The skeletal system provides a supportive framework for the body. It is the hardest of all living tissue and provides mineral storage, protection of many internal organs from injury e.g. the brain by the skull, and storage of blood producing cells. Bones are connected at joints and make movement possible as well as providing sites of attachment for muscles. The skeleton consists of 206 bones classified into four general groups of shapes: long, short, irregular and flat.
A fracture is a break in the continuity of any bone. Fractures are classified (named) usually after the mechanism of injury, that is, the way the bone has been broken or the appearance of the bone after the fracture.
Fractures are painful. The pain is usually localised to the fracture. The area surrounding the fracture is tender to touch and restricts movement. Swelling can be present, but may not relate to the severity of the injury and can occur several hours after the initial break. There may be associated bruising within the area of the fracture. There is loss of function of the area e.g. the fractured arm or leg, as a result of extreme pain on movement.
Types of Fractures
- Simple Fractures: Partial or incomplete – a fracture in which the break is incomplete. Closed (simple) – the bone does not break through the skin
- Complicated fractures:
- Complete – a fracture in which the break is complete across the bone so that it is broken into two or more pieces
- Open (compound) – the broken ends of the bone protrude through the skin
- Comminuted – the bone is splintered at the site of impact and smaller fragments of bone are found between the main fragments
- Greenstick – a partial fracture in which one side of the bone is broken and the other side bends. Often occur in children
- Spiral – the bone is usually twisted apart
- Transverse – a fracture at right angles to the long axis of the bone
- Impacted – one fragment of the bone is driven into the other
- Pott’s fracture – a fracture at the distal end of the fibula with serious injury of the distal tibial articulation
- Colle’s fracture – a fracture of the distal end of the radius in which the distal fragment is displaced posteriorly
- Stress – a partial fracture resulting from inability to withstand repeated stress due to a change in training, harder surfaces, longer distances and greater speed. About 25% of stress fractures involve the fibula
Complications
Several complications can result for a fracture. Deformity, or misshapenness, can present as limb shortening, curvature (abnormal bending) of the limb, and limb rotation (twisting). Lumps associated with the fracture are usually due to muscle damage rather than the fracture. There may be abnormal movement of the limb i.e. the ability to move a limb at a site other than a joint may indicate a fracture or dislocation. Loss of use (function) can occur from damage to the nerves and blood supply surrounding the fracture. Bone ends can rub together or grate against one another and the noise (crepitus) creates a similar sound to the rubbing of hair between fingers. It is an extremely painful sensation for the patient.