What Causes Bone Fractures?


Most people were introduced to the orthopedic surgeon at a young age when they were brought to the emergency room with their first broken bone. For me the memory of the event is now faint (something about a bicycle and pavement), but the cast that I was able to tote around the classroom is fondly recalled as one of my moments of youthful pride.

The first, and probably the most known cause for bone fractures is known as bone thinning or osteoporosis. Osteoporosis can lead to bone fractures because in time it makes the bones less dense by altering bone protein and other minerals. This increases the risk of bone fractures, because the bones become a lot more porous.

The ‘fatigue theory’ suggests that during repeated efforts (as in running), the muscles become unable to support the skeleton during impact as the foot strikes the ground. Instead of the muscles absorbing the shock, the load is transferred to the bone. As the loading surpasses the capacity of the bone to adapt, a fracture develops. The ‘overload theory’ suggests that certain muscle groups contract in such a way that they because the attached bones to bend. After repeated contractions and bending, the bone breaks.

Stress fractures are probably preceded by, causing bone pain and pain during exercise. Management of shin splints involves rest; if the symptoms still persist after two weeks, a stress fracture is suspected. When the pain has persisted for six weeks or more, a stress fracture is the likely cause.

The first step in describing a fracture is whether it is open or closed. If the skin over the break is disrupted, then an open fracture exists. The skin can be cut, torn, or abraded (scraped), but if the skin’s integrity is damaged, the potential for an infection to get into the bone exists. Since the fracture site in the bone communicates with the outside world, these injuries need to be cleaned out aggressively and many times require anesthesia in the operating room to do the job effectively.

Setting of bone through surgery. When surgery is needed, the procedure is called an open reduction. The doctor will give you local or general anesthesia. (General anesthesia will put you to sleep.) During the surgical procedure, the doctor may insert a rod, pin, plate, or screw into the injury to hold the bone in place. Advantages of surgery include: early mobility of injured bone and some use of the injured bone within weeks rather than months.

Impacted Fracture: An impacted fracture is similar to a compression fracture, yet it occurs within the same bone. It is a closed fracture which occurs when pressure is applied to both ends of the bone, causing it to split into two fragments that jam into each other. This type of fracture is common in car accidents and falls.

It may take a number of weeks or months for a fracture to heal. Your bone tissue will start growing new bone cells on the site of the fracture, creating new bone tissues until the fracture is closed. The healing process is usually painful, therefore you must strictly follow the doctor’s advice on handling the fracture so that you can recuperate faster and resume to normal activity. During rehabilitation, your activity may be limited to the extent of the pain threshold of the fracture. By the time the bone becomes strong again, you may have to undergo certain exercise to strengthen the muscles surrounding the bone fracture so that it can function again normally. The exercises will increase in activity over time until the fracture is completely healed, and normal skeletal activity is restored.