Fractures

Bones can break or crack in various patterns, depending on the direction and force of impact. Here are some of the most common types of fractures and how they are treated:

Transverse fracture. Transverse fractures are breaks straight across a bone that usually arise from a direct blow or an angled force. Doctors treat this type of fracture by immobilizing the bone in a cast.

Spiral fracture. Spiral fractures, which usually affect arm bones or leg bones, often occur when someone violently twists a limb. The bone can break through the skin and damage surrounding nerves and blood vessels. Doctors treat this type of fracture with immobilization in a cast or, sometimes, with traction (the application of tension to a bone to align and immobilize it) or surgery.

Comminuted fracture. Comminuted fractures, in which a bone splinters into three or more pieces, are usually caused by a high-impact injury or a direct blow. This type of fracture is sometimes difficult to treat because the pieces of bone need to be carefully repositioned.

Greenstick fracture. In greenstick fractures, a long arm bone or leg bone snaps or buckles on only one side, usually from a severe blow or a jarring force. Greenstick fractures are more common in children than in adults. Doctors treat this type of fracture by immobilizing the bone in a cast.

Transverse Spiral Comminuted Greenstick Fracture Fracture Fracture Fracture

Joints

After any serious injury, you should seek medical attention to rule out frac- 305

tures or detect them before they become worse. If you think you may have a frac- Bones and ture, take immediate steps to immobilize the injured bone to prevent further damage to the bone and surrounding blood vessels and nerves, and elevate the affected body part to reduce swelling. With an open fracture, be sure to place a clean cloth or a bandage gently over the wound to reduce the risk of infection.

Fractured bones must first be restored to their normal position and alignment. This process is referred to as "reduction." A cast or a splint may be sufficient to hold a broken bone in place for healing. If you fracture a large bone or experience a complicated break, you may need surgery. Sometimes bones must be screwed together or rejoined using metal plates or rods. Pins or screws also may be inserted to hold an external frame in place that immobilizes the bone while it heals. You will need to rest the affected limb and avoid overuse until the bone heals.

A stress fracture refers to a condition in which a tiny crack (or cracks) occurs in a bone that has been exposed to repeated injury or overuse. Your lower leg and foot are especially prone to stress fractures. Early symptoms include sharp pain and swelling in the affected area. If the cracks are too small to see on an X ray, the doctor may perform a computed tomography (CT) scan (see page 90) to determine the location and extent of the fracture. Treatment consists of resting the affected area long enough to allow healing to take place.

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