Fractures - Let’s ‘break’ it down

Have you ever broken a bone? We hope you haven't, but it’s a common injury that happens to people every day! Any break in the structure of a bone is known as a ‘fracture’. We’ve written a quick guide to understanding all the lingo relating to fractures below. Let’s check it out!

Causes

Fractures are usually caused in one of three ways:

• Excessive force: This can be through either a direct force to a body part (i.e. a high tackle in football which breaks the shin-bone) or an indirect force (i.e. having your foot planted and twisting your leg which leads to a fracture of the shin-bone).

• Repetitive stress: These result from repetitive, strenuous activities like running or jumping.

• Other disease: These are fractures secondary to another disease process in the body which leaves the bone more prone to breaking. This may be a hereditary disease like Osteogenesis Imperfecta (aka Brittle bone disease) or as a result of cancer or infection.

Types of fracture: General description

Fractures are broadly classified into two main types:

• Closed: The bone fractures and the overlying skin remains intact.

• Open: The bone fractures and protrudes through the skin exposing the bone and other tissues to the elements. These types of fractures are prone to becoming infected, which complicates everything.

We can also classify fractures on whether they are:

• Complete: A clean break of a bone into two or more pieces

• Incomplete: The bone is not completely broken with some of the outer structure of the bone remaining intact.

Types of fracture: Now let’s REALLY break it down!

Each fracture can also be given a more specific description based on where exactly the bone is broken and in what way it has broken:

• Transverse: A horizontal break across the shaft of a bone.

• Linear / fissure: A vertical break along the shaft of a bone.

• Oblique / spiral: A diagonal, or as the name suggests, spiral type fracture around the shaft of a bone.

• Greenstick: One side of a bone has broken but the other side remains intact. This is common in children where bones are much more flexible than adult bones.

• Comminuted: The bone is broken into more than two pieces, possibly into several fragments

• Impacted: Two parts of a bone fracture are forced into one another

• Crush: Usually seen in the spine caused by vertical and forward bending forces down through the vertebrae

• Hairline: A tiny crack in the bone — these are so small that they are commonly missed on an x-ray!

• Avulsion: A piece of bone is ripped away from the main bone by way of tendon or ligament injury. (Remember tendon attaches muscle to bone and ligament attaches bone to bone).

Which type of fracture have you had in the past? We hope this guide will help you work it out. Next time you come across a fracture (fingers crossed you don’t) you’ll know exactly what the doctors are talking about!

References

1. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education

2. Xui, P. 2012. Pathology. 4th ed. UK: Elsevier Mosby

3. Tortora, G. and Derrickson, B. 2011. Principles of Anatomy and Physiology. 13th ed. Asia: John Wiley & Sons