What is a traumatic fracture?
THE traumatic fractures These are common bone injuries, responsible for numerous emergency room and traumatology visits. They occur when a sudden impact or significant mechanical stress exceeds the normal resistance of the bone. Rapid recognition of the signs, combined with appropriate management, is essential to limit complications and promote good functional recovery.
They correspond to a partial or complete rupture of a bone resulting from a violent trauma. Unlike fragility fractures, which are linked to an underlying bone pathology such as osteoporosis, the traumatic fracture most often affects a bone that was initially healthy.
It can affect all segments of the skeleton, but more frequently affects the upper and lower limbs, particularly the wrist, ankle, forearm, leg or clavicle.
What are the main causes of traumatic fractures?
Traumatic fractures are most often related to:
- falls (domestic, sports or from height),
- road accidents,
- workplace accidents,
- impact or contact sports activities,
- direct trauma (shock, crushing).
The violence of the trauma, the direction of the force, and the position of the body at the time of impact influence the type and severity of the fracture.
The different types of traumatic fractures
Depending on the condition of the skin
- Closed fracture : the skin is intact, despite the bone fracture.
- Open fracture The bone pierces the skin. This is a medical emergency due to the high risk of infection.
According to the alignment of the fragments
- Non-displaced fracture : the bone fragments remain correctly aligned.
- Displaced fracture : the fragments are misaligned and often require reduction.
According to the fracture pattern
Fractures are among the types that can be distinguished:
- transversals,
- oblique,
- Spiroids,
- comminuted (several fragments),
- green wood, common in children.
Symptoms: how to recognize a traumatic fracture?
Clinical signs usually appear immediately after the trauma:
- intense and sudden painaggravated by movement or pressure,
- rapid swelling of the affected area,
- hematoma localized,
- visible deformation of the member,
- functional impotence, with the inability to use the limb,
- sometimes a cracking sensation at the moment of impact.
In the case of an open fracture, a wound is visible, sometimes with exposure of the bone.
When should you seek emergency medical attention?
A prompt medical consultation is essential in the following situations:
- intense and persistent pain following trauma
- inability to move a limb or to bear weight,
- obvious deformity of an arm or leg,
- wound associated with bone trauma,
- numbness, loss of sensation, or change in limb color,
- violent trauma (road accident, serious fall).
Any suspicion of a fracture should lead to medical advice, even if the signs seem moderate.
First aid measures while waiting for emergency services in case of a traumatic fracture
While waiting for medical attention, some simple actions can help limit the worsening of the injury:
- Immobilize the limb in the least painful position, using an improvised splint or fabric, by blocking the neighboring joints.
- Apply cold (ice wrapped in a cloth) for 15 to 20 minutes to reduce pain and swelling.
- Elevate the limb if this is possible without excessive pain.
- Never try to put the bone back in place nor force a movement.
In case of an open fracture, cover the wound with a clean cloth without touching the exposed bone and seek emergency medical attention.
How is the diagnosis made?
The diagnosis is based on:
- A clinical examination assessing pain, mobility, and neurovascular status,
- a X-ray, the reference examination to confirm the fracture,
- A scanner in the case of a complex or joint fracture,
- a MRI when the fracture is not visible on x-rays but remains suspected.
These tests allow the treatment to be precisely tailored.
Treatment of traumatic fractures
Orthopedic treatment
It is based on:
- immobilization by splint or cast,
- fracture reduction if necessary,
- pain management.
surgical treatment
Surgery is indicated particularly in cases of:
- unstable displaced fracture
- open fracture
- joint fracture
- Associated vascular or nerve damage.
It uses internal or external fixing devices (plates, screws, nails).
Rehabilitation
Once the bone has healed, the functional rehabilitation is essential to restore mobility, muscle strength and prevent stiffness.
Recovery time and possible complications
The consolidation period depends on:
- of the bone in question,
- the patient's age,
- of the complexity of the fracture.
On average:
- 4 to 6 weeks for a simple fracture,
- several months for a complex fracture.
The main complications are delayed union, pseudarthrosis, infection and joint stiffness.
Preventing traumatic fractures
Prevention is based on:
- the wearing of protective equipment during sporting activities,
- securing the home environment,
- maintaining muscle strength and balance,
- a diet adapted to bone health.
Conclusion
Traumatic fractures are common but potentially serious injuries. rapid recognition of symptoms, of the appropriate actions while waiting for emergency services and one early medical care are essential to ensure optimal healing and limit functional sequelae.
