Fractured means broken. Whether you have a complete or a partial fracture, you have a broken bone. A bone may be completely fractured or partially fractured in any number of ways (spiral, chip, midshaft, growth plate).
How do fractures happen?
Fractures can happen in a variety of ways, but there are three common causes:
Trauma accounts for most fractures. For example, a fall, a motor vehicle accident or a tackle during a football game can all result in a fracture.
Osteoporosis also can contribute to fractures. Osteoporosis is a bone disease that results in the "thinning" of the bone. The bones become fragile and easily broken.
Overuse sometimes results in stress fractures. These are common among athletes.
Types of fractures
Closed or simple fracture. The bone is broken, but the skin is not lacerated.
Open or compound fracture. The skin may be pierced by the bone or by a blow that breaks the skin at the time of the fracture. The bone may or may not be visible in the wound.
Particular types of fractures are:
Transverse fracture. The fracture is at right angles to the long axis of the bone.
Greenstick fracture. Fracture on one side of the bone, causing a bend on the other side of the bone.
Comminuted fracture. A fracture that results in three or more bone fragments.
Sprains and Strains
What is a sprain?
A sprain is a stretch and/or tear of a ligament, the fibrous band of connective tissue that joins the end of one bone with another. Ligaments stabilize and support the body's joints. For example, ligaments in the knee connect the upper leg with the lower leg, enabling people to walk and run.
What is a strain?
A strain is a twist, pull and/or tear of a muscle and/or tendon. Tendons are fibrous cords of tissue that attach muscles to bone.
What causes sprains and strains?
A sprain is caused by direct or indirect trauma (a fall, a blow to the body, etc.) that knocks a joint out of position, and overstretches, and, in severe cases, ruptures the supporting ligaments. Typically, this injury occurs when an individual lands on an outstretched arm; slides into a base; jumps up and lands on the side of the foot; or runs on an uneven surface.
Chronic strains are the result of overuse - prolonged, repetitive movement - of muscles and tendons. Inadequate rest breaks during intensive training precipitates a strain. Acute strains are caused by a direct blow to the body, overstretching or excessive muscle contraction.
Common Sprains
Ankle Sprains
The ankle is the most commonly sprained joint. The anterior talofibular ligament, posterior talofibular ligament, calcaneofibular ligament are the three ligaments most often involved in ankle sprains. The talus bone and the ends of two of the lower leg bones (tibia and fibula) form the ankle joint. The ligamentous structures of the ankle are divided into three groups: the tibiofibular, medial and lateral complexes. Most ankle sprains happen when the foot turns inward as a person runs, turns, falls or lands on the ankle after a jump. This common type of sprain is called an inversion injury. The lateral complex consists of three ligaments: anterior talofibular, calcaneofibular and posterior talofibular. These ligaments are frequently stretched or torn from an inversion ankle sprain.
Wrist Sprains
When you fall forward, your natural response is to put your hands out in front to catch yourself. As you land on your palm, your wrist bends backwards, this can stretch and perhaps tear the ligaments that connect bone to bone within the joint. The resulting injury is a sprain.
Degrees of injury
Wrist sprains are graded, depending on the degree of injury to the tissues.
Grade 1 or mild sprains occur when the ligaments are stretched, but not torn.
Grade 2 or moderate sprains occur when some of the ligaments are torn. Grade 2 sprains may involve some loss of function.
Grade 3 or severe sprains occur when there is a complete tear all the way through the ligament. These are significant injuries that require medical or surgical care to ensure recovery. As the ligament tears away from the bone, it may also take a small chip of bone with it, resulting in an avulsion fracture.
Back Strains
When the muscles that support the spine are twisted, pulled or torn, the result is a back strain. Patients who perform sudden or repetitious twisting or lifting often suffer from back strain.
Common Treatments for Orthopedic Injuries
RICE is recommended for the first 24 to 72 hours after an injury.
R est: Patients should avoid any strenuous activity with the effected extremity. Rest time frames will be determined by the practitioner.
I ce: Place a plastic bag with ice on the ankle for 15 to 20 minutes, three to five times a day for the first 24 to 72 hours. Leave ice off at least one and one half hours between applications.
C ompression: Wrap an elastic bandage using even pressure over the injured extremity until swelling decreases. If the area sounding the injury begins to turn blue or feel cold, the wrap should be loosened.
E levation: Elevate the extremity above the level of the heart.
Splinting is also used to treat common orthopedic injuries. Over the next few weeks we will be looking at different types of splinting techniques and procedures.
03/02/05 Written by Stephanie Malcolm, RN, BSN director of development
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