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Internal and external views of an arm with a compound fracture, both before and after surgery

A bone fracture is a medical condition in which a bone has cracked or broken. 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. Image File history File links This is a lossless scalable vector image. ... Image File history File links Download high-resolution version (826x370, 68 KB) taken by myself available online at http://www. ... Image File history File links Download high-resolution version (826x370, 68 KB) taken by myself available online at http://www. ... This article is about the skeletal organs. ... An impact force is a high force or shock applied over a short time period. ... This article is about stress wienerfractures in bones. ... Osteoporosis is a disease of bone - leading to an increased risk of fracture. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Osteogenesis imperfecta (OI and sometimes known as Brittle Bone Disease) is a genetic bone disorder. ...

Any type of bone break is a fracture. The word break is not used in a formal orthopaedic terminology.

Classification systems

Orthopedic

In orthopedic medicine, fractures are classified as closed or open (compound) and simple or multi-fragmentary (formerly comminuted). This fracture of the lower cervical vertebrae, known as a teardrop fracture is one of the conditions treated by orthopaedic surgeons. ... For the chemical substances known as medicines, see medication. ...

• Closed fractures are those in which the skin is intact, while open (compound) fractures involve wounds that communicate with the fracture and may expose bone to contamination. Open injuries carry an elevated risk of infection; they require antibiotic treatment and usually urgent surgical treatment (debridement). This involves removal of all dirt, contamination, and dead tissue.

• Simple fractures are fractures that only occur along one line, splitting the bone into two pieces, while multi-fragmentary fractures involve the bone splitting into multiple pieces. A simple, closed fracture is much easier to treat and has a much better prognosis than an open, contaminated fracture. Other considerations in fracture care are displacement (fracture gap) and angulation. If angulation or displacement is large, reduction (manipulation) of the bone may be required and, in adults, frequently requires surgical care. These injuries may take longer to heal than injuries without displacement or angulation.

Another type of bone fracture is a compression fracture. An example of a compression fracture is when the front portion of a vertebra in the spine collapses due to osteoporosis, a medical condition which causes bones to become brittle and susceptible to fracture (with or without trauma). An infection is the detrimental colonization of a host organism by a foreign species. ... Staphylococcus aureus - Antibiotics test plate. ... Debridement is a medical term referring to the removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. ... Prognosis (older Greek πρόγνωσις, modern Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term denoting the doctors prediction of how a patients disease will progress, and whether there is chance of recovery. ... A diagram of a thoracic vertebra. ... Osteoporosis is a disease of bone - leading to an increased risk of fracture. ...

Other types of fracture are:

• Complete Fracture- A fracture in which bone fragments separate completely.
• Incomplete Fracture- A fracture in which the bone fragments are still partially joined.
• Linear Fracture- A fracture that is parallel to the bone's long axis.
• Transverse Fracture- A fracture that is at a right angle to the bone's long axis.
• Oblique Fracture- A fracture that is diagonal to a bone's long axis.
• Compression Fracture-A fracture that usually occurs in the vertebrae.
• Spiral Fracture- A fracture where at least one part of the bone has been twisted.
• Comminuted Fracture- A fracture causing many fragments.
• Compacted Fracture- A fracture caused when bone fragments are driven into each other
• Open Fracture- A fracture when the bone reaches the skin

OTA classification

The Orthopaedic Trauma Association, an association for Orthopaedic surgeons, devised an elaborate classification system to describe the injury accurately and guide treatment.^[1][2] There are five parts to the code: This fracture of the lower cervical vertebrae, known as a teardrop fracture is one of the conditions treated by orthopaedic surgeons. ...

• Bone: Description of a fracture starts by naming the bone
  • (1) Humerus
  • (2) Radius/Ulna
  • (3) Femur
  • (4) Tibia/Fibula
  • (5) Spine
  • (6) Pelvis
  • (24) Carpus
  • (25) Metacarpals
  • (26) Phalanx (Hand);
  • (72) Talus
  • (73) Calcaneus
  • (74) Navicular
  • (75) Cuneiform
  • (76) Cuboid
  • (80) LisFranc
  • (81) Metatarsals
  • (82) Phalanx (Foot);
  • (45) Patella
  • (06) Clavicle
  • (09) Scapula
• Location: the part of the bone involved (e.g. shaft of the femur).
  • 1) proximal
  • 2) diaphyseal
  • 3) distal
• Type: It is important to note whether the fracture is simple or multifragmentary and whether it is closed or open.
  • A=simple fracture
  • B=wedge fracture
  • C=complex fracture
• Group: The geometry of the fracture is also described by terms such as transverse, oblique, spiral, or segmental.
• Subgroup: Other features of the fracture are described in terms of displacement, angulation and shortening. A stable fracture is one which is likely to stay in a good (functional) position while it heals; an unstable one is likely to shorten, angulate or rotate before healing and lead to poor function in the long term.

The humerus is a long bone in the arm or fore-legs (animals) that runs from the shoulder to the elbow. ... The radius is the bone of the forearm that extends from the outside of your limb to your phlangx (lateral) of the elbow to the thumb side of the wrist. ... The ulna (Elbow Bone) [Figs. ... The femur or thigh bone is the longest, most voluminous, and strongest bone of the mammalian bodies. ... This article is about the vertebrate bone. ... For other uses see fibula (disambiguation) The fibula or calf bone is a bone placed on the lateral side of the tibia, with which it is connected above and below. ... The vertebral column seen from the side Different regions (curvatures) of the vertebral column The vertebral column (backbone or spine) is a column of vertebrae situated in the dorsal aspect of the abdomen. ... The pelvis (pl. ... This article is about Carpal bones. ... The metacarpus is the intermediate part of the hand skeleton that is located between the fingers distally and the carpus which forms the connection to the forearm. ... The phalanges in a human hand Illustration of the phalalnges The name Phalanges is commonly given to the bones that form fingers and toes. ... FIG. 270– Left talus, from above. ... The calcaneus is the large bone making up the heel of the human foot. ... The navicular bone (also called the navicular or scaphoid) is one of the tarsal bones, found in the foot. ... There are three cuneiform bones in the human foot: the medial cuneiform, the intermediate cuneiform and the lateral cuneiform. ... The cuboid bone is one of seven Tarsal bones. ... The Lisfranc joint in the foot is a tarsometatarsal joint and collectively refers to the multiple articulations between the forefoot and midfoot. ... The metatarsus consists of the five long bones of the foot, which are numbered from the medial side (ossa metatarsalia I.-V.); each presents for examination a body and two extremities. ... The phalanges in a human hand Illustration of the phalalnges The name Phalanges is commonly given to the bones that form fingers and toes. ... The patella or kneecap is a thick, triangular bone which articulates with the femur and covers and protects the front of the knee joint. ... Collarbone and collar bone redirect here. ... Left scapula - front view () Left scapula - rear view () In anatomy, the scapula, or shoulder blade, is the bone that connects the humerus (arm bone) with the clavicle (collar bone). ... The femur or thigh bone is the longest, most voluminous, and strongest bone of the mammalian bodies. ... In zootomy, several terms are used to describe the location of organs and other structures in the body of bilateral animals. ... The diaphysis is the main or mid section (shaft) of a long bone. ... In zootomy, several terms are used to describe the location of organs and other structures in the body of bilateral animals. ... A spiral fracture (also called a torsion fracture) is a bone fracture in which the bone has been twisted apart; called also torsion fracture. ...

Other classification systems

There are other systems used to classify different types of bone fractures:

• "Neer classification" (PMID 9155417): humerus overview eMedicine
• "Denis classification": spine GP Notebook
• "Seinsheimer's Classification": femur Duke

The humerus is a long bone in the arm or fore-legs (animals) that runs from the shoulder to the elbow. ... The vertebral column seen from the side Different regions (curvatures) of the vertebral column The vertebral column (backbone or spine) is a column of vertebrae situated in the dorsal aspect of the abdomen. ... The femur or thigh bone is the longest, most voluminous, and strongest bone of the mammalian bodies. ...

Bone healing

Main article: Bone healing

The natural process of healing a fracture starts when the injured bone and surrounding tissues bleed. The blood coagulates to form a blood clot situated between the broken fragments. Within a few days blood vessels grow into the jelly-like matrix of the blood clot. The new blood vessels bring white blood cells to the area, which gradually remove the non-viable material. The blood vessels also bring fibroblasts in the walls of the vessels and these multiply and produce collagen fibres. In this way the blood clot is replaced by a matrix of collagen. Collagen's rubbery consistency allows bone fragments to move only a small amount unless severe or persistent force is applied. X-ray of a bone fracture in the process of healing. ... Coagulation is the thickening or congealing of any liquid into solid clots. ... Coagulation is the thickening or congealing of any liquid into solid clots. ... Angiogenesis is the physiological process involving the growth of new blood vessels from pre-existing vessels. ... White Blood Cells redirects here. ... NIH/3T3 Fibroblasts A fibroblast is a type of cell that synthesizes and maintains the extracellular matrix of many animal tissues. ... Tropocollagen triple helix. ...

At this stage, some of the fibroblasts begin to lay down bone matrix (calcium hydroxyalpatite) in the form of insoluble crystals. This mineralization of the collagen matrix stiffens it and transforms it into bone. In fact, bone is a mineralized collagen matrix; if the mineral is dissolved out of bone, it becomes rubbery. Healing bone callus is on average sufficiently mineralized to show up on X-ray within 6 weeks in adults and less in children. This initial "woven" bone does not have the strong mechanical properties of mature bone. By a process of remodeling, the woven bone is replaced by mature "lamellar" bone. The whole process can take up to 18 months, but in adults the strength of the healing bone is usually 80% of normal by 3 months after the injury. In biology, matrix (plural: matrices) is the material between animal or plant cells, the material (or tissue) in which more specialized structures are embedded, and a specific part of the mitochondrion that is the site of oxidation of organic molecules. ... For other uses, see Crystal (disambiguation). ... A fibrocartilage callus is a temporary fibrocartilage callus which forms as bone attemps to heal a fracture. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz...

Several factors can help or hinder the bone healing process. For example, any form of nicotine hinders the process of bone healing, and adequate nutrition (including calcium intake) will help the bone healing process. Weight-bearing stress on bone, after the bone has healed sufficiently to bear the weight, also builds bone strength. X-ray of a bone fracture in the process of healing. ... This article is about the chemical compound. ... For other uses, see Calcium (disambiguation). ...

Treatment

X-ray showing a healed tibia fracture with pins.

X-ray showing fractured tibia and pinning.

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. Image File history File links Download high resolution version (2083x1960, 236 KB) Beschreibung own knee with a titan nail. ... Image File history File links Download high resolution version (2083x1960, 236 KB) Beschreibung own knee with a titan nail. ... This article is about the vertebrate bone. ... Image File history File links Download high resolution version (2083x1666, 170 KB) Beschreibung own foot with a titan nail. ... Image File history File links Download high resolution version (2083x1666, 170 KB) Beschreibung own foot with a titan nail. ... A splint is a medical device for the immobilisation of limbs or of the spine. ... f you all The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... Biological tissue is a group of cells that perform a similar function. ...

At the hospital, closed fractures are diagnosed by taking an X-ray photograph of the injury. In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz...

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. X-ray of a bone fracture in the process of healing. ... This article is about the building material. ... It has been suggested that Fiber-reinforced plastic be merged into this article or section. ... cast A cast is a shell, frequently made from plaster, encasing a limb (or, in some cases, large portions of the body) to hold a broken bone (or bones) in place until it has healed. ... The Ilizarov apparatus is used in a surgical procedure that can be used to lengthen or reshape limb bones. ...

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. Toes are the digits of the foot of a human or animal. ... Buddy wrapping is the act of bandaging a damaged (particularly a fractured) finger or toe together with a healthy one. ... A fibrocartilage callus is a temporary fibrocartilage callus which forms as bone attemps to heal a fracture. ...

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. “Surgeon” redirects here. ... A hip fracture is a fracture in the proximal end of the femur (the long bone running through the thigh), near the hip joint. ... Osteoporosis is a disease of bone - leading to an increased risk of fracture. ... Osteogenesis imperfecta (OI and sometimes known as Brittle Bone Disease) is a genetic bone disorder. ... This article is about Deep-vein thrombosis. ...

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. An infection is the detrimental colonization of a host organism by a foreign species. ... Illustration depicting extracellular matrix (basement membrane and interstitial matrix) in relation to epithelium, endothelium and connective tissue In biology, the extracellular matrix (ECM) is the extracellular part of animal tissue that usually provides structural support to the cells in addition to performing various other important functions. ... White Blood Cells is also the name of a White Stripes album. ... An antiseptic solution of Povidone-iodine applied to an abrasion Antiseptics (Greek αντί, against, and σηπτικός, putrefactive) are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction. ... This page is a candidate to be moved to Wiktionary. ...

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. Atrophy is the partial or complete wasting away of a part of the body. ... In solid mechanics, Youngs modulus (E) is a measure of the stiffness of a given material. ... General Name, symbol, number titanium, Ti, 22 Chemical series transition metals Group, period, block 4, 4, d Appearance silvery metallic Standard atomic weight 47. ... For other uses, see Cobalt (disambiguation). ... REDIRECT [[ Insert text]]EWWWWWWWWWWWWW YO General Name, symbol, number chromium, Cr, 24 Chemical series transition metals Group, period, block 6, 4, d Appearance silvery metallic Standard atomic weight 51. ... The 630 foot (192 m) high, stainless-clad (type 304) Gateway Arch defines St. ... For the hazard, see corrosive. ... This article is about the electrically charged particle. ...

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 is a bone fracture seen almost exclusively in children. ...

• 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.

In anatomy and zoology the cortex is the outermost (or superficial) layer of an organ. ... This article does not cite any references or sources. ... For other uses, see Plasticity. ... An osteotomy is a surgical operation whereby a bone is cut to shorten, lengthen, or change its alignment. ...

See also

• Fibrocartilage callus
• Distraction osteogenesis
• Rickets

A fibrocartilage callus is a temporary fibrocartilage callus which forms as bone attemps to heal a fracture. ... Distraction osteogenesis, also called callus distraction[1], callotasis[1], is a surgical process used for the reconstruction of skeletal deformities and for the lengthening of bones (as limb lengthening or particularly leg lengthening when referred to the lower limbs). ... Rickets is a softening of the bones in children potentially leading to fractures and deformity. ...

References

• Ham, Arthur W. and William R. Harris (1972), "Repair and transplantation of bones", The biochemistry and physiology of bone, New York: Academic Press, p. 337-399

External links

• First Aid for Fractures - From Wildernessmanuals.com
• Fracture and Dislocation Compendium of the Orthopaedic Trauma Association
• Osteoporosis and Spine Fracture Patient Information
• Bone fractures
• Bone fracture Videos
• Long bone fracture and healing