Understanding Bone Fractures: Types, Causes, and the Healing Process - by Aayushi Sachdeva
What is a fracture?
A bone fracture is a complete or partial break in the continuity of bone tissue. Repeated strains, overuse, sudden force or pressure during accidents and conditions such as osteoporosis are the major causes of fractures.
Classification of Fractures-
Comminuted Fractures:
This is the most severe fracture type. This type of fracture is mainly caused by severe physical traumas like car accidents and so are common to all age groups. Comminuted fractures can affect large bones in the body like-
Femur
Tibia
Radius
Ulna
Clavicle (Collar bone)
And even the Skull
The recovery in these cases often require surgery and full recovery can take even an entire year.
2. Complete Fractures
This is the 2nd most severe type of Fracture. In this type of fracture, the bone separates into two pieces.
This is further classified into -
Open Fractures- In an open complete fracture, the ends of the broken bone tear through the skin. When your bone and other internal tissues are exposed, it results in higher chances of infection. For patients having open fractures some additional measures like cleaning the wound, removing all dead and devitalized tissue, closing the skin at the proper time and delivering antibiotics to the impacted area need to be taken.
Closed Fractures- In closed fracture, the broken bone doesn’t tear through the skin, resulting in lower chances of infection.
3. Impacted Fractures
In these Fractures, one fragment of bone pushes with high velocity into the second fragment of bone. These generally heal faster.
4. Greenstick Fractures
In these fractures, Collagen results in bending instead of breaking. The bone basically bends and cracks instead of breaking into separate pieces. It is similar to what happens on breaking a “green” branch on a tree. This kind of fracture is exclusively found in juveniles. Most greenstick fractures heal within 4 to 8 weeks, depending on the age of the child.
5. Colles’ Fracture
This type of fracture occurs when someone falls on a hard surface with an outstretched hand. It results in a fracture of the distal end of the radius. It is common to all age groups but most common in elderly and/ or post menopausal women. Also common in people with osteoporosis. In some cases, the tip of the ulna may also be broken.
6. Pott’s Fracture
Pott’s fracture affects the distal ends of the lower limb bones. It can occur during activities such as playing Basketball, Volleyball or landing after a jump and activities involving sudden change of direction like Football and Rugby etc. It affects one or both of the malleoli. A certain amount of stress is placed on the tibia, fibula and the ankle joint. When this stress is traumatic, a break in the medial, lateral or posterior malleolus may occur.
7. Pathological Fracture
A pathological fracture is a type of fracture caused by a disease rather than an injury. Some diseases tend to weaken our bones and make them vulnerable to even routine things like stepping out of a car, going for a walk, coughing and sneezing etc. Some illnesses leading to pathologic fractures are-
Osteoporosis- A medical condition in which the bones become fragile and brittle. In this disease, the osteoclast activity remains normal but the osteoblast activity goes down. It results in a hunched posture, shrinkage of vertebrae, height loss etc. It has higher incidence in women due to smaller body build and sexually dimorphic characters between women and men.
Osteomalacia- It is a condition that softens the bones.
Osteomyelitis- It’s caused by a bacterial or fungal infection spreading to nearby bones. In rare cases, it leads to pathological fractures.
Bone Repair
Hematoma Formation- It is a kind of clotting formed by the breaking of vasculature. The blood doesn’t go out of the periosteum so leads to the characteristic swelling.
Formation of Fibrocartilaginous callus-
Building up of cartilage in the region
Keeps the two portions of bone closely associated with one another
Allows the osteoblasts to secrete fully formed extracellular matrix
Allows the osteoclasts to breakdown portions of the bone that are no longer needed
Development of this callus can take 5-6 hours or some weeks depending upon how serious the fracture is
