Fractures

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Fractures

A fracture is a break in the bone. Fractures vary in severity depending on the amount of force the bone is subjected to when the fracture occurs and how the bone breaks. There are many different types of fracture, including:

Stable fracture – a clean break where the broken ends of bone line up, helping to facilitate healing.
Open, compound fractures – these have broken skin through which the bone may or may not protrude. There is a greater risk of infection when there is an open wound.
Comminuted fractures – the bone shatters into three pieces or more.
Oblique fractures – characterised by an angled break in the bone.
Transverse fractures – horizontal breaks in the bone.
Hairline fracture (also called a stress fracture) – a crack or severe bruise in the bone caused by overuse or repetitive actions that result in microscopic damage. If you don’t rest sufficiency between workouts, you are at greater risk of stress fractures.

Overview

Hip fractures are serious injuries that can lead to life-threatening complications. They occur most commonly among older people as the bones tend to weaken with age and older people may be more prone to falling due to reduced mobility or declining eyesight. Signs that you may have fractured your hip include severe pain, being unable to move after a fall and being unable to put weight in the injured side of your hip.

Knee fractures may be the result of a trip or fall, a heavy blow to the knee, a sporting injury or a car accident. Symptoms might include pain, being unable to bend your knee, a change in the shape of your leg, muscle spasms or a grating sensation when the knee is moved.

Causes of fractures

Fractures can have a number of causes but the most common are:

Trauma, due to a fall, collision or heavy impact
Overuse which can cause stress fractures due to the impact of repeated actions on the bone.
Osteoporosis, which is a condition that weakens the bones, increasing the likelihood of fractures.

Symptoms of fractures

Sometimes a fracture is obvious, particularly if fragments of bone are protruding through the skin. However, some of the symptoms of a fracture are similar to soft tissue injuries so it is important to get a proper diagnosis. Among the symptoms that might indicate that the bone is fractured are:

Being unable to put weight on the affected area.
Deformity of the limb.
Severe pain, swelling and tenderness at the site of the injury.
Bruising and/or bleeding.

Diagnosis of fractures

Following a physical examination to check for signs of pain, swelling, deformity and loss of movement, you will be referred for an X-ray to confirm whether or not the bone is fractured and, if so, what type of fracture you have.

Treatment of fractures

The treatment you receive for a fractured hip or knee will depend on the type and severity of the fracture. Common treatments include:

Internal repair using metal plates and screws to hold the bones in place while they heal.
Partial knee or hip replacement which involves removing the damaged parts of the joint and replacing them with prosthetic implants made of metal, ceramic or hard plastic.
Total knee or hip replacement which involves removing the entire joint and replacing it with a prosthetic implant.

Rehabilitation is an important part of recovery from a hip or knee fracture. You will be given exercises by a physiotherapist to help you to rebuild strength and mobility in the injured part of your body. You may also need to see an occupational therapist to help you to learn techniques to enable you to continue to live independently. The risk of further hip fractures is high once you have had one so it will be important to build rebuild strength and confidence. You may also be given medication to reduce the risk of further fractures.