A fracture is a break in the bone which can range from a thin crack to complete break where the bone fragment pierces through the skin. Fractures typically result from a fall, a collision, direct strikes to the body, other traumatic events such as road traffic accident (RTA) or gunshot wounds or sport injuries.
Some of the most common fractures include:
Clavicle Fracture
Clavicle or the collarbone connects our arms to the body through its joints with shoulder, rib cage and shoulder blade. Most clavicle fractures occur when a fall onto the shoulder or an outstretched arm puts enough pressure on the bone to break it. A broken clavicle can result in significant pain and impede movement of arm.
Most clavicle fractures can be treated by wearing a sling to keep the arm and shoulder from moving while the bone heals. With some clavicle fractures, however, the pieces of bone move far out of place when the injury occurs. For these more complicated fractures, surgery may be needed to realign the collarbone.
Wrist Fracture
Wrist is most likely to be fractured when a person suffers a fall on the outstretched hand and takes all the body weight through the arm. Whilst there are several bones in the wrist, the most common wrist fracture is a distal radius fracture which involves fracture of radius (one of the long bones of the forearm). The most common distal radius fractures is a Colles fracture, in which the broken fragment of the radius tilts upward.
These fractures can either be managed conservatively using a cast or splint or may need open reduction and internal fixation depending on the level of displacement of the bony fragments.
Ankle Fracture
Ankle joint has three main bones: tibia and fibula from lower leg and talus in the foot. Sometimes with single bone ankle fractures, it may be possible for the person to still walk and weight bear on the affected ankle. However, in more displaced ankle fractures, weight bearing may not be allowed for several weeks. A stress X ray may be conducted to confirm stability of ankle.
If the ankle is stable, the fracture may be managed by conservative methods such as high-top tennis shoe to a short leg cast. If there is signficant displacement or loss of ankle stability, either a closed or open reduction and fixation with pins and screws may be required.
Hip Fracture
Hip fractures are one of the most common and severe fractures in elderly clients. Usually it is the upper end of the thigh bone that is fractured during a fall on the side, though other common cause is weakening of the bone through osteoporosis.
Surgery is usually the only treatment option for a hip fracture.
The National Institute for Health and Care Excellence (NICE) recommends that someone with a hip fracture should have surgery within 48 hours of admission to hospital.
However, surgery may sometimes be delayed if the person is unwell with another health condition and treating that condition first will significantly improve the outcome of their hip surgery. The options for surgery include open reduction and internal fixation with srews and plates, though in about half the cases, partial or full hip replacement may be required.
Vertebral Fracture
The 24 vertebrae in our neck and back protect our spinal cord. Vertebral fractures are the most common breaks among people who have osteoporosis—a disease that weakens bones. Vertebral compression fractures most commonly occur near the waistline, as well as slightly above it (mid-chest) or below it (lower back).
Osteoporosis is a disease in which bones become very weak and more likely to break. It often develops unnoticed over many years, with no symptoms or discomfort until a bone breaks. It is usually diagnosed through bone density tests.
However, healthy, non-osteoporotic vertebrae can also be fractured through physical injury e.g fall on the back or road traffic accident.
For mild, undisplaced fractures, simple measures, such as a short period of rest and limited use of pain medications, are often all that is required for the bone to heal. Whilst for more severe, displaced fractures, surgical intervention e.g. vertebroplasty may be required.
Fracture management has improved considerably over the last few decades with excellent outcomes. Through early intervention, staying relatively active (whilst immobilizing the fractured segment) and subsequent rehabilitation to increase range of motion and strength, excellent outcomes can be obtained.
At RTW Plus, we provide rehabilitation management for all fractures, facilitating physiotherapy, pain management, self-management advice and return to activities of daily living, leisure, sport and work.
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