Types of Bone Fractures

A broken bone or bone fracture occurs when a force exerted against a bone is stronger than it can structurally withstand. Bones are a form of connective tissue, reinforced with calcium and bone cells. Bones have a softer centre, called marrow, where blood cells are made. The main functions of the skeleton include support, movement and protection of vulnerable internal organs.

Types of Bone Fractures There are different types of bone fractures that vary in severity. Factors that influence severity include the degree and direction of the force, the particular bone involved, and the persons age and general health.

Common sites for bone fractures include the wrist, ankle and hip. Hip fractures occur most often in elderly people. Broken bones take around four to eight weeks to heal, depending on the age and health of the individual, and the type of break. Symptoms The symptoms of a bone fracture depend on the particular bone and the severity of the injury, but may include: *Pain *Swelling *Bruising *Deformity * Inability to use the limb. Different types of fracture The different types of bone fracture include: * Greenstick fracture the bone sustains a small, slender crack. This type of fracture is more common in children, due to the comparative flexibility of their bones. * Comminuted fracture the bone is shattered into small pieces. This type of complicated fracture tends to heal at a slower rate. * Simple fracture or closed fracture. The broken bone hasnt pierced the skin. * Compound fracture or open fracture. The broken bone juts through the skin, or a wound leads to the fracture site. The risk of infection is higher with this type of fracture. * Pathological fracture bones weakened by various diseases (such as osteoporosis or cancer) tend to break with very little force. * Avulsion fracture muscles are anchored to bone with tendons, a type of connective tissue. Powerful muscle contractions can wrench the tendon free and pull out pieces of bone. This type of fracture is more common in the knee and shoulder joints. * Compression fracture occurs when two bones are forced against each other. The bones of the spine, called vertebrae, are prone to this type of fracture. Elderly people, particularly those with osteoporosis, are at increased risk.
Spiral - a fracture which runs around the axis of the bone

Complications Complications can include:

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fractures

* Blood loss bones have a rich blood supply and a bad break can result in substantial blood loss. * Injuries to organs such as the brain (in the case of skull fractures) or chest organs (if a rib breaks). * Growth problems the fractured long bone of a young child may not grow to its intended adult length if the injury is close to a joint, since bone fuses when it heals.

First aid

Suggestions for immediate treatment of a suspected bone fracture include: * Do not move the person unless there is an immediate danger, especially in the case of a suspected fracture of the skull, spine, ribs, pelvis or upper leg. * Attend to any bleeding wounds first. Stop the bleeding by pressing firmly on the site with a clean dressing. If a bone is protruding, apply pressure around the edges of the wound. * If bleeding is controlled, keep the wound covered with a clean dressing. * Do not attempt to straighten broken bones. * For limb fractures, provide support and comfort such as a pillow under the lower leg or forearm. However do not cause further pain or unnecessary movement of the broken bone. * Apply a splint to support the limb. * Immobilise the area by applying a sling for arms. Limbs should be immobilised above and below a fracture site to be effective. * If possible, elevate the fractured area and apply a cold pack to reduce swelling and pain. * In an emergency dial triple zero (000) for an ambulance. * Do not eat or drink anything until seen by a doctor, in case surgery is required. Diagnosis and treatment Bone fractures are diagnosed with x-rays. CT and MRI scans may also be used. Broken bones heal by themselves the aim of medical treatment is to make sure the two pieces are lined up correctly. Subsequent x-rays are taken to monitor the bones healing progress. Depending on the site of the fracture and the severity of the injury, treatment options may include: *Splintsto discourage movement of *Bracesto support the bone *Plaster castto provide support *Tractionthis option is less common *Surgically inserted metal rods or plates * Pain relief. the and to broken limb immobilize the hold the bone bone pieces together

The healing process The blood clots that form on the broken ends of bone are the beginning of the healing process. Over five or so weeks, the body fuses the two bone portions together with a combination of fibrous cells and cartilage. This bridge is temporary and not as strong as real bone. It can break easily with comparatively little force. A cast or splint may be removed after a few weeks, but the bone still needs to be handled with care for at least one more month. The temporary bone (callus) is slowly replaced with real bone over the next couple of months. Unlike skin, broken bones heal without forming scar tissue. However immobilised muscles tend to weaken and wither. Rehabilitation, including strengthening exercises, may be needed for a short time.

Where to get help *Your doctor *Hospital emergency department * In an emergency dial triple zero (000) for an ambulance Things to remember * A fracture occurs when force exerted against a bone is stronger than the bone can structurally withstand. * The most common sites for bone fractures include the wrist, ankle and hip. * Treatment options include immobilising the bone with plaster casts, or surgically inserting metal rods or plates to hold the bone pieces together.

Cast Types and Maintenance Instructions

What is a cast?
A cast holds a broken bone in place as it heals. Casts also help to prevent or decrease muscle contractions, and are effective at providing immobilization, especially after surgery. Casts immobilize the joint above and the joint below the area that is to be kept straight and without motion. For example, a child with a forearm fracture will have a long arm cast to immobilize the wrist and elbow joints.

What are casts made of?

The outside, or hard part of the cast, is made from two different kinds of casting materials.
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plaster - white in color. fiberglass - comes in a variety of colors, patterns, and designs.

Cotton and other synthetic materials are used to line the inside of the cast to make it soft and to provide padding around bony areas, such as the wrist or elbow. Special waterproof cast liners may be used under a fiberglass cast, allowing the child to get the cast wet. Consult your child's physician for special cast care instructions for this type of cast.

What are the different types of casts?

Below is a description of the various types of casts, the location of the body they are applied, and their general function.

Type of Cast Short arm cast:

Location Applied below the elbow to the hand.

Uses Forearm or wrist fractures. Also used to hold the forearm or wrist muscles and tendons in place after surgery. Upper arm, elbow, or forearm fractures. Also used to hold the arm or elbow muscles and tendons in place after surgery. To hold the elbow muscles and tendons in place after a dislocation or surgery.

Long arm cast:

Applied from the upper arm to the hand.

Arm cylinder cast:

Applied from the upper arm to the wrist.

Type of Cast Shoulder spica cast:

Location Applied around the trunk of the body to the

Uses Shoulder dislocations or after surgery on the

shoulder, arm, and hand. Minerva cast: Applied around the neck and trunk of the body. Applied to the area below the knee to the foot.

shoulder area.

After surgery on the neck or upper back area. Lower leg fractures, severe ankle sprains/strains, or fractures. Also used to hold the leg or foot muscles and tendons in place after surgery to allow healing. Knee, or lower leg fractures, knee dislocations, or after surgery on the leg or knee area.

Short leg cast:

Leg cylinder cast:

Applied from the upper thigh to the ankle.

Type of Cast Unilateral hip spica cast:

Location Applied from the chest to the foot on one leg.

Uses Thigh fractures. Also used to hold the hip or thigh muscles and tendons in place after surgery to allow healing. Thigh fracture. Also used to hold the hip or thigh muscles and tendons in place after surgery to allow healing.

One and one-half hip spica cast:

Applied from the chest to the foot on one leg to the knee of the other leg. A bar is placed between both legs to keep the hips and legs immobilized. Applied from the chest to the feet. A bar is placed between both legs to keep the hips and legs

Bilateral long leg hip spica cast:

Pelvis, hip, or thigh fractures. Also used to hold the hip or thigh muscles and tendons in place after

immobilized.

surgery to allow healing.

Type of Cast Short leg hip spica cast:

Location Applied from the chest to the thighs or knees.

Uses To hold the hip muscles and tendons in place after surgery to allow healing.

Type of Cast Abduction boot cast:

Location Applied from the upper thighs to the feet. A bar is placed between both legs to keep the hips and legs immobilized.

Uses To hold the hip muscles and tendons in place after surgery to allow healing.

How can my child move around while in a cast?

Assistive devices for children with casts include:
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crutches walkers wagons wheelchairs reclining wheelchairs

Cast care instructions:

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Keep the cast clean and dry. Check for cracks or breaks in the cast. Rough edges can be padded to protect the skin from scratches. Do not scratch the skin under the cast by inserting objects inside the cast. Can use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. Never blow warm or hot air into the cast.

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Do not put powders or lotion inside the cast. Cover the cast while your child is eating to prevent food spills and crumbs from entering the cast. Prevent small toys or objects from being put inside the cast. Elevate the cast above the level of the heart to decrease swelling. Encourage your child to move his/her fingers or toes to promote circulation. Do not use the abduction bar on the cast to lift or carry the child.

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Older children with body casts may need to use a bedpan or urinal in order to go to the bathroom. Tips to keep body casts clean and dry and prevent skin irritation around the genital area include the following:
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Use a diaper or sanitary napkin around the genital area to prevent leakage or splashing of urine. Place toilet paper inside the bedpan to prevent urine from splashing onto the cast or bed. Keep the genital area as clean and dry as possible to prevent skin irritation.

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When to call your child's physician:

Contact your child's physician or healthcare provider if your child develops one or more of the following symptoms:
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fever greater than 101 F increased pain increased swelling above or below the cast complaints of numbness or tingling drainage or foul odor from the cast cool or cold fingers or toes