All you need to know about fractures

What is a fracture?

A fracture refers to a broken bone, whereby the bone may be partially or completely cracked or broken due to falls, car accidents, sports injuries or underlying medical conditions.

What are the classifications of fractures?

Fractures can be classified into:

• Open fracture (compound fracture): The bone pierces through the skin and is visible, or a deep wound exposes the bone through the skin.
• Closed fracture (simple fracture): The skin is intact, but the bone is broken.

What are the common types of fractures?

Types of fracture	Description
Transverse fracture	Horizontal fracture line.
Oblique fracture	The bone is broken diagonally.
Spiral fracture	The fracture spirals around the bone. Commonly seen in twisting injuries.
Comminuted fracture	There are more than two fracture fragments.
Segmental fracture	At least two fracture lines that together isolate a bone segment.
Greenstick fracture	Incomplete fracture accompanied by angular deformity (like snapping a green twig). Seen in children.
Impacted fracture	Fracture due to impact on adjacent bone.
Compression fracture	A type of fracture that causes the vertebrae to collapse.
Stress fracture	A small crack or severe bruise within a bone caused by repetitive trauma.

What are the symptoms of a fracture?

Bone fracture symptoms include the following:

• Swelling, bruising or tenderness at the injury site
• Intense pain
• Deformity of the limb
• Inability to move the injured limb
• Numbness and tingling sensation

Why do fractures occur?

The bone has sufficient strength and resilience to withstand a significant amount of stress despite its fragility.

A fracture occurs due to the following:

• Injury: A sudden or excessive force that may be direct or indirect, such as a fall or an accident.
• Repetitive stress: Repeated heavy loading, such as in athletes or dancers.
• Abnormal weakening of the bone (pathological fracture): Weakened by change in the structure of the bone due to conditions such as osteoporosis or osteogenesis imperfecta.

How is a fracture diagnosed?

Patients with suspected fractures need prompt and, oftentimes, emergency evaluation to determine the presence of potentially life-threatening complications. Following a major trauma or significant injury, patients should go to the Emergency Department for a comprehensive evaluation immediately.

On the other hand, patients without life-threatening injuries can be assessed at the Orthopaedic clinic. Your doctor would first question your general health and symptoms before conducting a thorough physical examination. Diagnosis is made based on your reported symptoms, physical examination, and investigations.

Your doctor would request an x-ray to verify the diagnosis and determine the exact location of the fracture in the bone. When the full extent of a fracture is not apparent on an x-ray, computed tomography (CT) scan may be requested for accurate visualisation of the fracture.

How is a fracture treated?

1. Non-surgical methods
   
   • Reduction: A closed reduction may be required if the fracture is significantly displaced.
   • Immobilisation: To keep the bone in place and prevent further injury. This involves the usage of a splint, cast or brace.
   • Pain management: Adequate analgesia is required for effective pain management. Minor fractures may be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), whereas severe pain may require a combination of NSAIDs and short-acting opioids.
2. Surgical methods
   • External fixation: A device (external fixator) is used to hold the fracture in a steel frame outside the limb. Pins are passed through to hold the bone and are connected to the bar outside. It is useful for open fractures as internal fixators cannot be used due to infection.
   • Internal fixation: After reduction, the fracture is internally held with metallic or non-metallic devices such as screws, plates, Kirschner (K-wire) or intramedullary nail.

How long does a fracture take to heal?

The healing time for a fracture can range from several weeks to several months, depending on the severity of the injury, age of the patient, how well you follow your doctor's instructions, and other factors that influence fracture healing.

Book an appointment at Pantai Hospitals

A dedicated and expert team of Orthopaedic specialists at Pantai Hospital is available for consultation to provide the best care and assistance.

Get in touch with us to Accident and Emergency (A&E) department at your nearest Pantai Hospital for major trauma.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.