Comminuted vs. Compound Fractures: What’s the Difference?

A fracture or broken bone is extremely common—the average person experiences two broken bones in the course of their lifetime. Fractures occur when an outside physical force is applied to a bone. Although bones can bend to some degree, if the external force is too great, they reach a breaking point and snap. The risk of fractures is higher in children, but fractures tend to be more complicated in adults because bones become more brittle with age. There are different types of bone fractures. Please continue reading to learn more.

What are the most common causes of bone fractures?

The most common causes of bone fractures are trauma (sports injuries, motor vehicle accidents, falls), osteoporosis (a condition characterized by weak or brittle bones), and overuse or stress (this is more common in athletes).

What are the common symptoms of a bone fracture?

A broken bone can be very painful and may prevent you from moving the injured area. Other symptoms of fractures can include bruising, swelling, tenderness, deformity, and overlying skin wounds.

Is a broken bone serious?

Not all broken bones are serious. If the bone’s breaking point is exceeded only slightly by an outside force, it may crack but not break all the way through.

On the other hand, if the severity of the force is very great and the bone breaks into separate fragments, it is a more serious type of fracture. Some injuries can cause the bone to shatter into many pieces. If bone fragments are sticking out through the skin or there is an open wound that penetrates down to the bone, there is a risk of complications like wound and bone infections, representing a medical emergency.

What are the different types of bone fractures?

Some of the common fracture types are described below:

Traumatic Fractures vs Pathologic Fractures

A traumatic fracture occurs due to applying an extreme external force to a bone, such as during a car accident or fall.

A pathologic fracture occurs without any outside force due to a pre-existing health condition like osteoporosis or bone cancer.

Partial Fractures vs Complete Fractures

A partial or greenstick fracture is one in which the bone cracks but does not break completely. In other words, there is a hairline crack or incomplete break in the bone, and the fragments are not entirely separated. Greenstick fractures mostly occur in children under 10 years of age.

In a complete fracture, the affected bone is completely broken into two or more pieces.

Simple Fractures vs Complex Fractures

A simple fracture is one in which there is a break in the bone, but the overlying skin is intact.

A complex fracture results from a traumatic injury with multiple breaks in the bone and damage to the surrounding soft tissue.

Closed Fractures vs Open Fractures (Compound Fractures)

A closed fracture is one in which there is a break in the bone line, but the overlying skin is intact.

In an open fracture, the broken bone breaks through the skin or there is an open wound on the outer surface that exposes bone. Open or compound fractures are risky because they make it easy for bacteria and contaminants to enter the wound and invade the body.

Non-Displaced Fractures vs Displaced Fractures

A non-displaced fracture or stable fracture is one in which the broken ends of a bone are in alignment, i.e., they line up and are barely out of place.

A displaced fracture is one where two or more pieces of bone are not properly aligned. In severe cases, this can be a comminuted fracture where the bone shatters into many pieces and/or an open fracture with an open skin wound at the site where the bone broke.

Comminuted Fractures

In a comminuted fracture, the bone shatters into three or more pieces. It occurs when a great force is applied to the bone, even more so than other types of fractures.

Transverse Fractures

In a transverse fracture, there is a horizontal fracture line, i.e., the bone breaks straight across its width.

Oblique Fractures

In an oblique fracture, the break in the bone is in a curved or angled pattern. It occurs when the blow to the bone occurs at an angle.

Spiral Fractures

Strong twisting forces can lead to a spiral fracture in which the break in the bone resembles a corkscrew or spiral staircase. Spiral fractures commonly occur in high-impact injuries like car crashes, falls, and severe twisting injuries during sports like skiing and football.

Avulsion Fractures

This is a type of fractured bone in which a ligament or tendon tears away from the bone, taking a small piece of bone with it. It can occur during hard tackles in football or stopping suddenly while running.

Stress Fractures

A stress fracture can occur from performing the same movement again and again. The repeated force on the bone ultimately leads to a small break. Stress fractures are common in professional athletes and tend to occur in weight-bearing bones like the ankle, shin, and hip. They can also occur if you suddenly increase the duration or intensity of physical activity or place stress on an already weak bone, such as by wearing different shoes or running on a new surface.

Fragility Fractures

A fragility fracture occurs due to a low-energy force or low-impact trauma on a weak or brittle bone. Fragility fractures are common in people with osteoporosis, a condition characterized by fragile bones. They can also occur in certain types of bone conditions like bone cancer. Even something as minor as coughing strenuously or twisting while standing up can lead to a fragility fracture in a person with weakened bones. A type of fragility fracture called compression fracture occurs when the vertebrae (spinal bones) collapse.

What is a comminuted compound fracture?

As mentioned above, the term comminuted fracture is used when a bone is broken in at least three places. A compound or open fracture is one in which the skin overlying the broken bone is not intact, or there is a deep wound that exposes bone.

Comminuted compound fractures are typically caused by severe high-energy trauma such as motor vehicle accidents. These fractures are at high risk of infection and may need to be repaired surgically. Healing complications can lead to a prolonged recovery from these types of fractures.

What is the difference between a fracture and a compound fracture?

A fracture is a break in the bone. It can be classified in various ways, such as open vs closed, partial vs complete, and simple vs complex. A compound or open fracture is one in which the bone pokes through the skin, or there is a deep wound that exposes the bone.

How do doctors treat a fracture?

Splinting and Buddy Taping

A finger or toe fracture may be treated with a removable splint or by taping the affected digit to the adjacent digit for immobilization and stability.

Cast Immobilization

This is the most common type of fracture treatment. Most broken bones can be treated by placing a fiberglass cast or plaster that limits movement. This allows the bone to heal with the broken ends in the proper position.

Brace or Functional Cast

A functional cast or brace allows limited or controlled movement of the affected body part. This type of fracture treatment can be offered for some but not all fractures.

Traction

Traction is a steady pulling action that is used to gently align a bone into normal position.

Internal Fixation

This is a surgical procedure in which orthopedic surgeons reposition bone fragments into normal alignment and hold them in place with implants like metal plates, pins, wires, nails, or screws. Internal fixation can reduce the duration of your hospital stay and enable you to return to function sooner. It also reduces the chances of malunion and nonunion (improper healing).

External Fixation

This is a surgical procedure in which metal pins or screws are placed in the broken bone at the fracture site. The implants are connected to an external metal bar called the external fixator, which acts as a stabilizing frame to hold the bones in place as they heal. External fixation is done in patients with badly damaged skin and soft tissue who cannot tolerate surgery.

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