A bone fracture is a medical condition in which a bone becomes cracked, splintered, or bisected as a result of physical trauma. Grays illustration of a human femur, a typically recognized bone. ... In medicine, a trauma patient has suffered serious and life-threatening physical injury resulting in secondary complications such as shock, respiratory failure and death. ...

Classification

In medicine, fractures are classified as closed or open (compound) and simple or multi-fragmentary (formerly comminuted). 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. Medicine on the Web Medical Alarm & Use Medical Marijuana NLM (National Library of Medicine, contains resources for patients and healthcare professionals) Virtual Hospital (digital health sciences library by the University of Iowa) Online Medical Information- medical news, links and resources. ... An infection is the detrimental colonization of a host organism by a foreign species. ... An antibiotic is a drug that kills or slows the growth of bacteria. ...

Simple fractures are fractures that 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, comminuted 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. 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. ...

In children, whose bones are still developing, there are risks of either a growth plate injury or a greenstick fracture. This type of 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 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. A greenstick fracture is a bone fracture seen almost exclusively in young children. ... Cortex (Latin for bark) has different meanings, depending on the context: In neuroanatomy: the cerebral cortex (often simply called cortex) is the thin wrinkled outermost layer of the brain. ... In physics and materials science, plasticity is a property of a material to undergo a non-reversible change of shape in response to an applied force. ...

Orthopaedic surgeons have devised an elaborate classification system to describe the injury accurately and guide treatment. Description of a fracture starts by naming the bone and the part of the bone involved (e.g. shaft of the femur). It is important to note whether the fracture is simple or multifragmentary and whether it is closed or open. The geometry of the fracture is also described by terms such as transverse, oblique, spiral, or segmental. 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. Anterior view of the femur The femur or thigh bone is the longest (length), largest (volume) and strongest (mechanical ability to resist deformity) bone of the human body. ...

Bone response

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. 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 formation of new blood vessels from pre-existing vessels. ... White blood cells (also called leukocytes or immune cells) are a component of blood. ... A fibroblast is a cell that makes the structural fibers and ground substance of connective tissue. ... Collagen triple helix. ...

At this stage, some of the fibroblasts begin to lay down bone matrix (calcium hydroxyapatite) 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 remodelling, 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. Quartz crystal A crystal is a solid in which the constituent atoms, molecules, or ions are packed in a regularly ordered, repeating pattern extending in all three spatial dimensions. ... 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...

Treatment

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. A splint is a medical device for the immobilisation of limbs or of the spine. ... The arterial system 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 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. In some cases surgical nails, screws, plates and wires are used to hold the fractured bone together more directly. When a bone breaks the most important thing is the state of the periosteum, the membrane covering the bone. ... This article is about the building material. ... Glass-reinforced plastic (GRP), is a composite material or fibre reinforced plastic made of a plastic reinforced by fine fibers made of glass. ... 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. ...

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. ... A fibrocartilage callus is a temporary fibrocartilage callus which forms as bone attemps to heal a fracture. ...

Operative 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, 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. A break in the femur just below the pelvis; approximately 320,000 hospitalizations occur each year due hip fractures. ... DVT can also refer to Driving Van Trailer Deep vein thrombosis, also known as deep venous thrombosis or DVT, is the occlusion of a deep vein by a blood clot (thrombus). It generally affects the leg veins, such as the femoral vein or the popliteal vein, or occasionally the veins...

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. ... In biology, extracellular matrix (ECM) is any material part of a tissue that is not part of any cell. ... White Blood Cells is also the name of a White Stripes album. ... An antiseptic (Greek αντι, against, and σηπτικος, putrefactive) is a substance that prevents the growth and reproduction of various microorganisms (such as bacteria, fungi, protozoa, and viruses) on the external surfaces of the body. ... 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. ... The modulus of elasticity can also be measured in other units of pressure, for example pounds per square inch (psi). ... General Name, Symbol, Number titanium, Ti, 22 Chemical series transition metals Group, Period, Block 4, 4, d Appearance silvery metallic Atomic mass 47. ... This article is on the chemical element. ... General Name, Symbol, Number chromium, Cr, 24 Chemical series transition metals Group, Period, Block 6, 4, d Appearance silvery metallic Atomic mass 51. ... In metallurgy, stainless steel (inox) is defined as a ferrous alloy with a minimum of 10. ... Corrosion, atmospheric and biologic (Barnacles) Corrosion is deterioration of useful properties in a material due to reactions with its environment. ... An ion is an atom or group of atoms with a net electric charge. ...

See also

• Bone healing
• Distal radius fracture
• Fibrocartilage callus
• Hip fracture
• Osteoporosis
• Stress fracture
• Skull fracture

When a bone breaks the most important thing is the state of the periosteum, the membrane covering the bone. ... Distal radius fractures are a very common injury of the radius that occur at the distal end, where the wrist joint lies. ... A fibrocartilage callus is a temporary fibrocartilage callus which forms as bone attemps to heal a fracture. ... A break in the femur just below the pelvis; approximately 320,000 hospitalizations occur each year due hip fractures. ... Osteoporosis is a disease of bone in which bone mineral density (BMD) is reduced and bone microarchitecture is disrupted. ... A stress fracture is a very small sliver or crack in the bone that is accompanied by intense pain. ... A skull fracture is a break in one or more of the bones in the skull caused by a head injury. ...

External links

• First Aid for Fractures - From Wildernessmanuals.com
• Fracture and Dislocation Compendium of the Orthopaedic Trauma Association