Fractures

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are

• Intense pain

• Deformity - the limb looks out of place

• Swelling, bruising, or tenderness around the injury

• Numbness and tingling

• Problems moving a limb

You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.

The worst place you could possibly break a bone is out in the wilderness, but of course it does happen, and it happens quite often, in fact.

The main reason for this is simple: The wilderness is a place that hasn’t been sanitized and made perfectly safe for human habitation. There are no building codes to prevent someone from falling off a steep trail; no convenient handrails on trees, boulders or loose ground. In short, the wilderness is rife with potential hazards, and each year, hundreds of people find themselves with an injury sustained due to a little outdoor adventuring.

In theory, you can break any bone in your body up to and including your skull in the wilderness. In practice, most breaks tend to revolve around the lower arm (radius and ulna), the upper arm (humerus), the lower leg (tibia) and the upper leg (femur). Mainly, these bones are broken more frequently than others in the outdoors because of falls, although it’s common to see non-limb breaks as well.

Bone breaks are grouped into two major categories – open fractures and closed fractures. An open fracture is one in which the bone has broken such that it penetrates the skin; this is sometimes referred to as a compound fracture. A closed fracture is one in which the bone is broken or cracked, yet does not penetrate the skin.

All forms of treatment of broken bones follow one basic rule: the broken pieces must be put back into position and prevented from moving out of place until they are healed. In many cases, the doctor will restore parts of a broken bone back to the original position. The technical term for this process is “reduction”.

Broken bone ends heal by “knitting” back together with new bone being formed around the edge of the broken parts.

Surgery is sometimes required to treat a fracture. The type of treatment required depends on the severity of the break, whether it is “open” or “closed”, and the specific bone involved. For example, a broken bone in the spine (vertebra) is treated differently from a broken leg bone or a broken hip.

Cast Immobilization

A fiberglass cast is the most common type of fracture treatment, because most broken bones can heal successfully once they have been repositioned and a cast has been applied to keep the broken ends in proper position while they heal.

Brace

The brace allows limited or “controlled” movement of nearby joints. This treatment is desirable for some, but not all, fractures.

Traction

Traction is usually used to align a bone or bones by a gentle, steady pulling action.

External Fixation

In this type of operation, metal pins or screws are placed into the broken bone above and below the fracture site. The pins or screws are connected to a metal bar outside the skin. This device is a stabilizing frame that holds the bones in the proper position while they heal.

In cases where the skin and other soft tissues around the fracture are badly damaged, an external fixator may be applied until surgery can be tolerated.

Open Reduction and Internal Fixation

During this operation, the bone fragments are first repositioned (reduced) in their normal alignment, and then held together with special screws or by attaching metal plates to the outer surface of the bone. The fragments may also be held together by inserting rods down through the marrow space in the centre of the bone.