Bone Fractures: Types, Symptoms, Healing, and Diagnosis

Types of Bone Fractures

According to Their Pattern of Interruption

Incomplete Fracture: The fracture line does not cover the entire thickness of the bone.

• Fissures: Affects part of the thickness of the bone.
• Greenstick Fractures: Bending fractures in flexible bones (children).
• Bamboo Fractures: Children's fractures generated by compression, produced by a wrinkling of the bone cortex.

Complete Fracture: Affecting the entire thickness of the bone. It can be divided into:

• Simple Fractures: They have a single line and there is no displacement.
• Complete Fractures with Displacement: One fragment deflects relative to the other. If the normal alignment of the longitudinal axis of the bone is lost, it is said to be angled (may be in varus or valgus).

Depending on Their Configuration

• Transverse: The fracture line is perpendicular to the longitudinal axis of the bone.
• Oblique: Fracture lines form an angle less than 90° to the longitudinal axis of the bone.
• Bifocal or Double: Occur in the same bone but at two different points.
• Spiral: The fracture line is curved and spiral.
• Impacted: Characterized by the penetration of the fracture line of one bone fragment into the other.
• Vertical: Follow the longitudinal axis of the bone.
• Intra-articular: Located in a joint or involving its articular surfaces.
• Comminuted: There is more than one fracture line and therefore more than two fragments.

Fracture Symptoms

Any bone interruption will cause:

• Pain that increases with movement.
• Deformity, when there is displacement of fragments.
• Crepitus: Friction caused by harsh rubbing of the bone fragments against each other.
• Loss of function: Inability to make movements with the affected area.

Phases of Fracture Healing

We distinguish the following phases:

1. Phase of injury.
2. Phase of inflammation.
3. Phase of soft callus.
4. Phase of hard callus.
5. Phase of remodeling.

Factors Influencing the Repair Process

• Age: Healing is more rapid in children than adults.
• Level of Trauma: The higher the level, the slower the healing.
• Location: If intra-articular, healing is more difficult.
• Infection: Delays healing.
• Immobilization: Facilitates good healing.
• Separation of Fragments: The larger the separation, the greater the delay.

Diagnosis

Anamnesis: Special attention to what caused the accident, the activity being performed at the time, location of the fracture, and presence of pain.