Broken Bone - Why see an orthopedist?
There are 206 bones in the body, multiple ways to break them, and significant consequences should they fail to heal correctly. Seeing an orthopedist for a suspected broken bone ensures a correct diagnosis, immediate treatment, and no time wasted in the hospital ER.
In today’s post, sports medicine specialist Dr. Joseph L. Finstein, MD discusses the different kinds of bone breaks, and why consulting an orthopedist is best next step.
Types of Fractures
A bone fracture and a broken bone are the same thing: the bone structure is disrupted--either by a crack or break. While this may seem straightforward, it can be hard to know if you’ve actually broken a bone without a physical examination and an X-ray. Dr. Finstein says, “if you can’t bear weight on the bone or if it’s painful to put pressure on it, that’s a good indication you may have fractured a bone.”
The following includes some of the ways a bone may fracture:
Avulsion fracture
A broken bone, like avulsion fractures, can be tricky to diagnose without an X-ray. An avulsion fracture occurs when a tendon or ligament and bone are pulled in the opposite direction. When this happens, a piece of bone can detach with the ligament or tendon. This is also called a “chip” fracture. The structure of the bone is sound enough to bear weight, but you’ve still experienced a break in the bone.
Transverse fracture
A transverse fracture is the most severe and obvious break. With a transverse fracture, the bone breaks at a 90-degree angle, often as a result of a direct blow to the bone. It will need the immediate attention of an orthopedic surgeon.
Oblique fracture
An oblique fracture most commonly comes from a twisting injury. The break is usually at an angle in contrast to the bone. These types of breaks can often occur in the leg bones like the femur, fibula or tibia.
Comminuted fracture
Here, the bone usually breaks into more than one fragment. It’s essentially like a splintering crack in the bone. This type of fracture can happen in any bone.
Greenstick fracture
A greenstick fracture is primarily limited to children, whose bones aren’t fully developed. When a young bone receives force that isn’t enough to break it all the way through, it bends. Like a green branch, the bone flexes and cracks instead of breaking completely.
Stress fracture
Unlike other fractures, a stress fracture is caused by repeated, mechanical stress rather than a sudden blow to the bone. A stress fracture may only be a hairline break and show little outward physical change, but it can still be very painful.
Pathologic fracture
Bone fractures can also be caused by diseases like osteoporosis and cancer. As the disease progresses and bones become weaker or more brittle, pathologic fractures like insufficiency fractures, are more likely to occur.
Diagnosing and Treatment
In order to diagnose a broken bone, the area of the concern is examined to look for tenderness, swelling or a wound. After reviewing your symptoms and how the injury happened, the doctor likely will order X-rays to determine the location and extent of the fracture. In some cases, additional imaging like CT or MRI may be needed for more detailed images.
For bones to heal, the broken pieces must be close to each other, be prevented from significant movement, and receive proper nutrition and blood flow. “With complicated fractures, time is of the essence.” Dr. Finstein says, “It’s better to get your injury looked at sooner rather than later. If you have pain and swelling in a joint that’s acute, you should come in as soon as possible.”
“With complicated fractures, time is of the essence...you should come in as soon as possible.”
- Dr. Joseph L. Finstein, MD
Nonsurgical Treatment of a Broken Bone
Slings & Splints
A sling is used for arm or shoulder breaks and holds the limb in a specific position to encourage healing. A splint is more rigid than a sling but also holds the limb straight. Splints are often used after surgery or as immediate treatment until your fractured limb’s swelling is reduced.
Casts
A cast, generally made of plaster or fiberglass, holds a broken bone in place as it heals. Casts also help to reduce muscle contractions and provide immobilization.
Bone stimulation
Electronic or ultrasonic bone stimulation helps speed up the process of bones healing. Electrodes are placed on the skin by the bone break and low electrical currents are sent to the bone. These are typically only used when your fracture is delayed in healing.
Surgical Repair of a Broken Bone
Some fractures require surgery to reposition and stabilize broken bones with devices like screws, plates, rods, or external frames.
Surgical Repair of a Bone May Include:
Open reduction and internal fixation
This surgical repair is recommended for fractures that can’t be realigned with a cast. Metal rods, screws or plates are surgically placed to reposition and stabilize the bone.
Closed reduction and external fixation
When a complex fracture cannot be repaired using open reduction, the fracture is surgically repaired with an external frame. The frame is used to support the bone and hold it in the correct position while healing. Sometimes the frame is temporary and sometimes it can be the definitive treatment.
The Healing Process for Fractures
When not properly treated, bones can experience a malunion, delayed union or nonunion. Malunion is when the fracture heals in a position that not ideal. Delayed union is when a fracture heals slower than expected. If a fracture fails to heal at all, it is called a nonunion. The causes for these conditions include infections after fracture, insufficient blood flow to the bone, or an inadequate stabilization of the break. As a result a thorough examination and diagnosis are important. With modern treatment from an orthopedic specialist, most broken bones heal without any problem in about 6-12 weeks.
Why you should see an orthopedist
An orthopedist is trained and licensed to treat your musculoskeletal system. Seeing an orthopedist for a suspected fracture ensures a correct diagnosis, immediate proper treatment, and no time wasted in the hospital ER.
If you think you or someone you know has experienced a fracture, make an appointment to see Dr. Finstein or one of our region’s other leading orthopedic specialists for a fast and accurate evaluation. Pontchartrain Orthopedics & Sports Medicine also has a Saturday Orthopedic Clinic, available on a walk-in, no appointment basis.
About the Doctor
Dr. Joseph L. Finstein, MD
Dr. Joseph L. Finstein specializes in sports medicine, focusing on shoulder, elbow, hip, knee, foot, and ankle injuries. Dr. Finstein completed his Sports Medicine Fellowship at the Rothman Institute at Thomas Jefferson University He is currently the team physician at De La Salle High School. Prior to joining Pontchartrain Orthopedics & Sports Medicine, Dr. Finstein assisted in the care of athletes from the Philadelphia Eagles, Flyers, Phillies, Soul and St. Joseph’s University.
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