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Bone fractures
Abrokenboneorbonefractureoccurswhenaforceexertedagainstaboneisstrongerthanitcan structurallywithstand. Bonesareaformofconnectivetissue,reinforcedwithcalciumandbonecells.Boneshaveasofter centre,calledmarrow,wherebloodcellsaremade.Themainfunctionsoftheskeletoninclude support,movementandprotectionofvulnerableinternalorgans. Therearedifferenttypesofbonefracturesthatvaryinseverity.Factorsthatinfluenceseverity includethedegreeanddirectionoftheforce,theparticularboneinvolved,andthepersonsage andgeneralhealth. Commonsitesforbonefracturesincludethewrist,ankleandhip.Hipfracturesoccurmostoftenin elderlypeople.Brokenbonestakearoundfourtoeightweekstoheal,dependingontheageand healthoftheindividual,andthetypeofbreak. Symptoms Thesymptomsofabonefracturedependontheparticularboneandtheseverityoftheinjury,but mayinclude: Pain Swelling Bruising Deformity Inabilitytousethelimb.

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Different types of fracture Thedifferenttypesofbonefractureinclude: Greenstick fracturethebonesustainsasmall,slendercrack.Thistypeoffractureis morecommoninchildren,duetothecomparativeflexibilityoftheirbones. Comminuted fracturetheboneisshatteredintosmallpieces.Thistypeofcomplicated fracturetendstohealataslowerrate. Simple fractureorclosedfracture.Thebrokenbonehasntpiercedtheskin. Compound fractureoropenfracture.Thebrokenbonejutsthroughtheskin,ora woundleadstothefracturesite.Theriskofinfectionishigherwiththistypeoffracture. Pathological fracturebonesweakenedbyvariousdiseases(suchasosteoporosisor cancer)tendtobreakwithverylittleforce. Avulsion fracturemusclesareanchoredtobonewithtendons,atypeofconnective tissue.Powerfulmusclecontractionscanwrenchthetendonfreeandpulloutpiecesof bone.Thistypeoffractureismorecommoninthekneeandshoulderjoints. Compression fractureoccurswhentwobonesareforcedagainsteachother.Thebones ofthespine,calledvertebrae,arepronetothistypeoffracture.Elderlypeople,particularly thosewithosteoporosis,areatincreasedrisk.

Complications of bone fractures Complicationscaninclude: Blood lossboneshavearichbloodsupplyandabadbreakcanresultinsubstantial bloodloss. Injuries to organssuchasthebrain(inthecaseofskullfractures)orchestorgans(ifa ribbreaks). Growth problemsthefracturedlongboneofayoungchildmaynotgrowtoitsintended adultlengthiftheinjuryisclosetoajoint,sincebonefuseswhenitheals.

Bonefractures

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First aid Suggestionsforimmediatetreatmentofasuspectedbonefractureinclude: Donotmovethepersonunlessthereisanimmediatedanger,especiallyinthecaseofa suspectedfractureoftheskull,spine,ribs,pelvisorupperleg. Attendtoanybleedingwoundsfirst.Stopthebleedingbypressingfirmlyonthesitewitha cleandressing.Ifaboneisprotruding,applypressurearoundtheedgesofthewound. Ifbleedingiscontrolled,keepthewoundcoveredwithacleandressing. Donotattempttostraightenbrokenbones. Forlimbfractures,providesupportandcomfortsuchasapillowunderthelowerlegor forearm.Howeverdonotcausefurtherpainorunnecessarymovementofthebrokenbone. Applyasplinttosupportthelimb. Immobilisetheareabyapplyingaslingforarms.Limbsshouldbeimmobilisedaboveand belowafracturesitetobeeffective. Ifpossible,elevatethefracturedareaandapplyacoldpacktoreduceswellingandpain. Inanemergencydialtriplezero(000)foranambulance. Donoteatordrinkanythinguntilseenbyadoctor,incasesurgeryisrequired.

Diagnosis and treatment Bonefracturesarediagnosedwithx-rays.CTandMRIscansmayalsobeused. Brokenboneshealbythemselvestheaimofmedicaltreatmentistomakesurethetwopieces arelinedupcorrectly.Subsequentx-raysaretakentomonitortheboneshealingprogress. Dependingonthesiteofthefractureandtheseverityoftheinjury,treatmentoptionsmayinclude: Splintstodiscouragemovementofthebrokenlimb Bracestosupportthebone Plaster casttoprovidesupportandimmobilisethebone Tractionthisoptionislesscommon Surgically inserted metal rods or platestoholdthebonepiecestogether Pain relief.

The healing process Thebloodclotsthatformonthebrokenendsofbonearethebeginningofthehealingprocess. Overfiveorsoweeks,thebodyfusesthetwoboneportionstogetherwithacombinationoffibrous cellsandcartilage.Thisbridgeistemporaryandnotasstrongasrealbone.Itcanbreakeasilywith comparativelylittleforce. Acastorsplintmayberemovedafterafewweeks,butthebonestillneedstobehandledwith careforatleastonemoremonth.Thetemporarybone(callus)isslowlyreplacedwithrealbone overthenextcoupleofmonths. Unlikeskin,brokenboneshealwithoutformingscartissue.Howeverimmobilisedmusclestendto weakenandwither.Rehabilitation,includingstrengtheningexercises,maybeneededforashort time. Where to get help Yourdoctor Hospitalemergencydepartment Inanemergency,calltriplezero(000)or112(ifyourmobileisoutofphonerangeor credit).

Things to remember

Afractureoccurswhenforceexertedagainstaboneisstrongerthanthebonecan structurallywithstand. Themostcommonsitesforbonefracturesincludethewrist,ankleandhip. Treatmentoptionsincludeimmobilisingthebonewithplastercasts,orsurgicallyinserting metalrodsorplatestoholdthebonepiecestogether.

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Bonefractures

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AmbulanceVictoria
Contentonthiswebsiteisprovidedforeducationandinformationpurposesonly.Information aboutatherapy,service,productortreatmentdoesnotimplyendorsementandisnotintendedto replaceadvicefromyourdoctororotherregisteredhealthprofessional.Contenthasbeen preparedforVictorianresidentsandwiderAustralianaudiences,andwasaccurateatthetimeof publication.Readersshouldnotethat,overtime,currencyandcompletenessoftheinformation maychange.Allusersareurgedtoalwaysseekadvicefromaregisteredhealthcareprofessional fordiagnosisandanswerstotheirmedicalquestions. Forthelatestupdatesandmoreinformation,visitwww.betterhealth.vic.gov.au Copyight 1999/2011StateofVictoria.ReproducedfromtheBetterHealthChannel (www.betterhealth.vic.gov.au)atnocostwithpermissionoftheVictorianMinisterforHealth. Unauthorisedreproductionandotherusescomprisedinthecopyrightareprohibitedwithout permission.

Bonefractures

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