Bone Fracture

DEFINITION:-
If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures the skin, it is called an open fracture (compound fracture)….>…..click & see

A stress fracture .>....(click & see)...is a hairline crack ->. (click & see).….in the bone that develops because of repeated or prolonged forces against the bone.

A bone fracture (sometimes abbreviated FRX or Fx or Fx) is a medical condition in which a bone is cracked or broken. It is a break in the continuity of the bone. While many fractures are the result of high force impact or stress, bone fracture can also occur as a result of certain medical conditions that weaken the bones, such as osteoporosis, certain types of cancer or osteogenesis imperfecta. Although fractures are commonly referred to as bone breaks, the word break is not part of formal orthopaedic terminology.

Fractures, broken bones–you can call it what you wish, it means the same thing–are among the most common orthopedic problems, about 6.8 million come to medical attention each year in the United States. The average citizen in a developed country can expect to sustain two fractures over the course of their lifetime.

Fractures happen because an area of bone is not able to support the energy placed on it (quite obvious, but it becomes more complicated). Therefore, there are two critical factors in determining why a fracture occurs:

*the energy of the event

*the strength of the bone

The energy can being acute, high-energy (e.g. car crash), or chronic, low-energy (e.g. stress fracture). The bone strength can either be normal or decreased (e.g. osteoporosis). A very simple problem, the broken bone, just became a whole lot more complicated!

Different Types of Fractures:-
A doctor may be able to tell whether a bone is broken simply by looking at the injured area. But the doctor will order an X-ray to confirm the fracture and determine what type it is.

Reassure your child that, with a little patience and cooperation, getting an X-ray to look at the broken bone won’t take long. Then, he or she will be well on the way to getting a cool — maybe even colorful — cast that every friend can sign.

For little ones who may be scared about getting an X-ray, it might help to explain the process like this: “X-rays don’t hurt.

……....CLICK & SEE

Doctors use a special machine to take a picture to look at the inside of your body. When the picture comes out, it won’t look like the ones in your photo album, but doctors know how to look at these pictures to see things like broken bones.”However, a fracture through the growing part of a child’s bone (called the growth plate) may not show up on X-ray. If this type of fracture is suspected, the doctor will treat it even if the X-ray doesn’t show a break.

You may click to see the different pictures of broken bones

Children’s bones are more likely to bend than break completely because they’re softer. Fracture types that are more common in kids include:

*buckle or torus fracture: one side of the bone bends, raising a little buckle, without breaking the other side

*greenstick fracture: a partial fracture in which one side of the bone is broken and the other side bends (this fracture resembles what would happen if you tried to break a green stick)

Mature bones are more likely to break completely. A stronger force will also result in a complete fracture of younger bones.

A complete fracture may be a:

*closed fracture: a fracture that doesn’t break the skin

*open (or compound) fracture: a fracture in which the ends of the broken bone break through the skin (these have an increased risk of infection)

*non-displaced fracture: a fracture in which the pieces on either side of the break line up

*displaced fracture: a fracture in which the pieces on either side of the break are out of line (which might require surgery to make sure the bones are properly aligned before casting)

Other common fracture terms include:

*hairline fracture: a thin break in the bone
*single fracture: the bone is broken in one place
*segmental: the bone is broken in two or more places in the same bone
*comminuted fracture: the bone is broken into more than two pieces or crushed

CAUSES:-
The following are common causes of broken bones:

*Fall from a height

*Motor vehicle accidents

*Direct blow

*Child abuse

*Repetitive forces, such as those caused by running, can cause stress fractures of the foot, ankle, tibia, or hip

In children:-
In children, whose bones are still developing, there are risks of either a growth plate injury or a greenstick fracture.

*A greenstick fracture occurs because the bone is not as brittle as it would be in an adult, and thus does not completely fracture, but rather exhibits bowing without complete disruption of the bone’s cortex.

*Growth plate injuries, as in Salter-Harris fractures, require careful treatment and accurate reduction to make sure that the bone continues to grow normally.

*Plastic deformation of the bone, in which the bone permanently bends but does not break, is also possible in children. These injuries may require an osteotomy (bone cut) to realign the bone if it is fixed and cannot be realigned by closed methods.

SYMPTOMS:

*A visibly out-of-place or misshapen limb or joint

*Swelling, bruising, or bleeding

*Intense pain

*Numbness and tingling

*Broken skin with bone protruding

*Limited mobility or inability to move a limb

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TREATMENT:-
FIRST AID :

*Check the person’s airway and breathing. If necessary, call 911 and begin rescue breathing, CPR, or bleeding control.Keep the person still and calm.

*Examine the person closely for other injuries.

*In most cases, if medical help responds quickly, allow the medical personnel to take further action.

*If the skin is broken, it should be treated immediately to prevent infection. Don’t breathe on the wound or probe it. If possible, lightly rinse the wound to remove visible dirt or other contamination, but do not vigorously scrub or flush the wound. Cover with sterile dressings.

*If needed, immobilize the broken bone with a splint or sling. Possible splints include a rolled up newspaper or strips of wood. Immobilize the area both above and below the injured bone.

*Apply ice packs to reduce pain and swelling.

*Take steps to prevent shock. Lay the person flat, elevate the feet about 12 inches above the head, and cover the person with a coat or blanket. However, DO NOT move the person if a head, neck, or back injury is suspected.

CHECK BLOOD CIRCULATION:-
Check the person’s blood circulation. Press firmly over the skin beyond the fracture site. (For example, if the fracture is in the leg, press on the foot). It should first blanch white and then “pink up” in about two seconds. Other signs that circulation is inadequate include pale or blue skin, numbness or tingling, and loss of pulse. If circulation is poor and trained personnel are NOT quickly available, try to realign the limb into a normal resting position. This will reduce swelling, pain, and damage to the tissues from lack of blood.

TREAT BLEEDING:-
*Place a dry, clean cloth over the wound to dress it.

*If the bleeding continues, apply direct pressure to the site of bleeding. DO NOT apply a tourniquet to the extremity to stop

the bleeding unless it is life-threatening.

DO NOT:-
*DO NOT move the person unless the broken bone is stable.

*DO NOT move a person with an injured hip, pelvis, or upper leg unless it is absolutely necessary. If you must move the

person, pull the person to safety by his clothes (such as by the shoulders of a shirt, a belt, or pant-legs).

*DO NOT move a person who has a possible spine injury.

*DO NOT attempt to straighten a bone or change its position unless blood circulation appears hampered.

*DO NOT try to reposition a suspected spine injury.

*DO NOT test a bone’s ability to move.

Call immediately for emergency medical assistance if:
Call 911 if:

*There is a suspected broken bone in the head, neck, or back.

*There is a suspected broken bone in the hip, pelvis, or upper leg.

*You cannot completely immobilize the injury at the scene by yourself.

*There is severe bleeding.

*An area below the injured joint is pale, cold, clammy, or blue.

*There is a bone projecting through the skin.

Even though other broken bones may not be medical emergencies, they still deserve medical attention. Call your health care  provider to find out where and when to be seen.

If a young child refuses to put weight on an arm or leg after an accident, won’t move the arm or leg, or you can clearly see a deformity, assume the child has a broken bone and get medical help.

First aid for fractures includes stabilizing the break with a splint in order to prevent movement of the injured part, which could sever blood vessels and cause further tissue damage. Waxed cardboard splints are inexpensive, lightweight, waterproof and strong. Compound fractures are treated as open wounds in addition to fractures.

At the hospital, closed fractures are diagnosed by taking an X-ray photograph of the injury.

Since bone healing is a natural process which will most often occur, fracture treatment aims to ensure the best possible function of the injured part after healing. Bone fractures are typically treated by restoring the fractured pieces of bone to their natural positions (if necessary), and maintaining those positions while the bone heals. To put them back into the natural positions, the doctor often “snaps” the bones back into place. This process is extremely painful without anesthesia, about as painful as breaking the bone itself. To this end, a fractured limb is usually immobilized with a plaster or fiberglass cast which holds the bones in position and immobilizes the joints above and below the fracture. If being treated with surgery, surgical nails, screws, plates and wires are used to hold the fractured bone together more directly. Alternatively, fractured bones may be treated by the Ilizarov method which is a form of external fixator.

Occasionally smaller bones, such as toes, may be treated without the cast, by buddy wrapping them, which serves a similar function to making a cast. By allowing only limited movement, fixation helps preserve anatomical alignment while enabling callus formation, towards the target of achieving union.

Surgical methods of treating fractures have their own risks and benefits, but usually surgery is done only if conservative treatment has failed or is very likely to fail. With some fractures such as hip fractures (usually caused by osteoporosis or Osteogenesis Imperfecta), surgery is offered routinely, because the complications of non-operative treatment include deep vein thrombosis (DVT) and pulmonary embolism, which are more dangerous than surgery. When a joint surface is damaged by a fracture, surgery is also commonly recommended to make an accurate anatomical reduction and restore the smoothness of the joint. Infection is especially dangerous in bones, due to their limited blood flow. Bone tissue is predominantly extracellular matrix, rather than living cells, and the few blood vessels needed to support this low metabolism are only able to bring a limited number of immune cells to an injury to fight infection. For this reason, open fractures and osteotomies call for very careful antiseptic procedures and prophylactic antibiotics.
Sometimes bones are reinforced with metal, but these fracture implants must be designed and installed with care. Stress shielding occurs when plates or screws carry too large of a portion of the bone’s load, causing atrophy. This problem is reduced, but not eliminated, by the use of low-modulus materials, including titanium and its alloys. The heat generated by the friction of installing hardware can easily accumulate and damage bone tissue, reducing the strength of the connections. If dissimilar metals are installed in contact with one another (i.e., a titanium plate with cobalt-chromium alloy or stainless steel screws), galvanic corrosion will result. The metal ions produced can damage the bone locally and may cause systemic effects as well.

Herbal Treatment For Bone Broken for quicker bone groth & healing:-

By eating garlic buds, frying it in ghee joins the broken bone and releives the fracture pain. Eat Agar Agar – sea weed boiled with water. Eat the powder of Vajiram – Pirandai.

Prevention:
*Wear protective gear while skiing, biking, roller blading, and participating in contact sports. This includes helmets, elbow pads, knee pads, and shin pads.

*Create a safe home for young children. Gate stairways and keep windows closed.

*Teach children how to be safe and look out for themselves.

*Supervise children carefully. There is no substitute for supervision, no matter how safe the environment or situation appears to be.

*Prevent falls by not standing on chairs, counter tops, or other unstable objects. Remove throw rugs and electrical cords from floor surfaces. Use handrails on staircases and non-skid mats in bathtubs. These steps are especially important for the elderly.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Bone_fracture
http://www.herbalking.in/diseases_b.htm#bonebroken
http://orthopedics.about.com/cs/otherfractures/a/fracture.htm
http://kidshealth.org/parent/general/aches/broken_bones.html

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