Broken Bones or Fractures

Broken or fractured bones are common for both adults and children. Such fractures usually result from falls, sports or athletic activities or car or other types of accidents.

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Symptoms

A loud cracking or snap is usually the first sign your bone is broken. It also may appear deformed, swollen, bruised or bleed. Other symptoms include great pain that gets worse when the limb or body segment is moved and loss of normal use of the limb.

There are different types of breaks or fractures including:

  • Open fracture, in which pieces of the broken bone are sticking out through the skin
  • Closed fracture, in which the broken bone is contained within unbroken skin
  • Simple fracture, in which the bone is broken in only one place
  • Compound fractures, in which the bone is broken in more than one place
  • Displaced fractures, where the bones have moved out of their normal alignment with each other
  • Nondisplaced fractures, where the bone is broken but the pieces are still aligned

Immediate Action

To slow any bleeding and to reduce swelling, raise the injured arm or leg above your heart. If a broken bone sticks out from the skin (open fracture), do not try to push it back in. Use a clean, dry cloth or bandage to cover it until medical help arrives.

It is important that you not try to use or move the broken limb. Moving a broken bone can cause more damage to blood vessels, nerves and other tissues. To keep the broken parts still, make a temporary splint by taping a ruler or other support to the limb or area of the body that has been injured. If an arm has been broken, a sling can also be made from scarf hung from the neck. Once your broken bone is secured, you should have someone take you to a local Emergency Room right away.

Children and Broken Bones

Because children are active they may be more likely to break bones than adults, particularly arms or legs. Breaks in the thighbone (the femur) are common in children. As many as 40% of boys and 25% of girls break their thighbones during childhood. They usually result from a moderate- to high-energy injury. About one out of every 2,000 breaks his or her femur every year. Femoral shaft fractures in children are common and usually result from a moderate to high-energy injury.

Because children are growing, care must be taken that in treating a broken bone, the bone's growth plates are not damaged. In broken thighbones, for example, a child's muscles that span the femur, will tend to shorten the bone. This can cause one leg to be shorter than the other, if the bone is not correctly treated. Usually, traction - pulling the bones away from the body is done to prevent the bone from being shortened before treatment.

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Diagnosis

During the examination, tell your doctor exactly what happened. Your doctor will physically examine the broken bone and check for other injuries, such as nerve damage. Your ability to flex and extend your limb and extremities may also be checked. Often, X-rays or other diagnostic imaging scans will be ordered.

With children, the long bones of the arms or legs are probably still growing, so the doctor may check for damage to growth plates.

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Treatments

The doctor may have to move pieces of the bone back into their correct position. This is called reduction. Depending on the severity of injury, you may need local or general anesthesia. More serious fractures may require surgery. Once the broken bone has been put back in place, the limb or area is immobilized with a cast or splint. The cast (or splint) is left on for different amounts of time, depending on how serious or complicated the break was.

It may take several weeks to months for the broken bone to heal completely. After healing, rehabilitation and physical therapy may be used to slowly increase your activities to make the muscles stronger and the joint more flexible and able to move a wider range of distance. Physical therapy may continue until the limb moves normally.

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