of each bone fracture can differ. Below, you will first find more information about the most common bone fractures.

How does a bone fracture occur?

A bone fracture can have several causes, with trauma (an accident) being the most common. A distinction is made here between direct trauma, such as a kick or blow to the bone, and indirect trauma. An example of indirect trauma is a fracture of the collarbone after a fall on the outstretched arm.

Overloading, such as a weightlifter lifting a weight heavier than the bones can handle, is also among the risk factors.

A third possible cause is associated with the aging process or in the case of osteoporosis, another word for bone demineralization. In both cases, the bones become weaker, making them more likely to break.

Characteristics (symptoms) of a bone fracture

Most characteristic is pain at the level of the fracture. This pain is often more severe with a serious fracture. Sometimes it is not possible to move the affected body part without aggravating the pain. Swelling and discoloration often accompany the pain.

With a complete fracture, there may be an abnormal position visible. This is not the case when there is "only" a crack in the bone. With all fractures, there may have been a cracking sound audible at the moment it happened.

How is a bone fracture diagnosed?

Often, during the consultation and physical examination, there will be a suspicion that it is a bone fracture. In that case, the GP or specialist will request an X-ray. This is necessary to visualize the precise position of the bone parts and the severity of the fracture. Any displacement of bone fragments is also visible on the X-ray.

Sometimes it is necessary to make a CT scan to examine the bone and visualize the details even better.

In people over the age of 50, it is important to perform a DEXA scan. A DEXA scan is a test using X-rays and provides more information about bone density. During the test, scans of the spine, hip, and wrist are made. The results of these scans are compared with the norm that matches age, height, and weight. Depending on this, it is determined whether there is osteoporosis (bone demineralization).

Treatment of a bone fracture

A bone fracture heals, in principle, by itself. The treatment is aimed at allowing the bones to grow together in the correct alignment.

The type of treatment is tailored to the location, the type of fracture, and any associated soft-tissue injury to tendons, muscles, nerves, and blood vessels. In practice, a classification is made into the following three treatment options: conservative, plaster, and operative.

Conservative treatment

In most bone fractures, a "watchful waiting approach" is chosen. The treatment is then aimed at allowing the bones to heal and grow together in the correct direction. If necessary, the bones are first reduced and then usually immobilized in plaster. The plaster provides protection and allows the bone to heal quietly. It is of great importance to take sufficient rest, possibly with the help of a sling or compression bandage.

Surgical treatment

A surgical treatment is often chosen if there is a fracture that will not heal in the correct direction by itself. The broken bone fragments are surgically fixed together with fixation material, such as metal rods, screws, and plates.