Bone Fracture

– The information has been reviewed by Dr. Sha Wai Leung

Current Statistics

According to the 2017 health statistics report published by the Department of Health, over 41,000 patients were hospitalized for various types of bone fractures in Hong Kong during the year, and about 90 of them died from this medical condition.

What is a bone fracture?

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.

Greenstick fracture	The bone bends and cracks, instead of breaking into separate pieces. This medical situation is named greenstick fracture as the bone behaves like a fresh green twig when it is being bent.
Growth plate fracture	This refers to the bone growth that begins at the end of a long bone. As this medical condition could hinder future bone growth, it must be treated with care.

Causes of bone fractures

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

External forces	This is the most common cause of fractures. Bone breaks when the direct external forces it receives exceeds its ability to withstand them.
Indirect forces	This is common in cases where a patient falls from a height and lands on both feet, resulting in a compression fracture of the spine due to the pressure caused by forces.
Muscle contraction	When muscles contract strongly, bones can break. Rib fractures caused by violent coughing is an example.
Fatigue fracture	This refers to fatigue-induced bone fractures caused by mild, repeated stress over time.
Pathological fracture	It is not caused by external forces, but by pathological conditions of the patient, such as cancer cells spreading to the bones (bone metastases), incomplete growth of bones that is congenital, etc.

Symptoms of bone fractures + Risk factors

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

How is a bone fracture diagnosed? + Treatment for bone fractures

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.

Closed reduction	Bone pieces are moved back into their correct position manually, which allows them to heal in 6-8 weeks.
Open reduction	If closed reduction is not suitable for the patient, open reduction, which refers to the use of surgery, will be performed to rearrange the alignment of the broken bones. During the process, the fractures will be stabilized with nails or plates. Patients may require physiotherapy after the surgery to help with the recovery of mobility.

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