Fractures

A fracture is a broken bone. The terms fracture, break and crack mean the same thing. Fractures range from a hairline stress crack to a bone in many pieces with a skin wound over it.

Most heal in 6 to 12 weeks if the ends are held in a good position and kept still enough. Treatment is about alignment, stability and early safe movement, using a cast, brace or surgery according to the bone and the pattern of the break.

Symptome

• Sudden pain after a fall, blow or twist
• Swelling and bruising within hours
• Deformity or an unnatural angle
• Inability to bear weight or use the limb
• Tenderness when pressing directly on the bone
• A grating feeling on movement
• In stress fractures, gradually increasing pain with activity and a tender spot

Ursachen und Risikofaktoren

Healthy bone breaks under high force: falls, sports injuries and road accidents. Weak bone breaks under little force. After middle age, a wrist, hip, spine or shoulder fracture from a standing height fall is a sign of osteoporosis and should trigger bone density testing. Repeated load without enough recovery causes stress fractures in runners, dancers and military recruits, often with low energy intake or low vitamin D. Rarely a fracture passes through bone weakened by a cyst, tumour or infection. Children have their own patterns: buckle and greenstick fractures, and injuries through the growth plate.

Wie es diagnostiziert wird

• X-rays in two planes: Identify most fractures; joints above and below are included.
• CT scan: Maps fractures entering joints, the pelvis and the spine, and plans surgery.
• MRI: Finds hidden hip and scaphoid fractures and stress fractures when X-rays are normal.
• Nerve and circulation check: Every fracture assessment includes pulses, sensation and movement beyond the injury.
• Bone density scan (DEXA): After any low force fracture in adults over 50.

Behandlungsmöglichkeiten

• Cast or splint: For stable, well aligned fractures; typically 4 to 6 weeks in the arm and 6 to 12 in the leg.
• Functional brace or walking boot: Allows joint movement while protecting the bone, used for many ankle, foot and humerus fractures.
• Closed reduction: Manipulating the bone into line under sedation or anaesthetic, then casting.
• Surgical fixation: Plates, nails, screws or external fixators for displaced, unstable, joint or open fractures.
• Joint replacement: For some hip and shoulder fractures in older people.
• Rehabilitation: Restores motion, strength and balance; essential after immobilisation.
• Bone health treatment: Vitamin D, calcium, and osteoporosis medication to prevent the next fracture.

Wenn es dringend ist

Call emergency services where you are for bone visible through the skin, a limb that is pale, cold or numb, severe deformity, suspected hip, pelvis, neck or back fracture, or heavy bleeding. Increasing, unbearable pain in a plastered or swollen limb, worse on stretching the fingers or toes, may be compartment syndrome and cannot wait.

Reisen nach Türkiye zur Behandlung

A fresh fracture should be treated where it happens; flying with an unstabilised fracture or a new full cast is unsafe, and airlines often require casts to be split within the first 48 hours. Travel for care is reasonable for the late problems: a fracture that has not healed after 6 to 9 months, one that healed crooked, infection around metalwork, or stiffness needing release. Bring all X-rays and operation notes.

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