Bone fractures happen as a result of trauma - falls, accidents, compression, twisting or rolling that act on the bone. A fracture is a break that occurs in a bone when a force is exerted against the bone that is stronger than it can withstand. Some bones are more prone to fracture than others due to their location and function in the body.
According to the National Institute of Health (NIH), approximately 6.3 million fractures occur each year in the United States alone. The incidence of fractures varies depending on age, gender and lifestyle factors, but in general, older adults are at higher risk of fractures due to age-related bone loss and increased risk of falls, while younger adults and children are more likely to experience fractures due to sports injuries or other accidents.
The clavicle (also known as the collar bone) connects the breastbone (the sternum) to the shoulder blade (the scapula). The clavicle is most commonly fractured in children and adolescents because it is not fully developed until around age 20, and it is relatively weaker in younger people. Children and adolescents are also more likely to engage in physical activities that increase the risk of clavicle fractures, such as sports or playing on playground equipment.
Clavicle fractures most commonly occur in the middle of the bone. This is the thinnest and most exposed part of the clavicle, making it more susceptible to fractures from a direct blow or a fall onto the shoulder. Fractures of the lateral third (near the shoulder) or medial third (near the sternum) of the clavicle are less common.
The treatment for a clavicle fracture depends on the severity of the injury. Most clavicle fractures can be treated non-surgically through immobilisation of the arm and shoulder, pain management and physical therapy.
Surgery may be recommended if the bone is severely displaced or if there is a compound fracture. Open reduction and internal fixation surgery involves realigning the broken bones and using metal screws, plates, or pins to hold the bones in place while they heal. Intramedullary fixation involves placing a metal rod through the centre of the clavicle to stabilise the bone while it heals.
Wrist: Distal Radius
The wrist is a complex joint that connects the forearm to the hand and is responsible for a wide range of movements. The bones of the lower arm, the radius and ulna, connect to eight small carpal bones. The carpal bones are arranged in two rows and they connect with the bones of the hand, called the metacarpals.
Wrist fractures are common injuries after a fall when someone throws out their hands to catch themselves. The most common bone in the wrist to fracture during a fall is the radius, though the ulna and hand bones may also break.
If the fracture is stable and not displaced, meaning the broken ends of the bone remain in their normal position and are aligned correctly, it may be treated with immobilisation using a splint or cast. It can take around 4-6 weeks until the bone heals. If the fracture is more severe and the broken ends are displaced, surgery may be required to realign the bone fragments and stabilise them with pins, screws, or plates.
After surgery, a splint or cast may also be used to immobilise the area as it heals. In some cases, physical therapy may also be recommended to help restore range of motion and strength to the wrist and hand.
Ankle: Distal Fibula
The ankle joint is made up of three bones: the tibia, the fibula, and the talus. The tibia is the larger of the two bones in the lower leg and is located on the inside of the leg. The fibula is the smaller bone and is located on the outside of the leg. The talus is a small bone that sits on top of the heel bone and connects the leg to the foot.
The ankle joint is a hinge joint, which means it allows movement in only one direction, allowing the foot to move up and down. The joint is held together by strong ligaments and tendons, which provide stability and support. The ankle is a weight-bearing joint, and it is essential for standing, walking, and running.
The most common way in which an ankle is fractured is when the foot twists or rolls unexpectedly. This can cause the bones of the ankle to twist and shift out of their normal position, leading to a fracture. Ankle fractures are common in athletes who participate in high-impact sports and older adults with weakened bones.
The treatment for an ankle fracture depends on the type and severity of the fracture. If the fracture is not displaced, it may only require immobilisation with a cast or a brace for several weeks until it heals. However, if the fracture is displaced or unstable, surgery may be necessary to realign the bones and stabilise them with metal plates, screws, or rods.
After surgery, the ankle may need to be immobilised with a cast or brace for a period of time, followed by physical therapy to restore range of motion, strength, and function. Pain relief medication may also be prescribed to manage pain and inflammation.
The hip joint is a ball-and-socket joint formed by the head of the femur (thigh bone) which forms the ball and the acetabulum of the pelvis, which forms the socket. The head of the femur is situated within the acetabulum of the pelvis and is attached to the shaft of the femur by the femoral neck. The femoral neck is a relatively thin portion of the bone and is prone to fracture.
Hip fractures are often caused by falls and are more common in older adults due to the decreased bone density associated with ageing. Women are also more likely to experience hip fractures due to a higher prevalence of osteoporosis, a condition in which bones become weak and brittle, making them more susceptible to fractures.
In most cases, surgery is necessary to repair a hip fracture and to restore function to the hip joint. The most common surgical procedure is a hip replacement, in which the damaged part of the hip joint is removed and replaced with an artificial implant. Internal fixation may also be used, where screws, plates, or rods are used to hold the broken bones together while they heal.
Physical therapy is an important part of the recovery process, as it helps to improve strength, flexibility, and range of motion in the hip joint. Pain management and medication may also be prescribed to alleviate discomfort and facilitate healing. In some cases, especially for elderly or frail patients, non-surgical treatments such as bed rest and pain management may be recommended instead of surgery.
Spine: Thoracic And Lumbar Vertebral Bodies
The spine is made up of a series of vertebrae stacked on top of each other, with cushion-like discs between them. A compression fracture of the spine occurs when one or more of the vertebrae collapse or become compressed. This can cause the entire vertebral column to lose height and can result in a stooped posture.
Compression fractures most commonly occur in the thoracic spine (the middle part of the vertebral column) and the lumbar spine (the lower part of the vertebral column) and can be caused by trauma, such as a fall or car accident, or can occur as a result of osteoporosis or other bone-weakening conditions.
For mild compression fractures, conservative treatments may be sufficient, including pain management, rest, and physical therapy. The use of braces or other supportive devices may be recommended to help stabilise the spine.
In more severe cases, spinal surgery may be necessary. One surgical option is a kyphoplasty, where a small balloon is inserted into the affected vertebra and inflated to create space.
The space is then filled with bone cement to stabilise the vertebra and relieve pain. Another surgical option is a vertebroplasty, where bone cement is directly injected into the fractured vertebra to provide stabilisation. In either case, physical therapy is typically recommended to help improve mobility and prevent further injury.
Some bones are more susceptible to fractures due to their location and function in the body. The clavicle, wrist, ankle, and hip are among the areas most commonly affected. The treatment for a fracture depends on its severity and the type of bone involved. Non-surgical treatment, such as immobilisation, pain management, and physical therapy, may be sufficient for mild fractures. However, orthopaedic surgery may be necessary for more severe fractures, especially if the bones are displaced or unstable.