What is a fracture?

A fracture is a broken bone. It can range from a thin crack to a complete

break. Bone can fracture crosswise, lengthwise, in several places, or into
many pieces. Most fractures happen when a bone is impacted by more
force or pressure than it can support.

If you suspect you have a fracture, seek medical help immediately.

What are the symptoms of a fracture?

Most fractures are accompanied by intense pain when the initial injury occurs. It
may become worse when you move or touch the injured area. In some cases,
you may even pass out from the pain. You may also feel dizzy or chilled from
shock.

Other potential symptoms of a fracture include:

 a snap or grinding sound when the injury occurs

 swelling, redness, and bruising in the injured area
 difficulty supporting weight with the injured area
 visible deformity in the injured area

In some cases, you may see broken bone poking through your skin.

What are the different types of fracture?

Fractures can be classified as closed or open, as well as incomplete or

complete.
Closed vs. open

A closed fracture is also called a simple fracture. In a closed fracture, the broken
bone doesn’t break your skin.

An open fracture is also called a compound fracture. In an open fracture, the

ends of the broken bone tear your skin. When your bone and other internal
tissues are exposed, it puts you at higher risk of infection.

Incomplete vs. complete

In an incomplete fracture, your bone doesn’t break completely. In other words,

it cracks without breaking all the way through. Types of incomplete fracture
include:

 hairline fracture, in which your bone is broken in a thin crack

 greenstick fracture, in which your bone is broken on one side, while the
other side is bent
 buckle or torus fracture, in which your bone is broken on one side and a
bump or raised buckle develops on the other side

In a complete fracture, your bone breaks completely. It’s snapped or crushed

into two or more pieces. Types of complete fracture include:

 single fracture, in which your bone is broken in one place into two pieces
 comminuted fracture, in which your bone is broken or crushed into three
or more pieces
 compression fracture, in which your bone collapses under pressure
 nondisplaced fracture, in which your bone breaks into pieces that stay in
their normal alignment
 displaced fracture, in which your bone breaks into pieces that move out of
their normal alignment
  segmental fracture, in which your bone is broken in two places in a way
that leaves at least one segment floating and unattached

Incomplete fractures are more common in children. Their bones are softer than
those of adults. As a result, they’re more likely to bend than break. Complete
fractures can happen at any age.

Who is at risk of a fracture?

Anyone can be experiencing a fracture. But you’re more likely to develop one if
you have brittle bones, or low bone density. You’re more likely to develop
brittle bones if you:

 are older
 have osteoporosis
 have endocrine or intestinal disorders
 are taking corticosteroids
 are physically inactive
 drink alcohol
 smoke

How is a fracture treated?

If you’re diagnosed with a fracture, the treatment plan will depend on its
type and location.

In general, your doctor will try to put the broken bone pieces back into
their proper positions and stabilize them as they heal. It’s important to
keep pieces of broken bone immobile until they’re mended. During the
healing process, new bone will form around the edges of the broken
pieces. If they’re properly aligned and stabilized, the new bone will
eventually connect the pieces.

Your doctor may use a cast to stabilize your broken bone. Your cast will
likely be made from plaster or fiberglass. It will help keep the injured
area stabilized and prevent broken bone pieces from moving while they
heal.

In rare cases, you may need traction to stabilize the injured area.
Traction stretches the muscles and tendons around your bone. Your
doctor will administer it using a system of pulleys and weights positioned
in a metal frame over your bed. This system will produce a gentle pulling
motion that your doctor can use to stabilize the injured area.

For more complex or compound fractures, you may need surgery. Your
doctor may use open reduction, and internal fixation or external fixation
to keep your bones from moving.

In open reduction and internal fixation, your doctor will first reposition or
“reduce” the pieces of broken bone into their normal alignment. Then
they will connect or “fix” the broken bone. This occurs by using screws,
metal plates, or both. In some cases, your doctor may insert rods
through the center of your bone.

In external fixation, your doctor will put pins or screws into your bone
above and below the fracture site. They will connect these pins or
screws to a metal stabilizing bar positioned on the outside of your skin.
The bar will hold your bone in place as it heals.

Your doctor may also prescribe medication to control pain, fight infection,
or manage other symptoms or complications. After the initial treatment
stages, they may recommend physical therapy or other strategies to help
you regain normal use.
Bone Fracture Fixation

When you experience a bone break (also known as a fracture), it’s important
that the bone can heal properly in its original position. There are several
treatments for a broken bone, and the one a doctor recommends is based upon
several factors. These include how severe the break is and where it is.

While some bones can heal by wearing a cast, others may require more invasive
treatments, such as bone fracture repair. Bone fracture repair is a surgery to fix a
broken bone using metal screws, pins, rods, or plates to hold the bone in place.
It’s also known as open reduction and internal fixation (ORIF) surgery.

Why is bone fracture repair done?

Bone fracture repair is used when a broken bone doesn’t or wouldn’t heal
properly with casting or splinting alone. Improper healing that requires ORIF
surgery can occur in cases when the bone is sticking through the skin
(compound fractures) and fractures that involve joints, such as wrists and
ankles. If bones that are surrounding the joints can’t be repaired, a person’s
functional mobility could be severely impacted.

How to prepare for bone fracture repair

Tell your doctor about your medical history, including any chronic conditions or
prior surgeries. Also tell your doctor about any medications you are taking or
are allergic to, including over-the-counter medicines and supplements.

Your doctor will also ask for imaging tests to view exactly where the bone has
broken. Examples could include X-rays, CT scans, and MRI scans. The day
before your procedure, your doctor will likely recommend that you don’t eat
anything after midnight. You should have someone drive you to the hospital or
surgery centre and take you home after your procedure.

The risks of bone fracture repair

Complications from this surgery are very rare. These complications may
include:

 an allergic reaction to anaesthesia.

 bleeding
 blood clots
 infection

You can minimize your risk for complications by disclosing all medical
conditions and medications you’re taking as well as following your doctor’s
post-procedure orders carefully. This can include instructions on keeping your
dressing clean and dry.

How bone fracture repair is performed

Bone fracture repair surgery can take several hours. You may be given general
anesthesia to put you to sleep during your surgery or local anesthesia to numb
only the broken limb. The surgeon may make an incision over the fracture site if
a plate and screws are to be utilized. He may make an incision at the end of a
long bone and place a rod down the inner aspect of the bone to stabilize and
repair a fracture.

The fractured bone is then set into place. Your surgeon may use metal screws,
pins, rods, or plates to secure the bone in place. These can be either temporary
or permanent. Your doctor might recommend a bone graft if your bone
shattered into fragments during your original injury. This procedure uses bone
from a different part of your body or from a donor to replace the portions of
bone that were lost. Blood vessels that were damaged during your injury will be
repaired during surgery. When the broken bone has been set properly, your
surgeon closes the incision wound with stitches or staples and wraps it in a
clean dressing. Your injured limb will most likely be put in a cast after the
procedure is complete.

After bone fracture repair

Your doctor will tell you the expected recovery time for healing your fracture.
According to the Cleveland Clinic, this process will typically take six to eight
weeks. However, this time frame can vary based on the fracture type and
location. Immediately after the procedure, you will be taken to a recovery room.
Here, hospital staff will monitor your blood pressure, breathing, heart rate, and
temperature.

Depending on the extent of your injury and surgery, you may need to stay in the
hospital overnight or longer, depending on your progress after surgery. There
will be some pain and swelling after the surgery. Icing, elevating, and resting
the broken limb can help to reduce inflammation. Your doctor will also
prescribe painkillers to ease your discomfort.

However, if your pain starts to worsen after a few days instead of getting better,
call your doctor.

Your doctor will give you instructions about how to care for your stitches or
staples. As a general rule, you will want to keep the surgical site clean and dry.
Doctors will often place a surgical bandage over the site that they will remove at
a follow-up visit.

You can expect some numbness at the incision site, but call your doctor if you
begin to experience:

 swelling
 redness
 foul-smelling drainage
In some cases, you may be able to feel a plate or screw if there is very little
muscle or soft tissue covering them — for instance, along the outside of your
ankle or the top of your hand. If the plate and screws are causing discomfort or
irritation to the skin (such as a shoe rubbing against the plate), your healthcare
provider may recommend removing the plate and screws once the fracture is
healed and mature. Your doctor will also likely recommend physical therapy to
help you strengthen and stretch the muscles around the injured bone. This will
aid in healing as well as ideally help to prevent further injury.

While it’s easy to think of your bones as a solid piece of material, they actually
have many blood vessels that can promote healing. With time, your body will
start to produce new threads of blood cells that will ultimately grow back
together, helping to heal the bone. Just remember that even though the fracture
has been repaired, it can happen again. Practice caution whenever possible to
prevent re-injury. This can include eating a diet rich in bone-boosting foods,
such as those that contain calcium and vitamin D. Wearing protective gear, such
as pads, braces, or a helmet, can all help you prevent a future fracture.

What is a tibia fracture?

The tibia, or shinbone, is the larger of the two bones in the lower leg. It’s one of
the most commonly fractured bones in the body. Symptoms of a fracture in your
tibia can range from bruising to intense pain in your lower leg, based on the
extent of your injury. To diagnose this type of injury, your doctor will do a
physical exam and may run some tests to get an image of the tibia fracture.

Depending on the type of tibia fracture you have, your doctor may recommend
surgery. Recovery time also depends on how bad the fracture is and can take
from four to six months to heal.

What are the main symptoms?

Your symptoms will vary depending on how bad the fracture is. Symptoms may
include:
  intense pain in your lower leg
 difficulty walking, running, or kicking
 numbness or tingling in your foot
 inability to bear weight on your injured leg
 deformity in your lower leg, knee, shin, or ankle area
 bone protruding through a skin break
 limited bending motion in and around your knee
 swelling around the site of your injury
 bruising and blueness on your injured leg

When the tibia is fractured, the other bone in the lower leg, called the fibula, is
often affected as well.

What causes a tibia fracture?

The most common reasons for tibia fractures are:

 High-energy collisions: These typically involve motorcycle or automobile

crashes and can result in the most severe fractures.
 Falls, especially from large heights and ones involving hard surfaces:
This most commonly applies to the elderly, who may lack stability, and
athletes.
 Twisting motions, such as pivoting: Sports such as snowboarding, skiing,
and contact sports are a common cause of this type of injury.

Some health conditions may also affect your tibia fracture. These include type 2
diabetes and pre-existing bone conditions such as osteoarthritis.

How is a tibia fracture diagnosed?

If you suspect you have a tibia fracture, your doctor may refer you to an
orthopedist. This is a specialist who diagnoses and treats abnormalities and
injuries in the bones. If you also have foot and ankle problems, you may see a
doctor called a podiatrist who specializes in those areas.

Your doctor will first ask you about your symptoms and a specific incident that
may have caused the fracture, such as a fall or collision. They will also review
your medical history to see if you have any risk factors for a tibia fracture or
any prior injury. They will then perform a physical examination to look for:

 bruises, especially with lots of blueness and swelling

 instability when walking
 tenderness
 any obvious deformities, such as an abnormal bend or shortening of your
leg
 any associated injury to your fibula

Your doctor will then perform a series of tests that check your muscle strength
and whether you can feel sensation in the lower leg, foot, and ankle. They may
also order the following tests to get a visual image of the fracture:

 X-rays
 CT scan
 bone scan
 MRI scan

Depending on the extent of your injury, you may need emergency surgery.
Conditions requiring surgery include the bone penetrating the skin, multiple
broken bones, or injury to a major artery or nerve.

What are the types of tibia fractures?

Type of Description
 fracture

The broken ends of the tibia line up correctly and stay in place
stable fracture
during the healing process.

transverse The fracture is horizontal, and the bone can become unstable if
fracture the fibula is also broken.

The tibia is moved out of place when it breaks. The broken

displaced ends of the bone are separated and don’t align. This type of
fracture fracture is fairly severe and may require surgery for full
recovery.

The bone fractures at an angle and is fairly stable. It may

oblique
become more displaced over time, especially if the fibula is also
fracture
broken.

comminuted The bone breaks into three or more separate pieces. This is the
fracture most unstable and severe type of tibia fracture.

Often caused by a twisting force, this break causes a spiraling

spiral fracture
line to appear on the bone and may become unstable over time

Tibia fractures can also be closed or open. With closed fractures, the bone
doesn’t break through the skin. Internal soft tissues such as tendons and blood
vessels may be affected by this type of break.

In open fractures, the broken bone breaks through the skin. This usually only
occurs during bad falls and vehicle accidents. Ligaments, muscles, tendons, and
other soft tissue surrounding the fracture site are at risk of injury. Your body is
more exposed to germs, increasing the risk of infection.

How is a fractured tibia treated?

Your doctor will consider several factors when treating a tibia fracture,
including:
  extent of the injury, taking into account the amount of damage to soft
tissues
 the reasons for the injury
 overall health and medical history
 personal preferences
 any other fractures, such as a fibula fracture

Nonsurgical treatment of a fractured tibia includes:

 casts
 functional braces, which allow some movement of your leg
 pain medications, such as narcotics or anti-inflammatories
 physical therapy
 at-home exercises
 splints

According to a study published in the journal InjuryTrusted Source, researchers

are starting to investigate a potential nonsurgical treatment for fractures
involving bone morphogenetic proteins. Research for this treatment is still in its
early stages.

In certain cases, your doctor may recommend surgery. This is more likely if you
have an open fracture, a comminuted fracture, or extreme instability in the bone
or limb. Surgery may also be necessary if a combination of the nonsurgical
treatments for fractured tibias don’t work. The following surgical procedures
are most commonly used to treat tibia fractures:

 internal fixation, which involves using screws, rods, or plates to hold the
tibia together
 external fixation, which connects screws or pins in the fracture to a metal
bar outside your leg for added stability
Typically, these surgical methods are accompanied by physical therapy, at-
home exercises, and pain medication. Small risks are associated with these
surgeries. Ask your doctor to discuss these risks with you before your surgery.

How long does recovery take?

Recovery time depends on the extent and type of fracture. Some shaft fractures
of the tibia take as little as four months to heal, with more extreme cases taking
a minimum of six months to heal. Your overall health and the extent of your
fracture will influence your recovery time.

Tibia fractures are painful and common. Recovery rarely requires more than 12
months. If you suspect you have a tibia fracture, schedule an appointment with
your doctor right away to get it evaluated, or go to an emergency room.

What causes a fracture?

Bone injuries are common. In the United States, more than 1 million people a
year fracture a bone.

A fracture occurs when a bone is struck by something stronger than the bone
itself. This causes it to break. Car accidents, sports injuries, and falls are
common causes of fractures.

Repeated wear on a bone, such as from running, can also cause small fractures.
These are called stress fractures or hairline fractures.

Sometimes fractures result from an infection or cancer that weakens the bone.
Weakened bones in older people, called osteoporosis, are also a frequent cause
of fractures.
Fractures can range from minor to severe depending on the force of the impact
and whether there is other damage to the body. Some other types of damage that
may occur include:

 breaks in the skin

 nerve damage
 muscle damage
 organ damage

What are the signs that you have a fracture?

The main sign of a fracture is pain. Most fractures will hurt, especially if you try
to move or put weight on the injured bone.

Other symptoms at the site of the injury include:

 swelling
 numbness
 bleeding
 bruising or change in color
 bone poking through the skin

You should go to the emergency room if you suspect a fracture. Call an

ambulance if you, or someone else, has multiple injuries or is unable to walk.

How will your doctor treat your fracture?

The treatment for a fracture depends on the type of injury, the location of the
injury, and its severity.
Bones heal themselves by producing new bone tissue to repair the fracture. New
bone tissue forms at the edges of the break to “knit” the broken pieces together.
The new bone is soft at first, and so it needs to be protected.

Usually a fracture is immobilized to protect the new, soft bone tissue. Your
doctor can immobilize the bone using options that include:

 cast
 splint
 sling
 combination

These devices can help keep the bone aligned while it heals. They also make it
more difficult for you to accidently use the injured bone.

For a small bone like a finger or toe, the fracture can be immobilized by
wrapping it with a soft wrap or a splint.

The injured bone may have to be realigned into its natural position before it’s
immobilized with a cast or splint. The realignment may be done without
surgery, and is called closed reduction. This often requires a local anesthetic and
painkillers.

Sometimes surgery will be required to reposition the injured bone. This is called
open reduction. The surgeon may also need to insert the following into your
bone to help surgically align the bone:

 pins
 rods
 screws
 wire cables

This may require anesthesia and pain medication.

Hip fractures almost always require surgery to promote faster and better
healing. Some limb fractures may need traction, a gentle pulling of the muscles
and tendons around the broken bone in order to realign the bone. The traction
can be created with a system of weights and pulleys that are mounted on a metal
frame over your bed.

What can you do to prevent fractures?

Keeping your bones healthy is important at every age. This means getting
enough calcium from your diet and doing weight-bearing exercises to keep your
bones strong. Weak bones break more easily.

After age 40, everyone begins to lose bone mass. Your genetic makeup
determines your peak bone mass, but diet and exercise make a big difference in
keeping your bones healthy as you age.

The American Academy of Orthopedic Surgeons recommends that both men

and women over the age of 40 have:

 at least 1,000 milligrams of calcium every day

 at least 1,000 international units (IU) of vitamin D every day

If you are a woman and have gone through menopause, you should increase
your calcium to 1,200 milligrams a day. This is because hormonal changes
decrease bone strength, which can lead to osteoporosis and increased risk for
fractures.

At any age, daily weight-bearing exercises, such as walking, are necessary for
bone health. Check with your doctor about an appropriate exercise program for
you.
There are also some things you can do to prevent falls and reduce your risk for
bone fractures:

 Wear sensible shoes.

 Minimize clutter around the house.
 Make sure that wires, cords, and other hazards are out of the way to
prevent tripping.
 Have adequate lighting and place nightlights in the bathroom or other
rooms you may have to access in the middle of the night.
 Secure rugs with no-slip pads.
 Get physical therapy to help improve your balance. Take a balance
training course, chair yoga, or tai chi.
 Use a cane or walker if needed.