Open and Closed Fractures

A fracture is called simple (closed) when the overlying skin is not broken and the bone is not exposed to the air; it is called compound (open) when the bone is exposed. When a bone weakened by disease breaks from a minor stress, it is termed a pathological fracture.

An incomplete, or greenstick, fracture occurs when the bone cracks and bends but does not completely break; when the bone does break into separate pieces, the condition is called a complete type. Fractured bones can also be classified by their configuration on the bone: a transverse fracture is perpendicular to the axis of the bone, while an oblique one crosses the bone axis at approximately a 45 degree angle. A spiral fractured bone, characterized by a helical break, commonly results from a twisting injury.

All fractures attempt to heal in the same fashion. The injured bone quickly produces new tissue that extends across the broken or cracked line and joins the broken pieces together. An impacted fracture occurs when the broken ends of the bone are jammed together by the force of the injury. A comminuted fracture is one in which the broken ends of the bone are shattered into many pieces. At first this new tissue is soft and puttylike; later, it is bony and hard. While re-forming, the bone must be protected from weight bearing and movement between the fracture ends.

The most common symptoms of fractured bones are pain and tenderness at the site, a sensation of grating or grinding with movement, and inability to use the limb or body part supported by the bone. Physical signs include deformity of the part, swelling in the region of the injured area, discoloration of the overlying skin, and abnormal mobility of the bone.