What is a comminuted fracture?

Do you know what is a comminuted fracture? Many of you must have suffered from some form of fracture or the other. Or else you might have seen many people who have suffered a fracture. There are many types of fractures. Let us explore more about comminuted fracture and comminuted fracture definition.

Comminuted fracture Definition:

A comminuted fracture is a type of fracture in which the bone is broken down into many pieces. If a bone is broken into 3 or more pieces, it is called as comminuted fracture by the doctors.

Many bones in the body can be affected by the comminuted fracture. Bones of the arm like humerus, bones of the leg like tibia and fibula, bones of hand called metacarpals can also be affected by comminuted fractures.

Some types of comminuted fractures have some specific names. For example, comminuted fracture of metacarpal bones of the hand is called Butterfly segment. Comminuted fracture of the tibia and fibula of the leg is called segmental fracture.

Causes of comminuted fractures:

Comminuted fractures can be caused by many different causes. Let us see the most common reasons which lead to these type of fractures.

• Motor vehicle accidents (Including Car accidents, bike accidents)
• Injuries during Sports like football, basketball
• Injuries in Athletes (runners, jumpers, etc)
• Falls in elderly people (Due to brittle bones)
• Osteoporosis (Both in men & women and people of any age. It is mostly seen in elderly people)
• Injuries from firearms like guns
• Bone diseases which weaken the bones

Symptoms of comminuted fractures:

Like any type of fracture, comminuted fractures also have pain, swelling, color changes, tenderness, etc.

Pain:

The person affected by comminuted fractures has a severe pain. This is due to several reasons. There is a profound swelling or inflammation in the region of fracture. It exerts pressure on the pain receptors or the nerve endings which leads to pain.

There are also hemorrhages or bleeding in the region which leads to pressure on the nerves. The protective layer of bone called the periosteum is damaged during the fracture, which aggravates the pain. The pain is just unbearable like any other fracture.

Swelling:

When there is a comminuted fracture, there is intense swelling or inflammation of the skin and tissues overlying the fractured bone. There is infiltration of many inflammatory cells in the area.

There is also an accumulation of blood in the region due to hemorrhages. All the factors lead to the appearance of a swollen area above the fracture.

Color changes:

Due to the inflammation and bleeding, there are many color changes in the region of comminuted fractures. The skin above the fracture appears bruised or red or blue in color.

Treatment of comminuted fracture:

The comminuted fractures are being treated with many different modalities. The broken pieces in the comminuted fracture are joined together. Then there is the formation of a junction or new bone after few days to months which attaches the two broken pieces together. Let us explore some of the treatments for comminuted fractures.

Cast:

In this method, the broken pieces are joined together manually by the doctor and then a cast is placed to immobilize the limb. If the cast is left in place for the prescribed duration, the broken pieces of bone or the fractured segments reunite. But, it is recommended only for minor comminuted fractures.

Some other techniques like braces and reduction are used. But, they are helpful only for treatment of mild comminuted fractures.

External fixation:

This is the main technique used for the treatment of comminuted fractures. In this method, the metallic screws and pins are used to join the broken pieces of bone together. Another bar of metal is placed over the skin.

Then this metallic bar is attached to the screws and pins which attach the fractured segments together. These metallic pins, screws, and bar are left in place for few weeks. Then the broken fragments reunite properly. Then these metallic substances are removed from the bones.

Open reduction internal fixation (ORIF):

This is a more complicated procedure. In this procedure, the bones are opened up surgically. Then a metal rod made of steel or titanium can be placed in the medullary cavity of the bone.

Screws and pins made of metals are also used to fix the broken segments in place. This technique of open reduction internal fixation is used to treat complicated comminuted fractures.

Some helpful Tips (For recovering fast from comminuted fractures):

• You will be given crutches to avoid weight bearing on the affected bones and limbs. Do use your crutches properly as per doctors advice.
• You will be given certain antibiotics to prevent infections of the surgical areas if your comminuted fractures are treated with surgery. Use them as per prescription without any negligence.
• If a cast is placed for treating comminuted fractures, you will need to take proper care of your cast.
• Avoid your cast from becoming wet. Keep it clean and dry. If it becomes wet it can lead to infections of the fractured region.
• Your cast must not be very tight. If the cast is very tight, it can impair the blood circulation to that area and lead to compartment syndrome.
• If your cast is tight, consult your doctor immediately for a correction of the cast.
• During the initial few days after the comminuted fracture occurs, keep your limbs elevated. This helps the swelling and bruising to subside fast.
• You can recover fast from comminuted fractures if you follow all of your physician’s advice properly.
• But, keep in mind that as comminuted fractures break the bone into multiple segments, the recovery from these fractures usually takes a longer time than other types of fractures.

You have seen all about the comminuted fracture definition, the causes of comminuted fractures, its symptoms, and treatments. Have you ever suffered from any comminuted fractures? How long did you take to recover? Share your story with us.