fracture

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Related to insufficiency fracture: stress fracture

fracture,

breaking of a bone. A simple fracture is one in which there is no contact of the broken bone with the outer air, i.e., the overlying tissues are intact. In a comminuted fracture the bone is splintered. In greenstick fracture (common in children) one side of the bone is fractured and the other side bent. In multiple fracture there is more than one break. A compound fracture is one in which the broken bone is in contact with the air because there is a wound through the skin; the bone may project through the wound. The bones of older people are especially liable to fracture, although no age is exempt. Fractures are caused most often by injury, although certain pathological conditions may predispose a bone to fracture. Osteoporosis, the leaching of calcium from the bone, can cause spontaneous fractures, as can malnutrition and cancer. A person with a fracture should not be moved unless the broken bone has been splinted or otherwise immobilized (see first aidfirst aid,
immediate and temporary treatment of a victim of sudden illness or injury while awaiting the arrival of medical aid. Proper early measures may be instrumental in saving life and ensuring a better and more rapid recovery.
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). Proper setting of bones and the application of a cast should be performed by a doctor. X rays aid in the repositioning of the bone as well as in determining the state of healing. Surgery that involves implanting metal pins or screws to join broken bones may be necessary; in certain cases traction devices are used to align bone fragments. Skull and jaw fractures require special treatment.

Fracture

 

(in medicine), a disruption of the anatomical integrity of bone as a result of injury.

Fractures are extremely rare during the intrauterine life of a fetus. Spontaneous fractures involve a history of bone disease, while traumatic fractures do not; the latter type can be either closed or open, depending on whether there is an external wound. Traumatic fractures are further classified as occurring with or without displacement of fragments and as being oblique, transverse, or comminuted. Fractures usually arise because of extreme mechanical stress at the moment of trauma. Chronic fractures, due to slight, prolonged stress, are less common. Half of all fractures occur in the upper extremities, one fourth in the lower extremities, and the total incidence is three to four times greater in men than in women.

The symptoms of fracture are severe local pain, deformation, abnormal mobility, and functional impairment of the extremity. X-ray diagnosis must be used to determine the site of the fracture, the type of displacement of the fragments, and the method of treatment. The destruction of bone and injury to the surrounding soft tissues cause internal bleeding in closed fractures and external bleeding in open ones. Traumatic shock may follow multiple or severe open fractures of large bones.

The integrity and mechanical function of a broken bone are restored as the bone first forms a central callus and then a definitive one. The time required for bones to heal is affected by the presence of other injuries and by the severity of injury to the soft tissues that surround the fracture; other factors are the extent of displacement of the fragments and the victim’s general physical condition.

First aid for fractures calls for immobilization of the fragments in the fracture zone using special splints or improvised materials. In open fractures and traumatic shock, prompt medical attention is required. Severe bleeding from the wound can be arrested with a tourniquet. The bone fragments should be juxtaposed as closely as possible and immobilized throughout the healing period; this is usually effected with a plaster cast or by skeletal traction. Complications of fractures include injury to large blood vessels and nerves, suppuration in the fracture zone, and failure of the fragments to unite; all of these conditions require special treatment.

With age, bones become increasingly fragile, and this explains the high incidence of fractures after slight injury in the elderly. Because of the greater flexibility of their bones, children often suffer subperiosteal fractures, often close to a joint. Fractures in children are mostly treated by juxtaposition of the fragments with application of a plaster cast; less commonly, skeletal traction is used, and surgery as a therapeutic recourse is very rare.

REFERENCES

Kaplan, A. V. Zakrytye povrezhdeniia kostei i sustavov, 2nd ed. Moscow, 1967.
Watson-Jones, R. Perelomy kostei i povrezhdeniia sustavov. Moscow, 1972. (Translated from English.)

V. F. POZHARISKII

fracture

[′frak·shər]
(geology)
A crack, joint, or fault in a rock due to mechanical failure by stress. Also known as rupture.
(medicine)
The breaking of bone, cartilage, or teeth.
(mineralogy)
A break in a mineral other than along a cleavage plane.
(science and technology)
The act, process, or state of being broken.
The surface appearance of a freshly broken material.
The break produced by fracturing.

fracture

1. Med
a. the breaking or cracking of a bone or the tearing of a cartilage
b. the resulting condition
2. Mineralogy
a. the characteristic appearance of the surface of a freshly broken mineral or rock
b. the way in which a mineral or rock naturally breaks
References in periodicals archive ?
Sacroiliitis and sacral insufficiency fracture: A rare coexistence.
In contrast to typical subtrochanteric fractures, about half of patients with atypical insufficiency fractures demonstrate poor fracture healing that requires surgical intervention.
Clinically, iliac wing insufficiency fractures may be asymptomatic or present with mechanical pain and should especially be considered in postmenopausal women with one or more osteoporosis risk factors.
Although the sacrum is the most commonly involved, pelvic insufficiency fractures are often multiple, and other typical locations should be mentioned.
[3-5] Herein, we report a repetitive spontaneous distal tibial insufficiency fracture in the right and left distal tibia and discuss predisposing factors, diagnosis, and treatment in the light of the current literature.
prolonged intravenous SFO administration induced hypophosphatemic osteomalacia with insufficiency fracture of the proximal tibia.
Abe et al, (4) showed that the time to present clinically is 1 to 2 year after radiation therapy and reported the--radiation dose response relationship and development of pelvic insufficiency fractures. They showed that the patients receiving more than 50Gy are more prone for development of this entity.
(37) Partial meniscectomy increases tibiofemoral contact pressures in the treated compartment, potentially leading to subchondral insufficiency fractures from altered load transmission.
To our best knowledge, this case report details the first published case of an insufficiency fracture of the tibial plateau presenting three weeks after ACL reconstructive surgery.
Horiuchi, "Pelvic insufficiency fracture associated with severe suppression of bone turnover by alendronate therapy," Journal of Bone and Mineral Metabolism, vol.