FRACTURES

Bone fractures occur from time to time in many peoples lives. They are more common in the young – more adventurous and reckless, and the old – less stable, weaker bones.

Osteoporosis is a thinning of bone density. It occurs in post menopausal women and older men and makes them more susceptible to fractures.

Clean

A clean break is pretty obvious but cracks or chips can be more ambiguous. Bone injuries are associated with falls, other trauma and lifting. Diagnosis is usually with plain x ray. If it’s a crack it might not show up straight away but it will in a week or 2 as new bone is laid down to repair the damage.

Stress

Stress fractures are caused by repeated mechanical stress. The classic of this is the march fracture in the foot. Typically occurring in soldiers doing endless hours of marching practice, often slamming their feet into the ground, and going on long forced marches carrying large amounts of gear.

Avulsion

Avulsion fractures occur when a tendon or ligament that attaches to a bone is yanked so hard it pulls a piece of bone off. These typically occur with a very nasty ankle sprain.

Cracks

Cracks run along or part way through a bone. A greenstick fracture happens in kids because of the flexibility of their bones. Like a green stick, they break on one side but not the other.

Compound

A compound fracture is when the broken bone pierces the skin. This drastically increases the chances of getting an infection. These infections can be very hard to heal.

For small and moderate breaks or cracks, the limb is put in a cast until the bone is healed, usually about 4-6 weeks.  Normally a backslab or half cast of plaster is firmly bandaged on for a week or so to allow the swelling to go down before the full cast is put on.

Get fibreglass

When you’re getting the full cast done make sure they use fibreglass with water friendly padding underneath. Do not get cotton padding, it gets to smell pretty bad and you can’t get it wet. This will make a huge difference to you’re or you’re kids for the next month or two. Fibreglass is much light than plaster. The weight of a plaster cast can strain the joints above the break, especially the larger leg casts. And they’re just harder to move around.

Water friendly cast

Water friendly padding means you can get the cast wet. You don’t have to tape a garbage bag over your cast and sit on a chair, or hold your arm up and out of the waters way every time you have a shower – what a hassle. You can have a soak bath or go for a swim anytime. They don’t get hot and itchy in summer and your foot doesn’t stink like you’ve be wearing the same jogger for 2 years.

There may be a small extra expense getting fiberglass instead of plaster but believe me it is worth it.

Get Moving

After you get out of the cast you must get the nearby joints moving again as well as they were before the accident or you will never fully recover. Not too bad is not good enough. Make it as good as it can be.

Stiff joints will get arthritic and they will never again work as well as they use to before your injury.

Pin or plate and screw

If you have a nasty fracture they may pin it, that is hammer a rod down the middle of the bone. This is generally of the femur, upper leg, or humerus, upper arm, because they are thick enough.

The bones or the lower arm, radius and ulnar, or lower leg tibia and fibula are more likely to be plated. A metal support is screwed to the outside of the bone across the fracture.

Long Term

Pins and plates are often left in place for life, especially in older people. If they start to cause problems down the track, they can be removed.

Replacement

This is typically for a fractured neck of femur, the top of your leg just below the hip joint. This is a common fracture site with advanced osteoporosis. Our femurs are closer together at our knees than they are at our hips.

Just below our hips they turn sharply in toward the hip joint. Between this turn and

the hip is the neck of the femur.

Because of its location, its shape, its duties and osteoporosis, the neck and head, which contacts the pelvis, are generally replaced with a metal prosthesis. The pelvic side of the joint is also replaced if it is badly worn.