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Comminuted Fracture - Healing time, Symptoms, Treatment, Causes

Updated on August 20, 2014

Comminuted Fracture Pictures

What is Comminuted Fracture?

Comminuted fracture is also called a multi-fragmentary fractures characterized by a break in the bone of at least three to several pieces. The break in the bone in this type of fracture is either splintered or fragmented and can occur in any area of the entire length of the bone. It is a complex form of fracture that is rather complicated to treat and is highly potential for infection if the fracture is an open type of fracture or where there is an open wound.

A fracture is described as a break or discontinuity in the bone due to a trauma or high impact force which a bone cannot withstand. The fracture can also damage the soft tissue, ligaments, muscle and blood vessels surrounding the bone. Approximately 9lbs. to 13lbs. of pressure can subject a minor bone to break while bigger bones such as a femur can break when applied with approximately 160lbs. of pressure. Elder people who have a decreased density of bone due to the normal aging process are highly potential for bone breaks as a bone with decreased density can break even with a simple gravity applied.

The fracture can also be classified either as open or close fracture. Open fracture is a bone break associated with an open skin or wound where the bone can project after it breaks. Close fracture on the other hand is described as a discontinuity in the bone without a break in the skin or where the skin remains intact despite the fracture.

Symptoms

Comminuted fracture has signs and symptoms that are similar to other forms of fracture. It also has a distinct symptom where medical treatment is required and such signs and symptoms signifying comminuted fracture include the following:

  • A tremendous pain at the site of the fracture is the pronounce symptom of comminuted fracture and which usually begins right after sustaining the fracture. The pain is due to the involvement of the periosteum that surrounds the bone and which contains numerous pain receptors. Pain is also due to the onset of edema of soft tissues resulting from hemorrhage of the vessels of worn out periosteum.
  • Loss of consciousness often follows and is the result of the tremendous pain after sustaining a fracture.
  • The site of fracture can be seen with signs of inflammation such as swelling of the skin, discoloration and is warm to touch.
  • Inability to bear weight is typically where a patient is unable to carry an object without suffering from a significant tremendous pain.

Causes

Bone fracture of any type occurs as a result of significant pressure applied in which the bone is unable to withstand. Comminuted fracture often results from high impact pressure which can subject the bone to break in splinter or fragments and the cause includes the following:

Structural changes in the skeletal system are part of the aging process which makes elderly people highly susceptible to comminuted fracture which often occurs as a result of a fall.

Fall from certain height is the most common cause of comminuted fracture especially in elderly people. The wrists and the forearms are the most common site of the fracture which is implicated on the defense reaction of an individual to prevent a fall. A fall from greater heights is always seen with a comminuted fracture that is often open fracture in form.

Disorders or conditions involving the bones and which can weaken the bone structure are also among the cause of comminuted fracture. Osteogenesis imperfecta is a genetic disease characterized by a brittle bone that subjects a bone to break easily. This genetic disease can subject a bone to a comminuted fracture due to the bone characteristic of brittleness.

Chronic cigarette smoking can make the bone weak and decrease its density. People who are smokers are at high risk for comminuted fracture when they experience a fall or any other form that can bring high pressure impact on the bone.

External force of high impact pressure is the most common cause of comminuted fracture and the external force that can result to this form of fracture includes the following:

  • Gun shots
  • Vehicular accidents
  • Contact sports and other form of sports that requires the use of solid surface

Treatment

Treating comminuted fracture is rather difficult and challenging due to fragmented pieces of the bone that needs to be reestablished. The treatment becomes challenging when there is a presence of infection when the fracture is open. The goal of treatment on the other hand is to reestablish the bone fragments in their normal place and make it function normally following complete healing of the bone.

Surgery is the treatment method most utilized to bring the fragmented bones line up together in the process known as reduction. The fragmented bones are put together with the use of pins to knit the bone closely together. Surgery is specially indicated to comminuted fracture with great extent or degree of fracture.

Immobilization of the fractured site is indicated for patient suffering from minor fracture. Plaster splints or fiberglass cast can be used to immobilize and place the bone fragments in its place while allowing the bone to form callus.

Pain and swelling can be addressed with pain medications such as ibuprofen or can also be relieved with acetaminophen or codeine.

Healing time

Comminuted fracture takes longer to heal compared to other types of fracture. Treatment requires an extended duration and which may also require a patient to stay longer in the hospital. Fractured bones generally require a great deal of time before restoring the bone in its normal state and proper function. A comminuted fracture patient may be required to stay in the hospital for approximately 2 to 3 months or even longer depending on the extent of bone fracture and the presence of complication. A physical therapy may be required to help the patient pull through and recover rapidly than expected. It is necessary however to follow a regular check up with the doctor to monitor the development and healing of the bone.

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