Common sites of fracture include the hand, wrist (see Colles’ fracture), ankle joint, clavicle, and the neck of the femur (see femur, fracture of). There is usually swelling and tenderness at the fracture site. The pain is often severe and is usually made worse by movement.
X-rays can confirm a fracture. Because bone begins to heal soon after it has broken, the first aim of treatment is to ensure that the bone ends are aligned. Displaced bone ends are manoeuvred
back into position, under general anaesthetic, by manipulation either through the skin or through an incision. The bone is then immobilized. In some cases the ends of the bone may be fixed with metal pins or plates.
Most fractures heal without any problems. Healing is sometimes delayed because the blood supply to the affected bone is inadequate (as a result of damaged blood vessels) or because the bone ends are not close enough together. If the fracture fails to unite, internal fixation or a bone graft may be needed. Osteomyelitis is a possible complication of open fractures. (See also Monteggia’s fracture; pelvis; Pott’s fracture; rib, fracture of; skull, fracture of.)... fracture
The fracture is usually the result of putting out a hand to lessen the impact of a fall.
The broken bones are manipulated back into position, and set in a cast.
Healing takes up to 6 weeks.
Hand and wrist movements usually return to normal, but there may be minor wrist deformity.... colles’ fracture
Complications include damage to the blood supply to the head of the femur, causing it to disintegrate. Osteoarthritis may develop in the hip joint after fracture of the femur neck itself. However, immobility and the need for surgery in the elderly may result in complications, such as pneumonia, that are not directly related to the fracture site.
Fracture of the bone shaft usually occurs when the femur is subjected to extreme force, such as that which occurs in a traffic accident. In most cases, the bone ends are considerably displaced, causing severe pain, tenderness, and swelling.
Diagnosis is confirmed by X-ray. With a fractured femoral shaft there is often substantial blood loss from the bone. In most cases, the fracture is repaired by surgery in which the ends of the bone are realigned and fastened together with a metal pin. Sometimes the bone ends can be realigned by manipulation, and surgery is not necessary. After realignment, the leg is supported with a splint and put in traction to hold the bone together while it heals.
Complications include failure of the bone ends to unite or fusion of the broken ends at the wrong angle, infection of the bone, or damage to a nerve or artery.
A fracture of the lower shaft can cause permanent stiffness of the knee.... femur, fracture of
Fractures may involve the crown or the root of a tooth, or both.
Fractures of the enamel can usually be repaired by bonding (see bonding, dental); in some cases, a replacement crown may be fitted (see crown, dental).
Pulpotomy may be performed if the pulp of a tooth is damaged.
Fractures of the root may be treated by splinting (see splinting, dental), root-canal treatment, or removing the tooth (see extraction, dental).... fracture, dental
and lower teeth together. The wires are removed after about 6 weeks.... jaw, fractured
The fracture of a rib causes severe pain, which may be relieved by analgesic drugs or by an injection of a local anaesthetic.... rib, fracture of
A fracture without complications usually heals by itself; damage to brain structures often requires neurosurgery.... skull, fracture of
A fracture to the shaft usually results from a blow to the forearm or a fall onto the hand. Sometimes the radius is fractured at the same time (see radius, fracture of). Surgery is usually needed to reposition the broken bone ends and fix them together using either a plate and screws or a long nail down the centre of the bone. The arm is immobilized in a cast, with the elbow at a rightangle, until the fracture heals.
A fracture of the olecranon process is usually the result of a fall onto the elbow. If the bone ends are not displaced, the arm is immobilized in a cast that holds the elbow at a rightangle. If the bone ends are displaced, however, they are fitted together and fixed with a metal screw.... ulna, fracture of