Bone fracture

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

In a closed fracture, the skin is not damaged; in an open fracture, it is. The bone then protrudes through the skin, making 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 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 fracture can differ. Below, you will first find more information about the most common 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 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 more weight than the bones can handle, is also a risk factor.

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

Characteristics (symptoms) of a bone fracture

The most characteristic sign is pain at the site 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, an abnormal position may be visible. This is not the case when there is 'only' a crack in the bone. A cracking sound may have been heard at the moment of injury.

How is a bone fracture diagnosed?

Often, during the interview and physical examination, there is a suspicion of a fracture. In that case, the primary care physician or specialist will request an X-ray. This is necessary to visualize the exact position of the bone fragments and the severity of the fracture. Any displacement of bone fragments is also visible on the X-ray.

Sometimes a CT scan is needed to assess the fracture and visualize details even better.
In people over age 50 with a fracture, it is important to perform a DEXA scan. A DEXA scan uses X-rays and provides more information about bone density. Scans of the spine, hip, and wrist are made. The results are compared with norms for age, height, and weight to determine whether osteoporosis (bone demineralization) is present.

Treatment of a bone fracture

A bone fracture generally heals on its own. Treatment aims to allow the bones to grow together in the correct alignment.
The type of treatment is tailored to the fracture location, fracture type, and any associated soft-tissue injury to tendons, muscles, nerves, and blood vessels. In practice, treatment options are divided into three categories: conservative, cast, and surgical.

Conservative treatment

In most fractures, a 'watchful waiting' approach is chosen. The bones are first reduced if necessary and then usually immobilized in a cast. The cast provides protection and allows the bone to heal quietly. It is very important to take sufficient rest, possibly with the help of a sling or compression bandage.

Surgical treatment

Surgery is often chosen if the fracture will not heal in the correct alignment by itself. The broken bone fragments are surgically fixed together with fixation hardware, such as metal pins, screws, and plates.