The Different Types of Fractures

A fracture is a break in the bone. Within the hand and upper extremity it can occur anywhere from the fingertip to the shoulder.

Among the most common fractures and dislocations of the hand and upper extremity include:

  • Finger Fractures
  • Distal Radius Fractures (also called Colles Fracture)
  • Scaphoid Fractures
  • Forearm Fractures
  • Clavicle Fractures (collar bone)

There are a number of different types of fractures – partial or complete, simple or compound, clean or shattered …each with their own classifications.  It is important to first define the type of fracture and its severity before determining the most effective treatment plan.

Fractures are defined by the severity of the break and the impact it imposes to surrounding tissue. Some fractures known as partial fractures may only cause a slight crack in the bone, while others may result in a complete break or shattered bone.

A fracture may also be either open or compound, which is a fracture that pierces through the skin creating an open wound.  A closed or “simple” fracture is a fracture that does not break through the skin.

Other classifications that help determine the best treatment plan for your type of fracture include:

  • Transverse Fracture – A fracture that goes across the bone and is situated at a right angle to the long axis of the bone.
  • Greenstick Fracture – A fracture situated on only one side of the bone, causing a bend but not a complete break. These are most commonly seen in children with more “pliable” bones.
  • Comminuted Fracture – A fracture that results in three or more bone fragments.
  • Intra-articular Fracture – A fracture with joint involvement.

Depending on the severity of the fracture, treatment may entail the non surgical realignment of the bone and casting, also referred to as closed reduction. Or surgical repair utilizing fixation support may be indicated.

Wrist Fracture – Distal Radius Fractures Among the Most Common Wrist Fractures

X-ray of a Distal Radius Fracture, also known as a Colles Fracture

One of the most common hand and upper extremity fractures we see is a distal radius fracture.  This is because of its position at the end of the forearm bone where it meets the wrist and the essential involvement of our hands and wrist in everyday activities and sports.  Our hands and wrists are also the first line of defense in a trauma – used as a shield to soften the blow of a harsh impact or to break a fall.

There are many opportunities to injure the distal radius.

The radius is the larger of the two bones located in the forearm. “Distal” radius refers to the lower end of this bone where it meets the wrist. The other forearm bone is the ulna, and together these two bones form the radioulnar joint.

Also called a “Colles” fracture for the anatomist who first described it, a distal radius fracture is common among those involved in contact sports as well as those suffering from osteoporosis.  It is occasionally misdiagnosed as a sprain and improperly treated – which could eventually lead to joint instability and osteoarthritis.

Some of the symptoms associated with a distal radius fracture include:

  • Swelling
  • Weakness and reduced range of motion
  • Persistent pain
  • Possible numbness
  • Deformity

Once identified, initial treatment will depend on the severity of the fracture, other soft tissue damage, and the type of break (simple or complex).  A wrist fracture may be treated non surgically by manipulating the broken sections back into place (closed reduction) and stabilizing the wrist with a splint.  More severe breaks may require surgical repair.

Next month’s blog will discuss how fractures are categorized and how they determine the treatment selected.