Fracture

It is a common presenting symptom of osteoporosis, but they also occur in other bone diseases, in osteopenia and in some patients with normal bone. [1]

Significant percentage of bone fractures occur because of high force impact or stress.

Most bone fractures are caused by falls and accidents. [2]

Indian epidemiology then other

The most common causes of fractures are i.e.:

Trauma:

• A fall, a motor vehicle accident, or a tackle during a sports game can all result in fractures.

Osteoporosis:

• This disorder weakens bones also makes them more likely to break.

Overuse:

• Repetitive motion can tire muscles also place more force on bone.
• This can result in stress fractures.
• Stress fractures are more common in athletes.

There are several different ways in which a bone can fracture; for example, a break to the bone that does not damage surrounding tissue or tear through the skin is known as a closed fracture.

On the other hand, one that damages surrounding skin and penetrates the skin is known as a compound fracture or an open fracture.

Compound fractures are generally more serious than simple fractures, because, by definition, they are infected.

There is a range of fracture types, including:

Different type:

Avulsion i.e.:

• A muscle or ligament pulls on the bone, additionally; fracturing it.

Comminuted fracture i.e.:

• Basically, The bone is shattered into many pieces.

Compression (crush) fracture i.e.:

• Generally occurs in the spongy bone in the spine.
• For example, the front portion of a vertebra in the spine may collapse due to osteoporosis.

Fracture dislocation i.e.:

• A joint becomes dislocated, also one of the bones of the joint has a fracture.

Green stick i.e.:

• The bone partly fractures on one side, but does not break completely because the rest of the bone can bend.
• This is more common among children, whose bones are softer and more elastic.

Hairline fracture i.e.:

• A partial fracture of the bone.
• Moreover, Sometimes this type of fracture is harder to detect with routine x rays.

Impacted i.e.:

• When the bone is fractured, one fragment of bone goes into another.

Intra articular fracture i.e.:

• In general, Where the break extends into the surface of a joint.

Longitudinal i.e.:

• The break is along the length of the bone.

Oblique fracture i.e.:

• It is especially, diagonal to a bone’s long axis.

Pathological fracture i.e.:

• When an underlying disease or condition has already weakened the bone, resulting in a fracture (especially bone fracture caused by an underlying disease/condition that weakened the bone).

Spiral i.e.:

• At least one part of the bone has been twisted.

Stress i.e.:

• More common among athletes.
• A bone breaks because of repeated stresses and strains.

Torus (buckle) i.e.:

• Bone deforms but does not crack.
• More common in children.
• It is painful but stable.

Transverse fracture i.e.:

• A straight break right across a bone. [2]

Risk factors are things that make you more likely to develop a disease in the first place.

Pathogenesis refers to the development of a disease. It’s the story of how a disease gets started and progresses.

Pathophysiology, on the other hand, focuses on the functional changes that occur in the body due to the disease. It explains how the disease disrupts normal physiological processes and how this disruption leads to the signs and symptoms we see.

Imagine a car accident. Pathogenesis would be like understanding how the accident happened – what caused it, the sequence of events (e.g., one car ran a red light, then hit another car). Pathophysiology would be like understanding the damage caused by the accident – the bent fenders, deployed airbags, and any injuries to the passengers.

In simpler terms, pathogenesis is about the "why" of a disease, while pathophysiology is about the "how" of the disease’s effects.

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Generally, The presentation is with localised bone pain, which is worsened by movement of the affected limb or region.

There is usually a history of trauma but it spontaneously occur in the absence of trauma in those with severe osteoporosis.

It can be divided into several subtypes, based on the precipitating event also presence or absence of an underlying disease.

The main differential diagnosis is soft tissue injury, but fracture should be suspected when there is;

• Marked pain
• Swelling
• Abnormal movement of the affected limb
• Crepitus
• Deformity [1]
• Angulation – the affected area may be bent at an unusual angle
• The patient is unable to put weight on the injured area
• The affected either bone or joint may have a grating sensation
• If it is an open fracture, there may be bleeding [2]

Femoral neck fractures typically produce a shortened, externally rotated leg that is painful to move.

[1]

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How to investigate a suspected fracture:

• Order X-rays in two projections at right angles to one another
• Include the whole bone also the joints at either end (this may reveal an additional unsuspected fracture)
• Check for evidence of displacement
• Check for a break in the cortex
• In suspected vertebral fractures, check for depression of the end plate
• If clinical suspicion is high but no fractures are seen, request MRI also CT Scan

Complications are what happen after you have a disease. They are the negative consequences of the disease process.

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Management of fractures in the acute stage requires adequate pain relief, with opiates if necessary, reduction of the fractures to restore normal anatomy, and immobilisation of the affected limb to promote healing.

This can be achieved either by the use of an external cast or splint or by internal fixation.

Femoral neck fractures present a special management problem since non­union and avascular necrosis are common.

This is especially true with intracapsular hip fractures, which should be treated by joint replacement surgery.

Following the fractures, rehabilitation is required with physiotherapy and a supervised exercise programme (this is especially important in older patients to prevent muscle ­wasting and loss of mobility).

Elderly patients with hip fractures also benefit from nutritional supplementation.

Patients with high energy and fatigue fractures generally require no further investigation or treatment once it has healed.

If the DEXA examination or other investigation shows evidence of osteoporosis or other metabolic bone disease, this should be treated appropriately. [1]

Immobilization:

This may include:

Plaster casts or plastic functional braces i.e.:

• These hold the bone in position until it has healed.

Metal plates and screws i.e.:

• In brief; Current procedures may use minimally invasive techniques.

Intramedullary nails i.e.:

• Internal metal rods are place down the center of long bones.
• Flexible wires may use in children.

External fixators i.e.:

• These may made of either metal or carbon fiber; they have steel pins that go into the bone directly through the skin.
• In detail, They are a type of scaffolding outside the body.

Usually, the fractured bone area is immobilize for 2-8 weeks.

The duration depends on which bone is affect and whether there are any complications, such as a blood supply problem or an infection. [2]

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Homeopathy helps in the formation of healthy callus, and they also boost the activity of proliferation of the osteoblast cells (bone forming cells).

Certain medicines also help speed up the process of laying a new bone.

In detail, These medicines are made of natural substances and can treat fractures effectively, without any side effects.

Some of the best medicines for fractures include Symphytum Officinale, Arnica Montana, Calcarea Phos, Silicea, also Calendula Officinalis.

Symphytum Officinale – Top remedy for bone healing:

• One of the best medicines for fractures is Symphytum Officinale.
• Also known as knit-bone, it is widely recommend as the first line of treatment of fractures.
• Symphytum Officinale is a natural and highly effective medicine that boosts the activity of fibroblasts cells also helps in healing the fractured bone.
• It also helps with the production of callous and treats irritability and pricking pains at the point of the its site.
• It is also a suitable medicine for hairline fractures.
• Symphytum is a healing herb that is use in different potencies to help accelerate the healing of a broken bone.
• As a natural substance, it causes no side-effects and is use to treat fractures that cause immense pain.

Arnica Montana – For fractures where there is excessive pain:

• Arnica Montana is a medicine which cause immense swelling and pain at the site of the fractures.
• The affected site is sore to touch and bruise.
• Fracture that occur from a fall or those caused as a result of an injury by a blunt instrument are treat with Arnica.
• This medicine is also use to treat old bone injuries.

Calcarea Phosphorica – for fractures that heal slowly:

• Calcarea Phos is a medicine for fractures that are slow to heal.
• Moreover, It is used to treat remote fractures and helps hasten the bone repair process in cases where the bone has not joined for a long time.
• Calcarea Phos provides calcium also phosphate, two elements required for quick union of the bone.
• It also promotes the formation of callus.

Silicea – for bone fractures and brittle bones

• Silicea is a medicine for fractures of brittle bones that get fractured often.
• It strengthens weak bones also prevents them from getting fractured frequently.
• It is commonly used to treat and manage osteoporosis and other bone problems such as caries, necrosis, also exostosis.

Calendula Officinalis – for compound and suppurating fractures:

• Calendula Officinalis is a medicine for fractures where the skin covering the fractured site becomes raw, red also inflamed.
• There may be a copious discharge of pus along with stinging pains.
• This medicine is used to treat compound fractures (where the broken bone pierces the skin) and also to prevent gangrene. [3]

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1. Davidson’s Principles and Practice of Medicine (22nd edition) Ch. 25
2. https://www.medicalnewstoday.com/articles/173312.php
3. https://www.drhomeo.com/fractures/fractures-and-homeopathic-treatment/

Frequently Asked Questions

What is Fracture?

A bone fracture is a medical condition where the continuity of the bone is broken.

Homeopathic Medicines used by Homeopathic Doctors in treatment of Fracture?

• Symphytum Officinale
• Arnica Montana
• Calcarea Phosphorica
• Silicea
• Calendula Officinalis

What causes Fracture?

• Trauma
• Osteoporosis
• Overuse

What are the symptoms of Fracture?

• Marked pain
• Swelling
• Abnormal movement of the affected limb
• Crepitus
• Deformity
• Angulation
• Unable to put weight on the injured area
• Affected bone or joint may have a grating sensation
• Open fracture- bleeding

Give the types of Fracture?

• Avulsion fracture
• Comminuted fracture
• Compression (crush) fracture
• Fracture dislocation
• Green stick fracture
• Hairline fracture
• Impacted fracture
• Intra articular fracture
• Longitudinal fracture
• Oblique fracture
• Pathological fracture