Fracture (cont.)

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Other fractures

Some bone is more likely to break because of underlying disease such as cancer. Pathologic fractures are breaks in a bone that has been invaded by tumor and has become weaker and unable to withstand normal activity. There may be no specific injury that causes the fracture. Some patients have bone cysts that have been present a lifetime and are only discovered when an X-ray is taken for another reason like injury.

Bone fracture in children

Children can break bones and yet have normal X-rays. Fractures appear as clear lines through the bone on an X-ray through the bone. If calcium hasn't yet accumulated in the repairing bone, the break may not be apparent. This lack of calcification happens in two ways.

  1. Bones mature at different times in a child's development and while the bony structure is there, it may have more cartilage than calcium.
  2. The second situation is associated with growth plates. Each bone has an area where cell activity is maximal and where the bone grows. These areas appear as lucent (clear) lines on X-ray. It may be one of the weaker points in the bone as well, and a fracture through the growth plate may not be seen.

The doctor needs to match the history and physical exam with what is seen on X-ray to make to a diagnosis. Sometimes, the child is placed in a cast for a period of time to protect the broken limb. As fractures heal, the body lays down extra calcium as building material and then remodels it to normal shape. After 7-10 days, there may be evidence on X-ray of the healing calcium to confirm the fracture.

Growth plate fractures are classified by Salter-Harris category. When a break occurs through the growth plate, it can involve different parts of the bone on each side of the plate. It is important that these fractures are aligned properly so that the bone grows properly as the child ages.

Children are more flexible than adults until the calcium completely solidifies their bone. If you think of an arm or leg bone as tubular, sometimes only one side of the bone breaks, just like an immature branch on a tree. This is referred to as a greenstick fracture, and may need to be "set" so that it heals properly. Sometimes the bones can bend but not break because they are so pliable. This is called a plastic deformity or bow fracture and will need to be set or aligned to allow proper healing.

Medically Reviewed by a Doctor on 4/9/2013

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Fracture - Describe Your Experience Question: Please describe what type of fracture you experienced.
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