What is a fracture? Understanding fracture symptoms, types, causes, and treatment.

A bone fracture is when a bone breaks or changes its shape due to excessive external forces that exceed the bone's ability to withstand them. Other causes such as accumulated stress, osteoporosis, etc., can also cause a bone to break. Fractures vary significantly depending on the age of the injured person. For example, elderlies are more likely to experience broken bones due to osteoporosis, while children tend to experience greenstick fractures or growth plate fractures as their bones are softer and easier to bend since they are still in their development phase.

There are many causes of bone fractures, and they can generally be categorized into the following types.

A fracture occurs when a bone breaks due to external force or pressure, disrupting its structural integrity. Based on the severity and pattern of damage, fractures can be classified into various types.

Different types of fractures require different treatment approaches. If a fracture is suspected, it is recommended to seek medical attention as soon as possible for diagnosis and treatment.

Upper limb fractures are among the most frequently occurring bone injuries in daily life, especially after falls, sports activities, or traffic accidents.

Clavicle Fracture (Broken Collarbone)

Most commonly caused by falling onto an outstretched hand or direct impact to the shoulder, this type of fracture is frequently seen in children and adolescents. Patients experience severe shoulder pain and difficulty lifting their arm.

Distal Radius Fracture (Wrist Fracture)

Usually caused by falling onto an outstretched hand, this type of fracture is common among older adults or individuals with osteoporosis. Typical symptoms include wrist swelling, deformity, and difficulty in movement.

Proximal Humerus Fracture (Upper Arm Fracture)

Occurs near the shoulder in the upper arm, often resulting from falls from heights or direct impact. This type of fracture can affect shoulder mobility and the ability to lift the arm.

Phalangeal or Metacarpal Fracture (Finger/Hand Fracture)

Often caused by impact, crushing, or twisting injuries, this type of fracture leads to noticeable finger deformity, swelling, and pain, affecting fine motor skills of the hand.

Elbow Fracture

Includes fractures of the ulna and radius near the elbow joint, often caused by falls or strong impacts. Symptoms may include swelling, restricted movement, or deformity in the elbow.

Children and Adolescents

Common fractures in children and adolescents include forearm fractures (such as the radius and ulna), clavicle fractures, and growth plate fractures. Since bones at this age are still soft and flexible, fractures often occur as "greenstick fractures," where the bone bends but does not completely break. In terms of recovery, children's bones heal relatively quickly. However, if the fracture involves the growth plate, careful monitoring is needed to prevent potential effects on future bone development.

Adults

Common types of fractures in adults include wrist, ankle, finger, shoulder, and hip fractures, often caused by sports injuries, traffic accidents, or falls from heights. At this age, bone density remains relatively strong, so the location and severity of fractures can vary significantly. Recovery depends on the fracture site and treatment method, such as cast immobilization, metal plate implantation, or surgery. Rehabilitation therapy is crucial to restoring mobility and function.

Elderly (65 Years and Older)

Common fractures in the elderly include hip fractures, vertebral compression fractures, and wrist fractures. Due to the prevalence of osteoporosis in this age group, falls can easily lead to severe fractures, impacting mobility and daily self-care. Recovery tends to be slower and requires a combination of physical therapy, nutritional supplementation, and improvements in home safety to prevent further falls and support functional recovery.

Patients will have different symptoms depending on the severity of their bone fractures. The most common ones are swelling, bruising or deformation of the fracture site, and this often leads to pain. However, if the fracture is severe, it may cause internal bleeding or the following symptoms:

• Paleness
• Chills
• Nausea
• Mild headache
• Fever or faintness

Risk factors for bone fractures

• Elderlies
• Postmenopausal women
• People with chronic illnesses
• Osteoporosis patients
• Athletes

Fractures can generally be diagnosed by X-ray, but in cases of complex or comminuted fractures, patients may need a CT scan.

Treatment for bone fractures

Bone fracture treatments aim to set the broken bone back to its original position. Doctors will choose the most appropriate treatment based on the location of the patient’s bone fracture and its severity. If it is a simple fracture, a plaster cast will be used to immobilize the broken bone. However, if the fracture cannot be treated with reduction, surgery may be required to stabilize the bone with nails or plates.

Bone Fracture Healing Time

The healing time of a fracture varies depending on age, fracture location, severity, and overall health condition. Generally:

• Children heal faster, usually within 3 to 6 weeks;
• Adults typically take around 6 to 8 weeks;
• Elderly individuals or those with chronic illnesses may require 10 weeks or more for recovery.

During the healing period, it is essential to follow medical advice for proper immobilization (such as a cast or brace) and attend regular follow-up checkups. Additionally, physical therapy plays a crucial role in rehabilitation, helping restore joint mobility and muscle strength while preventing long-term stiffness or loss of function.

Rehabilitation Precautions

• Avoid excessive weight-bearing or intense exercise too soon to prevent healing disruptions;
• Maintain a balanced diet with sufficient calcium, protein, and vitamin D to support bone regeneration;
• Perform physical therapy progressively, adjusting intensity according to recovery progress;
• Prevent falls, especially for elderly individuals, by improving home safety with non-slip mats and handrails.

During the bone fracture recovery process, in addition to proper immobilization and physical therapy, nutritional supplementation plays a crucial role in healing. The body requires sufficient nutrients to repair damaged bone tissue and enhance bone density. Key nutrients and their sources include:

• Calcium – The primary component of bones, essential for repair and strengthening. Good sources include milk, cheese, tofu, and dark green vegetables such as kale and spinach.
• Vitamin D – Enhances calcium absorption. Sunlight is the best natural source, but it can also be obtained from salmon, egg yolks, and vitamin D-fortified milk.
• Protein – Supports tissue repair and wound healing. Recommended sources include fish, eggs, legumes, and lean meats.
• Vitamin C – Boosts immunity and promotes collagen synthesis, aiding fracture healing. Good sources include kiwis, oranges, and strawberries.
• Zinc and Magnesium – Assist in bone metabolism and regeneration, found in nuts, whole grains, and seafood.

Is a Cast Necessary for a Bone Fracture?

This depends on the location and severity of the fracture. Some minor fractures may not require a cast and can be managed with a brace, bandaging, and limited movement. However, if the fracture is in a highly mobile area or carries a risk of displacement, doctors typically recommend casting for stabilization and optimal healing. The decision to use a cast should be based on X-ray or imaging results, with a doctor providing professional assessment and guidance.

Common Issues After a Bone Fracture

Bone fractures can lead to several complications, including pain, swelling, bruising, and restricted movement. In more severe cases or after surgery, recovery may involve joint stiffness, muscle atrophy, or reduced mobility. Additionally, prolonged immobility may result in poor blood circulation or deep vein thrombosis. Some individuals may also experience psychological effects such as anxiety or depression, especially if the injury impacts daily activities or independence. Beyond physical therapy, mental health and emotional well-being should also be considered during recovery to ensure a holistic approach to healing.

Is Rehabilitation Necessary After a Fracture? When Can It Begin?

Rehabilitation is essential in most cases, especially for fractures near joints or those affecting mobility. It helps restore range of motion, muscle strength, balance, and coordination, ultimately speeding up recovery and preventing long-term complications. The timing for starting rehabilitation depends on the fracture location and severity. Generally, it begins once the bone has started healing and a doctor confirms it is safe—this could range from a few days to several weeks. Initially, light stretching is recommended, followed by progressively increasing movement and weight-bearing exercises. For best results, rehabilitation should be guided by a professional physical therapist to ensure a safe and effective recovery.