Fractures

Fracture is condition that involves the breaking of bones, which results in pain. Click the headers below to learn more about each of the types of fractures we treat.

Elbow Fractures

An elbow fracture is a break in one or more of the bones that make up the elbow joint. The bones in the elbow joint include the humerus (upper arm bone), the ulna (the larger of the forearm bones at the elbow) and the radius (the smaller of the forearm bones at the elbow). Elbow fractures are typically caused by trauma to the elbow which can occur by:

• Falling on an outstretched arm
• Falling directly on the elbow
• Direct blow to the elbow
• Twisting the elbow beyond the elbow's normal range of motion

Some sports are more likely than others to create these circumstances for injury including football, basketball, hockey, wrestling and gymnastics. Natural risk factors that can increase the chance of elbow fracture include advancing age, decreased muscle mass, osteoporosis or other bone diseases.

Symptoms

• Pain in and around the elbow
• Numbness in fingers, hands or lower arm
• Decreased range of motion
• A lump or visible deformity over the fracture site
• Tenderness, swelling and bruising around the elbow

Foot/Ankle Fractures

Any one of the three bones that make up the ankle joint could break as the result of a fall, an automobile accident or some other trauma to the ankle.

Because a severe sprain can often mask the symptoms of a broken ankle, every injury to the ankle should be examined by a physician. Symptoms of a broken ankle include:

• Immediate and severe pain
• Swelling
• Bruising
• Tender to the touch
• Inability to put any weight on the injured foot
• Deformity, particularly if there is a dislocation as well as a fracture

A broken ankle may also involve damage to the ligaments. Your physician will order X-rays to find the exact location of the break. Sometimes, a CT (computed tomography) scan or a bone scan will also be needed.

Metatarsal Stress Fracture

A metatarsal stress fracture is a complete or incomplete break in the foot involving one or more of the longer foot bones (metatarsals), and is caused by intense exercise or repetitive pressure on the extremity. A stress fracture can occur anywhere within the metatarsal, although it most commonly affects the lower third of the second metatarsal (next to the big toe's metatarsal).


Hand/Wrist Fractures

A fracture occurs when enough force is applied to a bone to break it. When this happens, there is pain, swelling, and decreased use of the injured part. Many people think that a fracture is different from a break, but they are the same. Fractures may be simple with the bone pieces aligned and stable. Other fractures are unstable and the bone fragments tend to displace or shift. Fractures often take place in the hand when falling on an outstretched hand. Some fractures will cause an obvious deformity, such as a crooked finger, but many fractures do not.

Common Hand and Wrist Fractures

Radial and Ulnar fractures - the radius and ulna are the two bones in your forearm. The most commonly broken bone of the wrist is the radius. Often the wrist appears crooked and deformed.
Scaphoid fracture - fractures of the scaphoid occur most commonly from a fall on the outstretched hand. Diagnosis of scaphoid fractures

Hip Fractures

A fracture (break in the bone) of the hip is a very common injury. This is usually the result of a fall from a standing height in the older individual, but it can also occur in younger patients. Most commonly, the fracture occurs in the femoral neck (the area of bone that joins the ball to the shaft of the femur bone). This fracture is usually treated with a partial or total hip replacement. The fracture can also occur in the area below the femoral neck called the intertrochantetic region of the femur. In this case, the facture is usually repaired with a specially designed nail or plate.

Symptoms

• Pain over the outer upper thigh or in the groin
• Significant discomfort with any attempt to flex or rotate the hip
• Aching in the groin or thigh area
• The leg may appear to be shorter than the non-injured leg

Knee Fracture

Fractures (a break in the bone) around the knee typically occur following some type of trauma. This may be low energy (such as a fall from a standing height) or high energy (such as a motor vehicle accident). The most common type of fractures include patella fractures (the knee cap), proximal tibia fractures (the top portion of the lower leg bone), distal femur fracture (the bottom portion of the thigh bone), and fractures around a knee replacement.

Some fractures can be treated conservatively, without surgery. Other fractures require surgical intervention with plates and screws, rods, or other hardware. The treatment is based on the location, stability, and type of fracture.

Symptoms

• Pain with weight bearing
• Swelling and bruising
• Tenderness to touch
• Deformity — the knee may look "out of place" and the leg may appear shorter and crooked

Shoulder Fractures

Broken Collarbone/Clavicle fracture

The collarbone (clavicle) is located between the ribcage (sternum) and the shoulder blade (scapula), and it connects the arm to the body. The clavicle is a long bone and most breaks occur in the middle of it. Occasionally, the bone will break where it attaches at the ribcage or shoulder blade.

Clavicle fractures are often caused by a direct blow to the shoulder. This can happen during a fall onto the shoulder or a car collision. A fall onto an outstretched arm can also cause a clavicle fracture. In babies, these fractures can occur during the passage through the birth canal.

Symptoms

• Clavicle fractures can be very painful and may make it hard to move your arm.
• Sagging shoulder (down and forward)
• Inability to lift the arm because of pain
• A grinding sensation if an attempt is made to raise the arm
• A deformity or "bump" over the break
• Bruising, swelling, and/or tenderness over the collarbone

There is usually an obvious deformity, or "bump," at the fracture site. Gentle pressure over the break will bring about pain. Although a fragment of bone rarely breaks through the skin, it may push the skin into a "tent" formation. In order to pinpoint the location and severity of the break, your doctor will order an x-ray. X-rays of the entire shoulder will often be done to check for additional injuries.

If the broken ends of the bones have not shifted out of place and line up correctly, you may not need surgery. Broken collarbones can heal without surgery.

Spine/Back (Lumbar) Fractures

Compression Fractures

With aging populations and osteoporosis prevalent in spite of medical therapy, compression fractures, especially in the thoracic and lumbar spine, occur. These almost never involve neurologic injury and generally heal on their own. They can be very painful; sometimes even necessitating bed rest. In these cases the anterior structures of the spine, the vertebral body, lose enough bone mass to become weaker. Ordinary stresses may cause a slight buckling of the anterior portion of the vertebral body, and the body may end up wedge shaped. Sometimes massive collapse will occur, and the vertebra becomes almost pancake shaped. With this collapse, there is added forward shift and pressure on the structures. These are acute fractures and are painful. Sometimes if the fracture and deformity occur very slowly, there may be almost no pain and the fracture may be picked up by routine exam or X-ray.

Learn more about lumbar compression fractures and treatment options>