The x-rays above show two views of a bone fracture—specifically, the shaft of the ulnar (forearms) bone.

Photo 48623830 © Puwadol Jaturawutthichai - Dreamstime.com

The likelihood of experiencing a bone fracture or break is alarmingly high. American Bone Health says that half of all women and 25 percent of men over the age of 50 will have a fracture in their lifetime. The likelihood of breaking a bone continues to increase with age.

What happens when a bone is fractured? We know that what doctors call a fracture is a broken bone, but there is more to it than that. There are different causes of broken bones and different kinds of fractures when it happens.

Bones are strong, but there is a limit to how much force they can withstand. When too much stress is put on a bone, it breaks—not necessarily into two parts, but enough of a break to change the shape of the bone. The older we get, the less force our bones can withstand. Here are just a few of the ways the medical community categorizes broken bones.

• A simple, or closed, fracture happens when no part of the bone has broken through the skin.
• An open, or compound, fracture is when the bone has broken through the skin. The risk of infection increases with compound fractures.
• A stress fracture occurs when a bone breaks because of repeated stress. It might also be called a hairline fracture.
• A displaced fracture is when the two ends of the broken bone are separated from each other.
• A non-displaced fracture is one in which the bone breaks only in one place and stays aligned.

There are other, more technical, terms that doctors use to describe broken bones—transverse, spiral, oblique, impacted, comminuted, compression, for example—but they are not ones often needed or used by the public.

What Causes Broken Bones?

The exact causes of bone fractures are a lot easier to recognize and understand than the broken bone categories (see sidebar). The three main causes of fractures, according to the American Academy of Orthopaedic Surgeons (AAOS) are trauma, overuse, and osteoporosis.

• Trauma. Most fractures are caused by falls and accidents in which a bone is impacted by a high force. Impact fractures happen in a single moment. You’ll probably know immediately that a bone has been broken. It could happen playing a sport, taking a direct hit by on object, or being in a car crash.
• Overuse. Overuse fractures are frequently associated with runners, exercisers, and athletes who perform the same movements repeatedly over a period of time. The repetitive forces placed on a bone cause it to eventually break. The nature of the break would likely be a stress, or hairline, fracture. When muscles are fatigued, the stress they normally absorb goes straight to the bone instead. The bones in the lower leg, heel, and feet are particularly vulnerable.
• Osteoporosis. A person who has osteoporosis has bones that are brittle, fragile, thin, and especially vulnerable to fractures. Ten million people in the U.S. have osteoporosis. Osteoporosis is the cause of 1.5 million bone fractures a year, mostly in the hip, spine, and wrist. Fifty percent of women over the age of 50 are at risk of having a fracture caused by osteoporosis, and older men who have sustained a minor fracture are as likely to have a subsequent fracture as women.

What Are the Symptoms of a Broken Bone?

It depends on the bone broken, but these symptoms are apparent in most fractures.

• Pain
• Swelling
• Tenderness
• Bruising
• A popping noise at the time of the injury
• Difficulty or inability in moving a joint
• Deformity

How Are Broken Bones Diagnosed?

The most common diagnostic tool used for fractures is an x-ray image. It can show the doctor where the fracture is located, its type, and severity. Magnetic resonance imaging (MRI) might be needed for stress fractures and smaller bone breaks. Even less frequently, bone scans or computed tomography are used.

How Are Broken Bones Treated?

The body is very good at repairing itself. If doctors can get bones back to their normal alignment, healing moves along relatively fast.

• Traction is sometimes used to realign and stabilize a fractured bone before surgery. Pulleys and weights move muscles and tendons during the process.
• Surgery may be required to realign bones or to keep broken pieces together. Screws, pins, rods, and plates are commonly-used fixation devices.
• Casts. A broken bone may be immobilized with a plaster or fiberglass cast (or splint) once it has been repositioned. A functional cast or brace allows for limited, controlled movements of nearby joints. Smaller bones (in toes, for example) may be taped together.
• Physical therapy. After a fracture has healed, physical therapy can help restore muscle strength and mobility.

How Long Does it Take to Recover from a Broken Bone?

If a child suffers a broken bone, it typically heals quickly—perhaps in a few weeks. For older adults, it could take several months. The average time is six to eight weeks.

How Can You Lower the Risk of a Fracture?

Regular exercise, particularly weight-bearing/resistance exercise, can help. Bones that are underused become thinner and weaker. Exercise can slow the loss, maintain a current level of bone strength, or make bones stronger.

Calcium and vitamin D are necessary to promote bone strength. How much calcium?

• For women 50 and under, 1,000 mg per day, including food and supplements; 1,200 mg per day for those 51 and older.
• For men 70 and younger, 1,000 mg/day, including food and supplements; 1,200 mg/day for men 71 and older.

How much vitamin D?

• For men and women under 50, 400 to 800 IU per day.
• For those 50 and older, 800 to 1,000 IU per day.

Finally… Don’t Smoke

Tobacco slows the process in which cells create new bone tissue. The bones of people who smoke become thinner and more fragile over time. (See our post Quit Smoking: 6 Steps to Success.)

Take-Away Message

Broken bones are common injuries, and the risk increases with aging. They are painful at first, but immensely treatable. With proper treatment and rehabilitation, you should expect full recovery.