Broken Bones and Fractures

Why is an experienced attorney critical to my broken bone injury case?

Without an experienced attorney representing you, it's possible that:

• the insurance company has denied your broken bone injury claim,
• they have ignored your calls, hoping you tire and go away,
  
• they make an offer to you that is insulting,
• they have told you that your broken bone wasn't a result of the accident, or that there is no physical evidence to support your injury claim.

DO NOT believe them.

Is there a difference between a broken bone and a fracture?
You might believe that one is worse than the other, or that your treatment type will depend on whether or not a bone is broken or fractured. The truth is, a "fracture" and a "break" are used interchangeably and mean the same thing. And though there is no difference between a fracture or a break, there are many different types:

Compound Bone Fracture
If the broken bone penetrates the skin, then you have suffered a compound fracture. Besides the immediate injury to the bone, infection is also of high concern with this type of break.

Closed Fracture
Simply said, if the bone does not penetrate the skin, yet x-rays or examination reveal a break, then you have suffered a closed fracture.

Complete Bone Fracture
If the bone has broken through it's entire width, then you have a complete bone fracture. A "crack" or "hairline fracture" and a complete bone break are opposites and should never be spoken of interchangeably.

Hairline Fracture
The least severe of any type of break, a hairline fracture results in minimal trauma to the bone and surrounding tissue. It is an incomplete fracture with no significant bone displacement and is considered a stable fracture. Instances of this type of fracture involve a crack that only extends into the outer layer of the bone, but not completely through the entire bone. It is also known as a "fissure fracture."

Compression Fracture
A compression fracture often occurs in a person's back. In an auto accident, or a fall, the vertebral column can be compressed until the pressure results in a break. Another name for a compression fracture is an "impact fracture."

Spiral Fracture
A spiral fracture results from a type of twisting motion that leaves the bone with a corkscrew-type break in appearance and runs parallel with the axis of the bone. This type of break is highly unstable and needs immediate medical attention. Without proper x-rays, a spiral fracture may be diagnosed improperly as an oblique fracture.

Double Fracture
Also known as a "segmental fracture," this type of break occurs when multiple fractures exist on the same bone, or when two bones are fractured at the same time (i.e., tibia and fibula). This type of break is often severe and will require surgical intervention.

Fracture-Dislocation
A fracture that occurs in the proximity of a joint, and also results in displacement/dislocation of that joint.

Fragmented Fracture
The trauma that causes a fragmented fracture will often leave the bone somewhat shattered, breaking the bone into several pieces.

Greenstick Fracture
This is an incomplete fracture that leaves one side of a bone broken. The bone is "bent" and only shows a fracture on the outside of the bend. This is commonly seen in children and is considered a stable fracture, as the whole bone is not broken. Recovery time for this type of break is usually rapid if the bone is kept stabilized.

Oblique Fracture
This type of fracture is severe yet not as common as other types of breaks. This type of fracture occurs when the break is an angle across the bone. The cause is usually a trauma that involves a sharp angled blow to the bone. These types of breaks are unstable and require immediate medical attention. They can also be easily misdiagnosed as spiral fractures.

Transverse Bone Fracture
In this type of fracture the bone has been broken giving rise to a transverse break or fissure within the bone at a right angle to the long portion of the bone. It is most often caused by direct traumatic injuries.

Stable Fracture
A stable fracture is a broken bone which is generally transverse, oblique, greenstick or hairline in nature and is normally secure.

Unstable Fracture
An unstable fracture is a broken bone which, in most instances, is comminuted, oblique or spiral and requires external or internal fixation.

How does a doctor detect a broken bone injury?
Certain fractures, e.g., the compound fracture, can be easily diagnosed by observing the afflicted area. In this instance the bone will be seen protruding through the skin, a sign that an obvious fracture exists.

If the break is not visible to the eye, the x-ray is a traditional and effective means of detection. X-rays will allow a doctor to see an image of the damaged or broken bone. However, x-rays are not always definitive and there are instances in which the results are questionable. For example, a broken rib is often difficult to see on a single X ray. In cases like this, the doctor may order a series of x-rays from different angles to properly diagnose a fractured rib.

Another fracture type that can be difficult for a doctor to detect by x-ray is the stress fracture. A stress fracture is a very small break in a bone that may not be visible on an x-ray. Interestingly, a stress fracture can possibly be detected with the aid of a tuning fork. (A tuning fork is a metal instrument used to tune musical instruments.) The tuning fork is placed on the skin over the bone in which a stress fracture is suspected, and if the patient experiences increased pain, a stress fracture may be present.

What treatment is available for broken bone injuries?
The treatment of a broken bone and the amount of time it takes to properly heal will depend on many factors:

• the serious nature of the injury
• how the injury occurred
• the location of the injury
• the age of the person
• the health history of the person
  
  

If the fracture is determined to be serious, several treatment modalities may be necessary. For example, anyone with a compound fracture will need to be treated for blood loss, as well as prescribed the appropriate antibiotics to defend against infections.

The primary goal in treating any fracture is to return the bone to its original position, if needed, and then stabilize the area. Bones begin to grow back soon after they are broken, so it is imperative that a medical professional examine and treat the trauma as quickly as possible.

In most instances, the only required treatment for a fracture will be a cast or splint. However, because some breaks are more severe than others, there is the likelihood that a bone will need to be "set," or placed back in its original position before being placed in a cast or splint. Once the bone is set and stabilized, it will begin to return to its former shape.

"Fracture reduction" is one procedure that can be performed to re-position a bone back to its original location.

If the reduction does not require the doctor to break the skin, then the procedure is known as closed reduction. If the break is severe, surgical intervention may be required. In this instance the doctor will perform an open reduction.

Open reductions are commonly referred to as O.R.I.F. (open reduction internal fixation). This allows the doctor to surgically manipulate the bone until it is in proper alignment. Often, a patient will require screws, plates, rods or nails to hold the bone alignment in place while healing occurs. Depending on a doctor's recommendation, it may be possible that this hardware will remain in place permanently, even after the healing has completed.

Another form of treatment is known as "traction." Often times, movies will depict a person in traction as they lie in their hospital bed, connected to a series of pulleys and weights, their arms and legs held in mid-air. Traction makes use of the weights to provide a constant pull on a damaged bone. This constant pull encourages the bone to line up correctly and return to proper alignment. The time a person must spend in traction will depend on how long it takes the bone to grow back into its original position.

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