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Bone fractures

Bone Fractures
Thank goodness it's only a fracture. I thought it might be broken. People
often think that a fracture is less severe than a broken bone, but fractures are broken
bones.
To understand why bones break, it helps to know what bones do and what
they are made of. The bones of the body form the human frame, or skeleton, which
supports and protects the softer parts of the body. Bones are living tissue. They
grow rapidly during one's early years, and renew themselves when they are broken.
Bones have a center called the marrow, which is softer than the outer part of
the bone. Bone marrow has cells that develop into red blood cells that carry oxygen
to all parts of the body and into white blood cells that help fight disease. Bones also
contain the minerals calcium and phosphorus. These minerals are combined in a
crystal-like or latticework structure. Because of their unique structure, bones can
bear large amounts of weight.
Bones are rigid, but they do bend, or give somewhat when an outside force
is applied to them. When this force stops, bone returns to its original shape. For
example, if you fall forward and land on your outstretched hand, there's an impact
on the bones and connective tissue of your wrist as you hit the ground. The bones of
the hand, wrist and arm can usually absorb this shock by giving slightly and then
returning to their original shape and position. If the force is too great, however,
bones will break, just as a plastic ruler breaks after being bent too far.
The severity of a fracture usually depends on the force that caused the
fracture. If the bone's breaking point has been exceeded only slightly, then the bone
may crack rather than breaking all the way through. If the force is extreme, such as
in an automobile collision or a gunshot, the bone may shatter. If the bone breaks in
such a way that bone fragments stick out through the skin or a wound penetrates
down to the broken bone, the fracture is called an open fracture. This type of
fracture is particularly serious because once the skin is broken, infection in both the
wound and the bone can occur.
Because fractures hurt and make it difficult if not impossible to use the part of
the body that is injured, most people call a doctor or seek emergency care quickly.
In some cases, however, a person can walk on a fractured bone in the leg or foot, or
use a fractured arm. Just because you can use your hand or foot does not mean that
you do not have a fracture. If you think a bone may be broken, you should seek
medical help immediately. A medical examination and x-rays are usually necessary
to tell for sure and to ensure proper treatment.
It is very important to control the movement of a broken bone. Moving a
broken or dislocated bone can cause additional damage to the bone, nearby blood
vessels, and nerves or other tissues surrounding the bone. That's why people giving
first aid or emergency treatment may splint or brace your injury before medical
treatment is given. Also, if there is an open wound it should be covered by a clean
cloth or bandage on the way to further medical treatment.
At the emergency room, clinic or doctor's office, the physician usually applies
a splint to prevent further damage, to lessen the pain and to help stop any bleeding.
The patient is usually asked to recline and elevate the injured part. Elevation helps
to reduce bleeding and swelling.
X-rays can help the physician determine whether there is a fracture, and if so,
what type of fracture it is. If there is a fracture, the doctor will reduce it, by
restoring the parts of the broken bone to their original positions. Reduction is the
technical term for this process.
All forms of treatment of broken bones follow one basic rule: the
broken pieces must be put back into position and prevented from moving out
of place until they are healed. Broken bone ends heal by knitting back
together with new bone being formed around the edge of the broken parts.
The specific method of treatment depends on the severity of the break,
whether it is open or closed, and the specific bone involved.
There are many different treatments for bone fractures.
A plaster or fiberglass castis the most common type of fracture treatment,
because most broken bones can heal successfully once they have been
repositioned and a cast has been applied to keep the broken ends in proper
position while they heal.
The cast or brace allows limited or controlled movement of nearby joints.
This treatment is desirable for some but not all fractures.
Traction is usually used to align a bone or bones by a gentle, steady pulling
action. The pulling force may be transmitted to the bone through skin tapes or
a metal pin through a bone. Traction may be used as a preliminary treatment,
before other forms of treatment.
Another treatment is open reduction and internal fixation. In this type of
treatment, an orthopedist must perform surgery on the bone. During this
operation, the bone fragments are first repositioned (reduced) into their
normal alignment, and then held together with special screws or by attaching
metal plates to the outer surface of the bone. The fragments may also be held
together by inserting rods down through the marrow space in the center of the
bone. These methods of treatment can reposition the fracture fragments very
exactly. Because of the risks of surgery, however, and possible
complications, such as infection, they are used only when the orthopedic
surgeon considers such treatment to be the most likely to restore the broken
bone to normal function.
In external fixation, pins or screws are placed into the broken bone above and
below the fracture site. Then the orthopedic surgeon repositions the bone
fragments. The pins or screws are connected to a metal bar or bars outside the
skin. This device is a stabilizing frame that holds the bones in the proper
position so they can heal. After an appropriate period of time, the external
fixation device is removed.
Each of these treatment methods can lead to a completely healed,
well-aligned bone that functions well. Remember that the method of treatment
depends on the type and location of the fracture, the seriousness of the injury, the
condition and needs of the patient, and the judgment of the orthopedist and the
patient.
Successful treatment of a fracture also depends greatly on the patient's
cooperation. A cast or fixation device may be inconvenient and cumbersome, but
without one a broken bone can't heal properly. The result may be a painful or poorly
functioning bone or joint. Exercises during the healing process and after the bone
heals are essential to help restore normal muscle strength, joint motion and
flexibility. Help your broken bone heal properly-follow your orthopedist’s advice.
Even though healthy bones are very strong, any bone will break if the force
applied against it is great enough. Bones that are weakened by disease or misuse
may break more easily than healthy bones. To develop and maintain healthy bones,
a person needs adequate amounts of calcium and proper exercise.
Because of the way bones are made, calcium is very important in the growth,
development, and maintenance of strong bones. Adequate amounts of calcium are
necessary as a child grows and for the adult as well. Women, in particular, must
have enough calcium in their diet. The female hormone estrogen regulates the use of
calcium in women's bodies. Following menopause, when women produce far less
estrogen, calcium regulation is more difficult. So it is very important that women
make their bones as strong as possible before menopause, through weight-beating
exercise and adequate calcium in their diets. In some women after menopause,
bones fracture very easily because they have been weakened by calcium depletion.
Because of the way bones are made, they also get stronger with regular but
not excessive exercise. If a person is active, bones will become stronger and more
dense. The bones of an inactive person are often not as strong and may fracture
more easily than those of an active person. For this reason, older people should try
to remain physically active.
Proper diet and exercise, along with an understanding of what bones are made
of and how they break, may help in preventing some fractures. If you do break a
bone, seek medical treatment and remember-follow your orthopedist’s advice.



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