What are the types of fractures?

Comminuted - the bone is broken into several pieces.

Complete - the bone is broken into 2 parts.

Compound - the broken end of bone pokes out of the skin to the outside.

Greenstick - the break occurs part of the way through the bone along the lenght of the bone (like trying to break a fresh branch from a tree).

Growth plate - the break occurs near the end of a long bone (i.e., an arm or leg bone) at the growth plate.

Impacted - the broken ends of bone are jammed together.

Partial - the bone is broken partially through, but remains in one piece.

Simple - not a compound fracture, that is, the bone doesn't poke out of the skin.

What type of fractures are most common in children?

Greenstick fractures are more common in children because kid bones are softer and more flexible than adult bones.  Kid bones break more like a fresh or "green" stick removed from a tree.  Adult bones break more like a dry stick that has been off of the tree for some time.

Growth plate fractures occur in children because children's bones grow actively until the mid teenage years, and therefore have growth plates.  These growth plates form weak areas in the bones.  The growth plates harden and stop growing shortly after puberty.

Do babies have fractures?

Fracture of the clavicle (collar bone) may occur in newborn infants who have a difficult delivery.

Other fractures in babies occur due to accidents, physical abuse and some uncommon metabolic disorders.

How do broken bones heal?

Bones will repair themselves after an injury.  Splints, pins and casts are used to keep the ends of the bones motionless and close together.  Bones heal in the following steps:

1.  A blood clot forms to stop the bleeding at the break.  Many bones are filled with bone marrow, where blood cells are born.  Bones are filled with blood vessels that may bleed when broken.

2.  Tissue repair begins at the site of the break.  Scar tissue forms and fibrous cartilage fills the gap between the broken edges.

3.  A bone callus forms.  This is basically a big knot of spongy bone that begins replacement of bone in the gap.  Imagine repairing a broken stick with a big wad of bubble gum!

4.  Bone remodling occurs.  The large knot of spongy bone is slowly remodeled by osteoclasts (bone-destroying cells) and osteoblasts (bone-building cells) until it regains its original appearance.

How are broken bones diagnosed?

An X-ray is typically the best test.

A doctor may be able to feel a bump where bone should normally be smooth or the broken bone ends may crunch together when moved (ouch!).

Sometimes a broken bone is not seen on the first X-ray.  If a break is suspected, the bone may be put in a cast just in case or thX-ray may need to be repeated.

How is a broken bone treated?

In some cases, no treatment is necessary other than avoiding further trauma to the bone.

Many broken bones require a cast or brace to hold the broken ends together.  A broken arm or wrist for example may require a cast for 4-6 weeks.

If the break is severe or the broken ends won't stay close together with just a cast, surgery may be necessary.  A variety of pins, bolts and plates can be jused to hold the broken ends together.

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