There are many different types of fractures. Direct impact or trauma causes acute fractures. Stress fractures develop over time through overuse.
Acute fractures occur suddenly from direct trauma, falls or violent twisting movement. They are more common in contact sports, skiing and motor racing.
Symptoms include severe pain at the time of the injury, tenderness and rapid swelling. Bruising develops and if the bones displace then deformity is likely.
An open fracture or compound fracture occurs when a bone fragment pierces the skin. As a result, the risk of infection is high.
Overuse or repetitive stress causes stress fractures. They develop gradually over time beginning with a ‘stress reaction’ of the bone. This progresses to a stress fracture and eventually, if ignored can become an acute fracture.
Read more on stress fractures.
Types of acute fractures
The following are common types of acute fractures in sports.
Types of foot fractures
- Metatarsal fractures – occur in the long bones in the foot.
- Calcaneal fracture – this is a break of the calcaneus (heel bone). It is not a common injury but may occur when landing badly from a height.
- Jones fracture – is a fracture of the 5th metatarsal bone on the outside of the foot. Either overuse or an ankle sprain causes a Jones fracture.
Types of geg & ankle fractures
- Broken ankle (Pott’s fracture) – any of the bones in the ankle can be broken. A Pott’s fracture is one of the more common.
- Ankle avulsion – where a ligament tears, pulling a piece of bone with it. This occurs from a sprained ankle and may often be missed initially.
- Broken leg – the tibia and fibula bones in the lower leg are more commonly broken than a break of the femur bone.
- Femur fracture – a break of the femur (thigh bone).
- Biceps femoris avulsion – occurs when the tendon comes away from the bone at the outside back of the knee.
- Tibial plateau – is a break of the upper surface of the tibia (shin) bone.
- Pelvic avulsion fracture – most commonly occurs at the ischial tuberosity where the hamstrings attach at the back of the leg.
Shoulder, arm & elbow
- Broken arm – can include breaks to the radius and ulna in the forearm.
- Humerus fracture – is a break of the humerus bone in the upper arm.
- Broken elbow – can involve any of the arm bones.
- Olecranon fracture – occurs at the prominent bony protrusion at the back of the elbow.
- Broken collar bone – also known as a clavicle fracture is a common sports injury.
- Elbow avulsion fracture – occurs when a tendon or ligament tears, pulling a small fragment of bone away with it. It is more common in children, occurring on the inside of the elbow.
- Broken wrist – any of the carpal bones in the wrist may be fractured, often from falling onto an outstretched arm.
- Colles fracture – is a break at the wrist end of the radius bone in the forearm.
- Scaphoid fracture – is one of the more common injuries that should not be missed.
- Hook of hamate – this is a fracture of the hamate bone on the little finger side of the wrist.
- Triquetrium fracture – is a break of the Triquetral bone (sometimes called triquetrum).
- Bennett’s fracture – is an injury to the base of the thumb joint.
- Rolando fracture – is similar to Bennett’s fracture, but is more complex. The bone breaks into multiple fragments.
- Smith’s fracture – is a break at the end of the radius bone. The fragment of the fractured bone is displaced forwards to the palm side of the wrist.
Types of hand & finger fractures
- Metacarpal fracture – or broken hand is a break of any of the long metacarpal bones in the hand.
- Boxer’s fracture – is a break to either the 4th or the 5th Metacarpals which are the long bones on the outside of the hand.
- Broken finger – involves any of the phalanges (finger) bones.
- Broken thumb – is either a break at the base of the thumb or the phalanges.
Back & chest fracture types
- Spinal compression fracture – a break in one of the vertebrae bones, caused by compression in the spine.
- Broken ribs – a break of any of the rib bones.
- Skull fracture – a break to one of the bones which form the head.
Open fractures & closed fractures
- A closed fracture is a break of the bone where the skin surface remains intact.
- An open fracture (or compound fracture) occurs when the end of the bone breaks the surface of the skin. As a result, this type of fracture is susceptible to infection.
Other types of acute bone fracture
In addition to whether a type of fracture is open or closed, they are further classified depending on how the bone breaks.
- Transverse – a straight line.
- Oblique – an oblique (or diagonal).
- Spiral – which spirals around the bone.
- Comminuted – where the bone breaks into more than one piece.
- Avulsion – this is where a ligament or tendon tears, pulling a small piece of bone away with it.
- Greenstick fractures – these occur in young athletes. This is because their skeletons have not fully grown or hardened. As a result, the immature skeleton is more ‘bendy’ than an adult skeleton. Therefore when a bending force compresses the bone on the inside it stretches on the outside. The bone partially fractures in the same way that a live tree branch would break. Hence the name ‘greenstick’.
Growth plate fractures in children
The growth plate is the area at the end of a bone where new growth occurs. It is a weak point which has not fully hardened as it has in an adult skeleton. Often growth plate areas are points where tendons attach to bone. In particular, this makes the young athlete susceptible to avulsion fractures.
Complications of fractures
A complication is a problem or condition caused by or following a broken bone.
Fractures are most at risk of complications if they are open or displaced. In particular, they are at risk of developing an infection. If the skin is broken then foreign bodies and bacteria can enter. As a precaution, they are often treated with antibiotics.
Soft tissue damage
There is always the possibility of associated soft tissue damage to nearby muscles, tendons, ligaments, nerves, bursae and blood vessels. These are often more troublesome in the long term than the broken bone itself.
Deep vein thrombosis
Deep vein thrombosis (DVT) is a risk factor for lower limb fractures especially. The chance of this reduces through active muscle contractions whilst in the plaster cast. This maintains blood circulation.
Muscle wasting is unavoidable. Active muscle contractions help limit this.
How to treat different types of fractures?
Treatment depends on the type and severity of the fracture. However, in general:
- If your doctor suspects you have a fracture the X-ray to confirm the diagnosis, type and severity
- If there is no, or minimal displacement then a cast immobilises the limb for between 4 to 8 weeks
- Your doctor or surgeon ‘reduces’ (puts back into place) a displaced fracture.
- In some cases, surgery is indicated
- When you come out of the cast you should complete an exercise and rehabilitation program