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    Volume 9 Issue 10| March 5, 2010|

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Your bones are tough stuff but even tough stuff can break. Like a wooden pencil, bones will bend under strain. But if the pressure is too much, or too sudden, bones can snap. You can break a bone by falling off a stairway or slipping in the toilet.

When a bone breaks it is called a fracture. There's more than one way to break or fracture a bone. A break can be anything from a hairline fracture (a thin break in the bone) to the bone that's snapped in two pieces like a broken tree branch.

Doctors describe fractures in the following ways:
* A complete fracture is when the bone has broken into two pieces.

* A greenstick fracture is when the bone cracks on one side only, not all the way through.

* A single fracture is when the bone is broken in one place.

* A comminuted fracture is when the bone is broken into more than two pieces or crushed.

* A bowing fracture, which only happens in kids, is when the bone bends but doesn't break.

* An open fracture is when the bone is sticking through the skin.

It's different for everyone, but the pain is often like the deep ache you get from a super bad stomachache or headache. Some people may experience sharper pain especially with an open fracture. And if the fracture is small, you may not feel much pain at all. Sometimes, patients especially children won't even be able to tell that they broke a bone!

Breaking a bone is a big shock to your whole body. It's normal for you to receive strong messages from parts of your body that aren't anywhere close to the fracture. You may feel dizzy, woozy, or chilly from the shock. A lot of people cry for a while. Some people pass out until their bodies have time to adjust to all the signals they're getting. And other people don't feel any pain right away because of the shock of the injury.

If you think you or someone else has broken a bone, the most important things to do are to:

* stay calm

* make sure the person who is hurt is as comfortable as possible

* call for help.

* Go to a doctor. Get an X-Ray.

The worst thing for a broken bone is to move it. This will hurt the person and it can make the injury worse! In the case of a broken arm or leg, a friend or relative may be able to cushion or support the surrounding area with towels or pillows.

One super-important tip: If you're not sure what bone is broken or you think the neck or back is broken, do not try to move the injured person. Wait until a trained medical professional has arrived!

To treat the broken bone, the doctor needs to know which kind of fracture it is. That's where X-rays come in handy. X-rays give doctors a map of fractures so that they can set the bones back in their normal position.

With breaks in larger bones or when a bone breaks in more than two pieces, the doctor may need to put in a metal pin or pins to help set it. For this operation, you'll get some medicine so you'll be asleep and unable to feel any pain. When your bone has healed, the doctor will remove the pin or pins.

After your bone has been set, the next step is usually putting on a cast, the special bandage that will keep the bone in place for the 1 to 2 months it will take for the break to mend. Casts are made of bandages soaked in plaster, which harden to a tough shell.

Your bones are natural healers. At the location of the fracture, your bones will produce lots of new cells and tiny blood vessels that rebuild the bone. These cells cover both ends of the broken part of the bone and close up the break until it's as good as new!

How can a fractured limb grow back to its former strength? To understand, you first have to take a closer look at just what bones are made of and how alive they really are.

It's easy to think of our bones as solid, lifeless matter where all of our living tissue just sits. But your skeleton is as much a living part of your being as your softer tissues and organs. The body stores minerals in the hard, compact bone. It produces red blood cells in the inner red marrow and stores fat in the yellow marrow.

It's important to remember that your bones are constantly changing. Cells called osteoclasts constantly break down old bone so that osteoblasts can replace it with new bone tissue -- a process called bone remodeling. Another type of cell called a chondroblast forms new cartilage. These are three of the primary cells responsible for bone growth -- and not just the bone growth you experience early in life. This constant bone remodeling gradually replaces old bone tissue with new tissue during the course of months.

Doctors often divide the overall process into four phases:
When a bone breaks, the fissure also severs the blood vessels running down the length of the bone. Blood leaks out of these veins and quickly forms a clot called a fracture hematoma. This helps to stabilize the bone and keep both pieces lined up for mending. The clot also cuts off the flow of blood to the jagged bone edges. Without fresh blood, these bone cells quickly die. Swelling and inflammation follow due to the work of cells removing dead and damaged tissue. Tiny blood vessels grow into the fracture hematoma to fuel the healing process.

After several days, the fracture hematoma develops tougher tissue, transforming it into a soft callus. Cells called fibroblasts begin producing fibers of collagen, the major protein in bone and connective tissue. Chondroblasts then begin to produce a type of cartilage called fibrocartilage. This transforms the callus into a tougher fibrocartilaginous callus, which bridges the gap between the two pieces of bone. This callus generally lasts for about three weeks.

Next, osteoblasts move in and produce bone cells, transforming the callus into a bone callus. This hard shell lasts three to four months, and it provides necessary protection and stability for the bone to enter the final stage of healing.

At this point, the body establishes the position of the bone within the flesh, begins reabsorbing bits of dead bone, and creates a hard callus to bridge the gap between the two pieces of bone. However, this bulge of tissue needs a lot of work before the bone can take any strain. Osteoclasts and osteoblasts spend months remodeling bone by replacing the bone callus with harder compact bone. These cells also decrease the callus bulge, gradually returning the bone to its original shape. The bone's blood circulation improves and the influx of bone-strengthening nutrients, such as calcium and phosphorus, strengthen the bone.

Rest is essential if the broken bone is to heal as good as new.
Source: Medinet


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