A bone fracture is severe trauma. When bone breaks, muscles, tendons, ligaments, blood vessels, and even the nerves connected to it can also be involved in the injury. All of these structures can be damaged or even torn apart. An "open" fracture is accompanied by an open wound on the skin, which can be a focus of infection. A "closed" fracture, on the other hand, involves only the breaking of the bone, does not involve the skin and represents a less serious trauma than the exposed one. However, even in this second case the patient feels severe pain and the injury takes time to heal. Within these two categories of fractures there are a myriad of classifications and types.
Steps
Part 1 of 3: Recognizing Fracture Types
Step 1. Look for signs of an open fracture
In this case, the bone stump protrudes from the skin and carries some complications, including the risk of contamination and infection of the wound. Look closely at the area around the impact or suspected break. If you see bone protruding from the skin or if you notice any visible bone fragments, it is an open fracture.
Step 2. Learn about closed fractures
As the name suggests, these are lesions of the bone that do not affect the skin. Closed fractures can be compound, transverse, oblique, or comminuted.
- When the bone breaks without losing alignment between the two abutments or with minimal displacement, it is called a compound fracture. This means that the bone has remained in place.
- An oblique fracture indicates a line of break diagonal to the direction of the bone.
- A break is comminuted (or segmented) when the bone breaks into three or more fragments.
- The transverse fracture indicates a break more or less perpendicular to that of the bone.
Step 3. Recognize impact fractures
There are two types of fractures that fall into this category and which are difficult to distinguish. Impact (also called traumatic) ones typically involve the ends of long bones and occur when a piece of bone is pushed against another piece of bone. Compression ones are similar, but mostly occur at the vertebral level, when the spongy bone collapses on itself.
Compression fractures heal naturally over time, although they should always be monitored. Those from impact, on the other hand, are resolved surgically
Step 4. Recognize incomplete fractures
In this case, the bone does not separate into two stumps, but still shows the typical signs of breakage. Many variants fall into this category:
- Green stick fracture: This is an incomplete transverse injury that often occurs in children, as their still immature bones do not break completely under pressure.
- Microfractures (also known as stress fractures): These are difficult to recognize on X-rays because they look like very fine lines. They can only become visible several weeks after the trauma.
- Depressed fractures: In this case, the bone is pushed from the outside to the inside. There are several cracks that intersect and an entire area of the bone appears lower (depressed) than the rest. This is a typical injury to the skull.
- Incomplete fractures show almost all the symptoms of complete ones. If the limb is swollen, bruised, or twisted, it may be broken; it could also be deformed or put in an unnatural position, dangle or be bent abnormally. If the pain is severe enough to prevent the limb from being used or weight bearing, the bone is likely to be fractured.
Step 5. Understand the variations in fracture classification
There are many other types of bone breaks, the classification of which depends on the specific location or mode of the accident. If you know the types of fractures, you can better understand their nature, avoid them and treat them correctly.
- The spiral ones are the result of excessive twisting or the application of a rotating force to the limb.
- Longitudinal fractures occur when bone breaks along its vertical axis, parallel to its length.
- Avulse fractures occur when a fragment of the main bone breaks away from the connection point of a ligament to the joint. This often happens during traffic accidents, when bystanders try to help the victim by pulling the victim's arms or legs, thereby causing damage to the shoulders or knees.
Part 2 of 3: Recognizing the Symptoms
Step 1. Pay attention to a snap
If you can hear such a noise coming from the limb as you fall or suffer a sudden impact, there is a good chance the bone has broken. Depending on the force of the impact, the severity and angulation of the injury, the bone could break sharply into two stumps or fragment. The snap is the noise emitted by the bone or group of bones that receives a sudden stress and becomes damaged.
The sound caused by the bone during this trauma is referred to in the medical literature as "crepitus"
Step 2. Immediately there is intense pain followed by tingling or numbness
The patient may also complain of burning pain (except for skull fractures) which changes in intensity soon after the accident. Numbness or low temperature in the limb downstream of the injury indicates insufficient blood supply. As the muscles try to hold the bone in place, the victim may also experience cramps and spasms.
Step 3. Look for pain to touch, swelling, bruising with or without bleeding
Edema of the surrounding tissues is caused by the damaged blood vessels oozing blood to the area. This leads to an accumulation of fluids and a consequent painful swelling to the touch.
- Blood in the tissues becomes visible in the form of a bruise or hematoma. At first, it appears as a blue / purplish spot that turns green or yellow as the blood is reabsorbed. You may also notice bruising in places further away from the fracture site, as blood from the blood vessels flows through the body.
- External bleeding occurs only in cases of open fractures, when the bone fragment protrudes from the skin.
Step 4. Observe the deformity of the limb
Trauma could cause some degree of deformity based on the severity of the injury. For example, the wrist might be bent strangely; the arm or leg may show an unnatural deviation in a place where there is no joint. In cases of a closed fracture, the structure of the bone changes within the limb, while in the displaced one, the bone protrudes outside the site of the injury.
Step 5. Be prepared to treat any symptoms of shock
When there is severe bleeding (including internal), blood pressure drops suddenly causing shock. Individuals suffering from this syndrome turn pale, feel hot, or the face suddenly becomes red; however, as the shock progresses, excessive dilation of the blood vessels causes cold, clammy skin. The victim becomes silent, confused, feels sick and / or complains of dizziness. Breathing becomes rapid at first, then slows to dangerous levels when blood loss is massive.
It is normal for an individual to go into shock when the trauma is severe. However, some people show few symptoms of this syndrome and do not notice that they have sustained a bone fracture. If you are severely impacted and realize you are suffering from even a single symptom of shock, call for help immediately
Step 6. Evaluate any limitation of movement abilities or an alteration of them
If the fracture is located near a joint, you will likely have difficulty moving the limb normally. This is a sign of a broken bone. It may be impossible to do the movement without pain or you may not be able to carry your body weight.
Part 3 of 3: Getting a Diagnosis
Step 1. Go to the emergency room immediately
During the visit, the orthopedist will ask you some questions to understand the dynamics of the accident. This information will help you identify the location of the injuries.
- If you have suffered fractures and bone injuries in the past, please report this to your doctor.
- The orthopedist will check for other signs, such as the pulse in the affected limb, the color of the skin, the temperature, any bleeding, edema or open wounds. All these details help him assess your health condition and find the right therapy.
Step 2. Get an X-ray
This is the first test done when a fracture is suspected or recognized. The x-ray reveals broken bones and allows the orthopedist to analyze the extent of the injury.
Before starting, you will be asked to remove any jewelry or any metal elements on your person, based on the area that will be examined. You will need to stand, sit or lie down, depending on the location of the injury, and will be asked to stand still or hold your breath during certain stages of the exam
Step 3. Undergo more thorough diagnostic imaging tests
If radiographs show no fracture, bone scan can be used as an alternative test. This exam is very similar to MRI or computed tomography. You will be injected with a small amount of radioactive contrast fluid a few hours before the test. Later, doctors will trace the path of this substance within the body to identify where the bone has broken.
Step 4. Ask for a CT scan
This procedure is perfect for analyzing internal injuries or other physical trauma. Doctors use it when they know they are dealing with a complex fracture with multiple bone fragments. Computed tomography combines the images of several radiographs to obtain one, which in turn allows a three-dimensional view of the fracture.
Step 5. Consider having an MRI scan
This exam uses radio pulses, magnetic fields and computers to obtain three-dimensional images of the body. In case of fractures, MRI provides more information about the extent of the damage. In addition, it is useful in distinguishing bone fracture from cartilage and ligament injuries.
