Cracked or fractured bone: distinguishing features

The integrity of the bone is compromised when the load exceeds its strength limit. In professional terminology, there is no such thing as a "crack", but there is a complete or incomplete fracture, the latter corresponding to the widely accepted term "crack", that is, partial damage to the bone.

What's worse, a fracture or a crack? A crack, of course, heals faster and is easier to treat, but not everything is so clear-cut, since a fracture of the little finger, for example, is less painful than a crack in the leg. Everything depends on the location of the injury.

Epidemiology

Researchers from a number of Ukrainian medical institutes specializing in traumatism and orthopedics developed a questionnaire that included 17 sets of questions providing extensive information on the mechanism of injury, its localization, severity, treatment method used, its effectiveness, etc. In total, about 3 thousand fractures were analyzed. This analytical work provided the following data: of all the injured, 51% were women and 49% were men; of the injuries, domestic ones predominated (51%), followed by street ones (30%); the largest age group of victims was within 40-59 years (40%), followed by the range of 20-39 years (37%).

Causes a cracked or fractured bone

One of the criteria for classifying fracture types is the cause of their occurrence. There are two:

• traumatic (occurring under external influence);
• pathological (tuberculosis, bone tumors, osteoporosis and other pathologies), for which minor loads are sufficient.

Risk factors

The strength of bones largely depends on their density, which in turn is directly proportional to the content of minerals in bone tissue (phosphorus, boron, calcium, etc.). Their deficiency is one of the serious risk factors leading to fractures. Genetic factors, nutrition, environmental conditions, and lack of physical activity cannot be discounted.

An important role is played by a person’s age (older people experience a gradual loss of bone mass), gender (osteoporosis is much more common in women than in men), ethnicity (Europeans and Southeast Asians are more susceptible), weight (thin people have more fragile bones), bad habits (smoking, alcoholism), and certain medications (hormonal agents, anabolic steroids).

Pathogenesis

Bone tissue consists of 60% minerals, which determines its strength, 30% collagen, which is responsible for elasticity, and 10% water. The vessels are concentrated in the mineral part. A bone fracture leads to their rupture, and therefore to bleeding, hematomas, and edema.

Symptoms a cracked or fractured bone

The first signs of a fracture or crack are manifested by severe pain, which intensifies when touched or palpated. Injuries to the extremities: arms or legs are painful when moving, while at rest the pain is dull and muffled. Symptoms of a fracture or crack in a rib or chest are expressed by pain when taking a deep breath, coughing, or talking. Multiple rib fractures can cause increased heart rate, pallor, and sometimes cyanosis of the skin.

The next evidence of a violation of the integrity of the bone is the appearance of swelling at the site of injury, often a hematoma (the latter is more typical of fractures).

Complications and consequences

The most likely consequences are with fractures with displacement, since incorrect healing is possible, which leads to loss of organ functionality. Other complications include blood loss, hyperemia, and the development of inflammatory processes.

But the most dangerous fractures are those of the femur, since they lead to the development of fat embolism from the yellow bone marrow – blockage of the vessel with subsequent circulatory failure, which can even be fatal.

Diagnostics a cracked or fractured bone

A fracture is indicated by characteristic symptoms. The orthopedic doctor studies the anamnesis, conducts a physical examination, palpates the damaged area. Absolute signs of a fracture are an unnatural position of the limb, pathological mobility, a peculiar crunch that occurs when pressing, the presence of bone fragments in an open wound.

The most accurate confirmatory diagnostics is instrumental, carried out by means of radiography. The image is taken in two projections, direct and lateral. It is the X-ray examination that allows us to recognize the fracture. There are many types of fracture images on the image, but the classic one is a linear section of enlightenment, displacement of fragments, if any.

Cracks are sometimes not visualized, so computed tomography comes to the rescue.

Differential diagnosis

In the absence of obvious evidence of bone fractures, they are differentiated from bruises, dislocations, sprains, cracks. The treatment tactics depend on the accuracy of the diagnosis.

Treatment a cracked or fractured bone

Fractures require immediate response, as the complications that accompany them can be more dangerous than the injury itself. First, it is necessary to provide first aid to the injured person: determine the location and severity of the injury, stop the bleeding if there is bleeding, apply a splint in the case of an isolated injury, give a painkiller, a sedative, call an ambulance or take the patient to the emergency room.

Medical care depends on the severity of the condition and can be either conservative or surgical.

Conservative treatment consists of anesthesia and pain relief if necessary, application of a fixing plaster cast, use of traction methods - stretching to neutralize the action of muscles attached to bone fragments and to improve bone tissue regeneration. Also, according to indications, immobility of the affected areas is ensured.

Surgical treatment

In cases where conservative treatment is impossible (fractures of spongy (short) bones, cranial vault, jaws) or after improper bone fusion, surgical treatment is used. This may be fixation of bone fragments with pins, plates, pins, staples. The method is determined by the surgeon based on the location of the injury, its severity, the general condition of the patient, etc.

Prevention

It is impossible to foresee all possible situations that lead to injury, but it is necessary to try to avoid injury-prone moments. Other preventive measures include minimizing the risk factors that depend on the person and are listed above.

Forecast

Timely treatment of fractures in combination with rehabilitation measures, which include massage, therapeutic exercises, physiotherapy, gives a favorable prognosis. Usually, recovery periods range from several weeks to several months.