Broken Bones (Fractures)

The bones in the human body are very strong, but they can be broken (fractured) as a result of trauma. Breaks can range in severity from hairline fractures that require minimal treatment to shattered bones that require surgery and may result in permanent damage.

Ken's Elbow

Ken knew the steps to the attic were steep, but when his little sister ran off with his toy airplane, he took the stairs two at a time. Halfway down he slipped. Ken landed in a heap at the bottom and immediately howled in pain. When he got up, his arm was twisted in a strange way, and his elbow would not bend.

Ken's mother rushed him to the emergency room where doctors took x-rays of his arm. He had broken the bone in the upper part of his arm as well as his elbow. The breaks were so bad that Ken had to have surgery that afternoon. The doctor put a metal pin in his elbow to hold the bones together while they healed. After surgery, Ken's arm had to be in traction for two weeks. Being in traction means that he had to lie on his back in bed while his elbow was held in place by a special device hanging from the ceiling. This device put tension on his arm and elbow in just the right places to allow them to heal properly. After getting out of the hospital, Ken had a plaster cast on his whole arm for another eight weeks. Ken's arm and elbow healed completely, but every so often his elbow aches when he plays baseball.

What Are Bone Fractures?

Bone is the hardest tissue in the human body, but when bones are subjected to forces that exceed their strength, they may break. The terms break and fracture mean the same thing.




Bone is the hardest tissue in the human body, but when bones are subjected to forces that exceed their strength, they may break in several different ways.





Bone is the hardest tissue in the human body, but when bones are subjected to forces that exceed their strength, they may break in several different ways.
Illustration by Frank Forney. © 2016 Cengage Learning®.

What Causes Breaks and Fractures?

Bones break when they are subjected to extreme force or stress. The likelihood that a bone will break depends on the location of the bone in the body, the thickness of the bone, and the circumstances under which the force is applied. The most commonly broken bones are those in the wrist, hip, and ankle.

Bone is living tissue and, like other living tissue in the body, bone is affected by genetics, hormones, diet, physical activity, disease, and drugs. All of these factors determine which bones are more or less prone to injury. In addition, the strength of bone and the forces acting on bone vary with age, so the types of fractures and the number of people affected by them vary with age as well.

Other factors that weaken bone and predispose individuals for bone fracture include those associated with low bone-mineral density, such as osteoporosis, age (over 50), menopause and postmenopause in women (due to low estrogen levels), previous fractures, ethnicity (Caucasian and Asian groups have a higher incidence of osteoporosis), long-term corticosteroid * therapy, rheumatoid arthritis * , elevated levels of parathyroid hormone (associated with hyperparathyroidism), and androgen deficiency * in men. In addition, some cancer treatments, immunosuppressants * , steroids, antipsychotics * , and anticonvulsants * may predispose individuals who use them to bone fracture. Some diseases associated with nutritional deficiencies and/or immobility, such as Crohn's disease, rheumatoid arthritis, blood disorders, and endocrine disorders, may predispose a person to poor bone health.

Healing time also varies with the severity of the break as well as the patient's general state of health and nutrition.

Many types of trauma (e.g., skiing or car accidents) can cause a bone to break. However, some people are more prone to breaks because they have genetic conditions or bone diseases that weaken their bones, such as: