What Are Fractures?

A fracture is the medical term for a broken bone.

Fractures are common; the average person has two during a lifetime. They occur
when the physical force exerted on the bone is stronger than the bone itself.
Your risk of fracture depends, in part, on your age. Broken bones are very common
in childhood, though children's fractures are generally less complicated than
fractures in adults. As you age, your bones become more brittle and you are more
likely to suffer fractures from falls that would not occur when you were young.
Types Of Fracture
There are many types of fractures, but the main categories are displaced, nondisplaced, open, and closed. Displaced and non-displaced fractures refer to the way
the bone breaks.
In a displaced fracture, the bone snaps into two or more parts and moves so that
the two ends are not lined up straight. If the bone is in many pieces, it is called a
comminuted fracture. In a non-displaced fracture, the bone cracks either part or all
of the way through, but does move and maintains its proper alignment.
A closed fracture is when the bone breaks but there is no puncture or open wound
in the skin. An open fracture is one in which the bone breaks through the skin; it
may then recede back into the wound and not be visible through the skin. This is an
important difference from a closed fracture because with an open fracture there is a
risk of a deep bone infection.
Some fracture types are:
Greenstick fracture: an incomplete fracture in which the bone is bent. This type
occurs most often in children.
Transverse fracture: a fracture at a right angle to the bone's axis.
Oblique fracture: a fracture in which the break has a curved or sloped pattern.
Comminuted fracture: a fracture in which the bone fragments into several pieces.
An impacted fracture is one whose ends are driven into each other. This is
commonly seen in arm fractures in children and is sometimes known as a buckle
fracture. Other types of fracture are pathologic fracture, caused by a disease that
weakens the bones, and stress fracture, a hairline crack.
Other types of fracture are pathologic fracture, caused by a disease that weakens
the bones, and stress fracture.

The severity of a fracture depends upon its location and the damage done to the
bone and tissue near it. Serious fractures can have dangerous complications if not
treated promptly; possible complications include damage to blood vessels or nerves
and infection of the bone (osteomyelitis) or surrounding tissue. Recuperation time
varies depending on the age and health of the patient and the type of fracture. A
minor fracture in a child may heal within a few weeks; a serious fracture in an older
person may take months to heal.
Causes of Fracture
A fracture occurs when a bone cannot withstand an outside force.
The most common causes of fracture include Fall from a height (more common among children and elderly)
Road traffic accidents
Direct blow on the bone
Repetitive force such as that caused by running can cause stress fracture in the
specific area involved such as the foot, ankle, tibia or hip
Risk factors for fracture are Old age
Osteoporosis
Infection
Tumor
Pathophysiology
Management
Cast
What is a cast?
A cast holds a broken bone in place as it heals. Casts also help to prevent or
decrease muscle contractions, and are effective at providing immobilization,
especially after surgery.
Casts immobilize the joint above and the joint below the area that is to be kept
straight and without motion. For example, a child with a forearm fracture will have a
long arm cast to immobilize the wrist and elbow joints.
What are casts made of?
The outside, or hard part of the cast, is made from two different kinds of casting
materials.

Plaster (white in color)

Fiberglass (comes in a variety of colors, patterns, and designs)

Cotton and other synthetic materials are used to line the inside of the cast to make
it soft and to provide padding around bony areas, such as the wrist or elbow.
Special waterproof cast liners may be used under a fiberglass cast, allowing the
child to get the cast wet. Consult your child's doctor for special cast care
instructions for this type of cast.
What are the different types of casts?
Below is a description of the various types of casts, the location of the body they are
applied, and their general function.
Type of
cast

Location

Uses

Short
arm cast

Applied below the

elbow to the
hand.

Forearm or wrist fractures. Also used to hold the

forearm or wrist muscles and tendons in place
after surgery.

Long
arm cast

Applied from the

upper arm to the
hand.

Upper arm, elbow, or forearm fractures. Also

used to hold the arm or elbow muscles and
tendons in place after surgery.

Arm
cylinder
cast

Applied from the

upper arm to the
wrist.

To hold the elbow muscles and tendons in place

after a dislocation or surgery.

Type of
cast

Location

Uses

Shoulde
r spica
cast

Applied around the

trunk of the body to
the shoulder, arm,
and hand.

Shoulder dislocations or after surgery on the

shoulder area.

Minerva
cast

Applied around the

neck and trunk of the
body.

After surgery on the neck or upper back

area.

Short
leg cast

Applied to the area

below the knee to
the foot.

Lower leg fractures, severe ankle

sprains/strains, or fractures. Also used to
hold the leg or foot muscles and tendons in
place after surgery to allow healing.

Leg
cylinder
cast

Applied from the

upper thigh to the
ankle.

Knee, or lower leg fractures, knee

dislocations, or after surgery on the leg or
knee area.

Type of
cast

Unilateral
hip spica
cast

One and
one-half
hip spica

Location

Uses

Applied from the chest to the foot

on one leg.

Thigh fractures. Also used to

hold the hip or thigh
muscles and tendons in
place after surgery to allow
healing.

Applied from the chest to the foot

on one leg to the knee of the other
leg. A bar is placed between both

Thigh fracture. Also used to

hold the hip or thigh
muscles and tendons in

cast

Bilateral
long leg
hip spica
cast

Type of
cast
Short leg
hip spica
cast

Type of
cast

legs to keep the hips and legs

immobilized.

place after surgery to allow

healing.

Applied from the chest to the feet.

A bar is placed between both legs
to keep the hips and legs
immobilized.

Pelvis, hip, or thigh

fractures. Also used to hold
the hip or thigh muscles and
tendons in place after
surgery to allow healing.

Location

Uses

Applied from the chest

to the thighs or knees.

To hold the hip muscles and tendons in

place after surgery to allow healing.

Location

Uses

Abductio
n boot
cast

Applied from the upper thighs to the

feet. A bar is placed between both legs
to keep the hips and legs immobilized.

To hold the hip muscles

and tendons in place
after surgery to allow
healing.

Traction
What Is Traction?
In medical terminology, traction refers to the practice of exerting a slow, gentle pull
on a fractured or dislocated body part. The purpose is to guide the part back into
place and to hold it steady. Traction may also be used to stretch the neck and
prevent painful muscle spasms. Traction is often accomplished using ropes, pulleys,
and even the weight of the patients own body.
Types
Skeletal traction refers to placing a pin in the fractured bone. This is usually done
under general anesthetic or a spinal block, so you wont feel any pain during the
procedure. Weights are then applied to the pin, and you are placed in a special bed
to encourage traction, and also to make it easier for the nurses to care for you.
Skeletal traction is most commonly used to treat fractures of the femur (thigh
bone).

Skin traction is far less invasive. It involves applying traction tapes to your skin
directly below the fracture. The traction, or pull, is usually restricted to less than 10
percent of your body weight. Higher percentages than that do not yield faster
results, but they may cause irritation and damage to the skin. Skin traction is rarely
a final treatment. Instead, it is a way to stabilize a broken bone until doctors can
agree on the final treatment plan (Buckley).

Cervical traction can be used in two ways. First, it can stretch the muscles in your
neck to ease or prevent muscle spasms. It can also be used to bring your spine into
alignment and immobilize it after an injury to your neck. If you are receiving this
kind of traction, your neck will be encircled by a metal brace that is then attached
to a body harness, to weights, or to your skull. You will receive general anesthetic
before a pin is placed in your skull. This means you will be asleep through the entire
procedure and may not have much memory of it when you awaken. In some cases,
a rigid neck collar can be used to stabilize your head and neck sufficiently.