2. What is a stress fracture? A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture. What causes a stress fracture? Stress fractures often are the result of increasing the amount or intensity of an activity too rapidly. They also can be caused by the impact of an unfamiliar surface (a tennis player who has switched surfaces from a soft clay court to a hard court); improper equipment (a runner using worn or less flexible shoes); and increased physical stress (a basketball player who has had a substantial increase in playing time). Stress Fractures
3. Fractures Cont. Where do stress fractures occur? Most stress fractures occur in the weightbearing bones of the lower leg and the foot. More than 50 percent of all stress fractures occur in the lower leg. What activities make athletes most susceptible to stress fractures? Studies have shown that athletes participating in tennis, track and field, gymnastics, and basketball are very susceptible to stress fractures. In all of these sports, the repetitive stress of the foot striking the ground can cause trauma. Without sufficient rest between workouts or competitions, an athlete is at risk for developing a stress fracture.
4. What are the symptoms of a stress fracture? Pain with activity is the most common complaint with a stress fracture. This pain subsides with rest. How are stress fractures diagnosed? It is very important that during the medical examination the doctor evaluates the patient's risk factors for stress fracture. X-rays are commonly used to determine stress fracture. Sometimes, the stress fracture cannot be seen on regular x-rays or will not show up for several weeks after the pain starts. Occasionally, a computed topography (CT) scan or magnetic resonance imaging (MRI) will be necessary. Symptoms and Diagnosis of Stress Fractures
6. Comminuted fracture s are also sometimes known as multi-fragmentary fractures. This type of fracture often involves crushing or splintering of the bone, and it can occur anywhere along the length of the bone. A comminuted fracture is most common in elderly people or in people with conditions which weaken the bones, such as osteogenesis imperfecta or cancer. A comminuted fracture can also occur as the result of tremendous force, such as a car accident or a severe fall. A comminuted fracture is a fracture in which the bone involved in the fracture is broken into several pieces. At least three separate pieces of bone must be present for a fracture to be classified as comminuted. This type of fracture can be challenging to treat due to the complexity of the break, and it can be especially complicated if the fracture is open, meaning that the bone is protruding outside the skin. Open fractures are at a very high risk of infection and they typically take longer to heal. Comminuted Fractures
7. This type of fracture is usually easy to diagnose with an X-ray to look at the site of the suspected fracture. When a comminuted fracture is X-rayed, the doctor can use the image to gather more about the orientation of the pieces of bone and the location of the fracture to determine the best possible treatment. It may be necessary to pin the fracture with surgery so that the pieces will have a chance to knit together. Like many other types of fracture, comminuted fractures are associated with very distinctive symptoms which usually lead people to seek medical treatment. The patient usually experiences tremendous pain at the site of the fracture, and he or she may even pass out at the time that the break occurs as a result of the pain. The area around the break will also swell, and it may become warm to the touch. Typically the patient cannot bear any weight on the fracture without experiencing significant pain. Diagnosis and Treatments
8. Why do pathologic fractures occur? A pathologic fracture usually occurs with normal activities--patients may be doing very routine activities when their bone suddenly fractures. The reason is that the underlying disease process weakens the bone to the point where the bone is unable to perform its normal function. A pathologic fracture occurs when a bone breaks in an area that is weakened by another disease process. Causes of weakened bone include tumors, infection, and certain inherited bone disorders. There are dozens of diseases and conditions that can lead to a pathologic fracture Pathologic Fracture
9. For example: a bone cyst may grow to a significant size where the tumor effectively eats away a significant portion of normal bone. This area of bone is now much weaker, and prone to pathologic fracture. When a broken bone occurs through the weakened area it is called a pathologic fracture. Pathologic Fracture Cont.
10. What is the treatment of a pathologic fracture? This is a very complicated question, but the simple answer is that both the fracture, and the underlying process must be considered in order for treatment to be safe and effective. Some pathologic fractures require the same treatment as a normal fracture, while others may require highly specialized care. Treatments
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12. Because bones become brittle with age, a complete fracture is more likely in adults and among the elderly. This is called a Colles' fracture.Colles Fractures
13. Bones become more brittle (from osteoporosis) in adults ages 50 - 60 and older. Older adults are more likely to fracture a bone, even while walking slowly. Older people with Colles' fractures often fail to regain full mobility of the wrist joint. Carpal tunnel syndrome may occur as an early or late complication of the injury. Chronic pain may result from injury to the ligaments or the joint surface of the wrist. Colles Fractures Cont.
14. This injury usually occurs when a person attempts to break a fall by throwing the hands and arms out in front of them. The hands meet the ground with the body weight behind them. The radius and ulna (the bones in the forearm) may buckle or break just above the wrist. This injury is more likely to happen during sports such as rollerblading, skateboarding, running, or any other activity in which a forward fall can occur while a person is moving at a higher speed. Causes of Colles Fractures:
