Fractures

Fractures

A fracture is a break in a bone. There are many different types of fracture and contrary to popular belief, there is no difference between a 'break' and a 'fracture'. Fractures of any bone are usually caused by a direct impact, such as a fall or a severe tackle. When a bone is fractured, the surrounding tissues and ligaments may also be affected.

What are the Symptoms of a Fracture?

A fracture is usually a very severe injury and the athlete will know about it due to the pain, tenderness, bruising and swelling. In displaced fractures, there may be some deformity present. Dependent on the position of the fracture, there may be some restriction of movement.

Different Types of Fracture

Fractures usually occur as a result of a traumatic injury such as a fall or a car accident. They can also occur over a period of time due to repetitive stresses, this is classed as a stress fracture and is treated slightly differently.

The first classification of a fracture is whether it is open (compound) or closed. Closed fractures are more common and are where the overlying skin is not broken. Open fractures occur when one end of the broken bone pierces the skin.

Other classifications include:

  • Transverse - a straight line fracture
  • Oblique - an oblique (or diagonal) fracture
  • Spiral - a fracture which spirals around the bone
  • Comminuted - where the bone fractures in more than one part
  • Avulsion - a ligament or tendon pulls a piece of bone away

Possible Complications

Fractures are most at risk of complications if they are open or displaced. Open fractures are at risk of developing an infection and so are often treated with antibiotics as a precaution.

There is always the possibility of associated soft tissue damage to nearby muscles, tendons, ligaments, nerves and blood vessels. These are often more troublesome in the long-term than the fracture itself and so should not be overlooked.

Deep vein thrombosis is a risk factor in fractures of the lower limb especially. The chances of this can be reduced through active muscle contractions whilst casting to maintain circulation.

Muscle wasting is an unavoidable side-effect of a fracture as the muscles surrounding the area are barely used for the entire period of casting. Again, active muscle contractions can help to limit this to an extent.

How are they Treated?

Any suspected fracture should first of all be X-rayed to confirm the presence of a fracture and also the type of fracture and if there is any displacement which may need to be corrected.

Those fractures which are not displaced or are only minimally displaced can be cast, usually, for a period of 4-8 weeks, enough time for the fracture to heal.

Displaced fractures will need to be reduced, or put back into alignment before they are cast. In some cases, they may require surgical stabilisation.

Following the period of immobilisation, once given the all clear by the Doctor or surgeon involved, a rehabilitation program should be implemented which focuses on regaining full movement and strength to the limb.

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