Failing to diagnose fractures is fairly common as A&E departments are becoming increasing busier places. A failure to diagnose a fracture will normally result in very little harm but certain types of fractures, such as scaphoid fractures, may result in further complications. Misdiagnosis of such fractures may result in complicated surgery to resolve the problem.

There are many different types of fractures which include the following:

Simple fractures

Generally, an injury causes a single fracture, known as a simple fracture. A single crack across the shaft of a bone is called a simple transverse fracture. If it breaks at an angle across the bone it is called an oblique fracture. This is rare.

Complex fractures

In long bones, such as the thighbone (femur) an injury is more likely to cause a more complex, spiral fracture. This leaves surfaces that are less likely to re-unite easily.

Scaphoid fractures

The scaphoid bone is one of the eight small bones that make up the "carpal bones" of the wrist. There are two rows of bones, one closer to the forearm (proximal row) and the other closer to the hand (distal row). The scaphoid bone is unique in that it links the two rows together. This puts it at extra risk for injury, which accounts for it being the most commonly fractured carpal bone.

Stress fractures

Bones can break due to small repeated stresses and strains. This is known as a stress or fatigue fracture, and is most often seen in the lower leg or foot bones of athletes.

Avulsion fractures

Muscle or ligament that supports or is attached to bone can also cause a fracture called an avulsion fracture. This happens when the ligament or muscle pulls on the bone causing it to fracture.

Hairline fractures

Hairline fractures may occur after a trip or a fall. The bone is only partially fractured. They can be difficult to detect.

Depressed fractures

A depressed fracture is when part of the bone is pushed out of line with the rest of the bone. This is usually in the skull.

Pathological fractures

If a tumour or other disease causing factor is weakening the bone, it's called a pathological fracture.

Complicated fractures

A fracture is described as complicated if there is damage to major structures near the fractured bone, such as an artery.

Compound fractures

The broken end of a bone can break the skin, or protrude through the skin. This is known as an open or compound fracture and it can lead to infection and blood loss.

Closed fractures

If the bone doesn't damage the skin it's called a closed fracture.

Comminuted fractures

Sometimes, particularly in more serious accidents, the bone can fracture in a way that produces several fragments. This is called a comminuted fracture.

Impacted fractures

After a fracture, the broken fragments of bone usually separate to some degree. Sometimes one fragment of bone is driven into another. This is called an impacted fracture.

Fragility fractures

From middle-age onwards, your bones lose density and fractures are more likely. Osteoporosis is a bone disease that speeds up this process and weakens the bones. This makes people with osteoporosis more likely to have fragility fractures, which can occur after a minor fall, such as falling from standing height or less.

Fractures in Children

Fractures in children tend to be different to those in adults because bone is softer and more able to bend. When fractures occur, the bone is not always broken completely. The bone can buckle and split and result in what is known as a greenstick fracture.

Another type of fracture common in children is a growth plate fracture, called an epiphyseal plate fracture. Bone grows in length from the growth plates near the ends of long bones. These fractures can affect bone growth.

Diagnosis

Most fractures are diagnosed using X-ray images but MRI (magnetic resonance imaging) or CT (computerised tomography) scans may be used by your doctor to look at the fracture more closely.

Treatment

If you have had a serious accident, medical professionals will treat your circulation (blood flow), breathing and other injuries before they treat any fractures. Fractures are then usually treated in the following way.

•If necessary, the broken bone will be re-aligned. This may be done using an anaesthetic or painkiller, and is known as reducing the fracture.

•The broken bone will be immobilised either using a cast, splint or sling, or with surgery. Casts can be made from plaster, plastic or resin.

•You may need to have surgery if the broken ends of your bone can't be kept close enough to allow them to knit together. Surgeons use surgical steel screws, wires, rods, pins or plates to hold the broken pieces of bone together.

Complications

Serious fractures can cause on-going problems such as pain or stiffness in the limb or joint involved.

Some fractured bones don't knit together easily and surgery may be needed to help the bones to unite. Fractures can also damage nerves and blood vessels, which may need separate treatment.

Infection can also complicate and delay healing. Infection is more common if you had a compound fracture or if you need surgery to fix the bone. This can lead to an infection of the bone marrow which is called osteomyelitis.

Recovery

The repair of a fracture by the body is a gradual process. Fractures in children usually heal quickly. The speed of recovery also depends on the bone you break. It will take longer for fractures in lower limbs, such as the thighbone, to recover than those in smaller bones, such as the finger bones. This is because the thighbone is larger and more difficult to immobilise. After this it's important to begin gentle movements and exercise as this helps to build up strength in the healing bone. You may need to have physiotherapy to promote healing and increase your movement of the affected area. This will be specific to your injury.

Ultrasound or pulsed electromagnetic energy may be used for fractures that are not healing or are healing slowly.

If you have suffered a fracture through no fault of your own then you may be able to make a personal injury claim. For more information on this please visit www.accidentcompensation.com

If a fracture has been missed, which has caused additional complications, contact us today to find out if you are able to make a medical negligence claim?

 

 

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