Popping back bones

Fractures are not really as scary as most people seem to think. Most simple fractures heal in four to six weeks but complex fractures may need surgical intervention, says Dr G K Agrawal.

Fractures are quite common, especially among children and older people. They occur when a bone breaks either partly or completely under overwhelming force. Legs, ankles, arms, hip and wrists are the usual areas of the body prone to fractures.

Fractures can be caused by many reasons such as fall from a height, road accidents, direct blow on the bone, unnatural bending or twisting of limbs, and a forceful impact with some object.

Overuse or repetitive use of bones, such as excessive running, walking, or weightlifting, can cause stress fractures in specific areas of the body. Diseases such as tumors growing near the bones, osteoporosis, and bone cancer can lead to pathological fractures by weakening the bones.

When a fracture occurs, the area over the bone gets bruised and swollen. It is common for the skin to become painful, warm and red. A visible deformity may arise as the limb or joint goes out of place, especially in the cases of armor leg fractures.

Fractures result in a loss of function of the injured area. It is difficult to move or use the affected part of the body. The pain becomes intense with movement or applying pressure and there may also be numbness and tingling.

Fractures are classified into many types. In a complete fracture, the bone breaks into two or more parts; in an incomplete fracture, the bone cracks but does not break off. A compound (open) fracture occurs when the bone breaks through the skin and becomes visible to the eye. In closed (simple) fractures, there is no open wound. The bone, even if broken into two, remains underneath the skin.

Pathological fractures are caused by long-term diseases. Hairline fractures, on the other hand, involve very thin cracks in the bone that are formed due to overuse or repetitive stress-bearing activities such as dancing or running. In undisplaced fractures, the bone pieces crack or break but do not lose their alignment. In displaced fractures, the bones go out of alignment and surgery may be needed to get them back into their proper place.

How serious a fracture is depends on the area affected and the bone and tissue damage. Major fractures need urgent treatment because of the possibility of infection and damage to blood vessels and nerves. A fracture may take a few weeks to many months to heal, depending on its severity and the age and health of the patient.

Bones have the capability to heal themselves naturally, provided they are properly aligned and not disturbed in the healing process. Most ordinary fractures heal in one to one-and-a-half months. For treatment, orthopedic specialists first fix the broken bones back into their proper position and alignment. The area then may be encased in plaster or fiber-glass cast to keep the bones from shifting while they heal.

In some cases, metal rods, wires or screws may be inserted in bone parts to keep them joined together. In others, pins or wires are attached to the bone from above and below the affected part and connected to a ring outside the skin. This paraphernalia is later removed once the bones have healed.

During the healing process, the muscles become extremely weak. The tendons and ligaments turn stiff because of lack of movement for weeks. Patients needphysical therapy to gradually get flexibility, strength and balance back into the affected body part.
When a person suffers a fracture, professional medical attention is needed to judge the extent of the damage.

The broken bone has to be immobilized immediately with a sling or splint, such as a rolled up newspaper or a wooden stick. If there is bleeding or open wound at the fracture site, it has to be covered with a clean cloth. Once the area has been stabilized, the patient needs to be moved to a healthcare facility.

People with fractures of the head, neck, back, or hips should not be moved unless absolutely necessary. No pressure should be put on the affected area to shift the injured person. One should not attempt to straighten the bone or test its ability to move as this may cause more damage.

If the fracture has broken the skin, the area needs to be treated to prevent infection. It should be lightly rinsed to remove any dirt and contamination and covered with sterile dressings.

Ice packs are the most effective home remedy to reduce pain and swelling and speed up the recovery process after the bone has been set by a doctor. These packs should be applied every two hours over the area for 15 minutes.

The ice should not be put directly on the skin, but wrapped in a towel to prevent ice burns. Crushing the ice ensures it conforms to the affected area better than ice cubes. The bone has to be given complete rest till it has completely healed.

(The writer is an orthopaedic specialist)