Fractures of the bone can of course occur in almost every part of the body. They are also classified into different types depending on their severity. Fracture types include:
- Simple (closed) – although there is a crack or break in the bone, but the bone has not significantly deformed, and the skin has not been broken.
- Compound (open) – there is also some laceration or breaking of the skin (the bone may also be visible, but it may not be).
- Transverse – the fracture is at a right angle to the main axis of the bone (i.e.'across' the bone).
- Greenstick – only one side of the bone is fractured with the other side being only bent (often seen in fractures in children).
- Comminuted – where the bone has fractured into three or more fragments.
Here we cover some of the more common fractures:
Injuries to the hand are fairly common. Fractures to the bones in the fingers can often be dealt with by the fitting a splint, whereas serious fractures in other parts of the hand may need fixation.
Wrist fracture is very common and many of these result from 'FOOSH' – 'falling on an outstretched hand'. If the fracture is acute, some deformity will be evident, and x-rays are generally taken to determine the exact nature of the injury.
While fractures of the elbow are less common than wrist fractures, they do occur more frequently in children than in adults, usually due to falling on to an arm when the elbow is extended while running around or playing. These fractures are generally 'supracondylar', that is just above the elbow joint. Fractures of the elbow, while less common in adults, do occur, especially those affecting the radial head (the uppermost section of the radius bone in the forearm). See elbow fracture for more details.
Fractures of shoulder bones are generally either the result of 'high energy' trauma such as vehicle accidents (especially involving bicycle or motorbike riders) or – in the elderly – simple falls, which can cause shoulder fractures due to osteoporosis. There are three different types – clavicle fracture, proximal humerus fracture and scapular fracture. See also shoulder trauma.
Hip fractures are most commonly caused by a fall or a direct impact, for example in a vehicle accident. In older people with osteoporosis or pre-existing stress injuries hip fractures can occur more easily either in a fall or in extreme cases by just twisting the leg. In some cases, it may not be obvious that a fracture has occurred and symptoms such as pain in the outer upper thigh or in the groin may indicate hip fracture.
The most common knee fracture is of the patella – the kneecap – which sits over and protects the knee joint, followed by fractures of the proximal tibia (the upper part of the shin bone) and the distal femur (the lower section of the thigh bone). These fractures generally occur in vehicle accidents or where there is any direct high energy trauma to the knee. See also fracture fixation.