A bone fracture is the medical term for a broken bone, occurring when a force exerted against it is stronger than the bone’s structural capacity to withstand it. Fractures are categorized by severity, which determines the complexity of treatment and healing time. A complete fracture is defined as a break that extends all the way through the bone, separating it entirely into two or more distinct pieces. This injury often results from high-impact trauma, such as a severe fall or a motor vehicle accident.
Defining Complete vs. Incomplete Fractures
The defining characteristic of a complete fracture is the full separation of the bone’s cross-section, meaning the fracture line traverses the entire width of the bone’s outer layer, or cortex. In adults, most fractures are classified as complete due to the rigidity of mature bone tissue. A complete break results in two or more fragments that are entirely disconnected.
This condition is contrasted with an incomplete or partial fracture, where the break does not extend across the entire width of the bone. Incomplete fractures are common in children because their bones contain more cartilage and are more flexible than adult bones. A greenstick fracture is a common type of incomplete break seen in younger individuals, where the bone cracks on one side but only bends on the other.
Other types of incomplete injuries include stress fractures, which are tiny cracks resulting from repetitive force or overuse. Unlike a complete fracture, these partial breaks maintain structural continuity across the bone’s width. The degree of separation is a fundamental distinction, as complete fractures carry a higher potential for displacement, where the bone fragments shift out of their normal alignment.
Common Types of Complete Fractures
Once a bone is completely broken, the injury is further classified by the pattern of the break and whether the skin remains intact. The pattern of the fracture line offers specific details about the forces involved in the injury. A transverse fracture, for example, is characterized by a break that runs perpendicular, or straight across, the long axis of the bone, often caused by a direct blow.
An oblique fracture occurs when the break has an angled or diagonal pattern across the bone, resulting from a sharp blow delivered at an angle. A spiral fracture is caused by a twisting force, creating a fracture line that corkscrews around the bone shaft. The most severe pattern is a comminuted fracture, where the bone shatters into three or more pieces, indicating high-energy trauma.
A second classification divides complete fractures into closed and open types, based on the integrity of the overlying skin and soft tissue. A closed fracture (simple fracture) is one where the broken bone fragments do not pierce the skin. Conversely, an open fracture (compound fracture) involves the bone breaking through the skin or a wound exposing the bone to the outside environment. Open fractures are serious because they introduce a significant risk of deep infection in the bone and surrounding tissue.
Initial Management and Healing
The immediate goal of managing a complete fracture is to ensure proper alignment and stabilization of the separated bone fragments. Initial treatment involves a process called reduction, which repositions the broken bone segments into their correct anatomical alignment. This may be performed manually (non-surgically) or may require surgical intervention for more complex breaks.
Once the fracture is reduced, the bone must be immobilized to allow the natural healing process to occur without disruption. Immobilization is commonly achieved with a plaster or fiberglass cast, which holds the bone fragments steady. For unstable or highly displaced complete fractures, surgeons may use internal fixation, such as metal plates, screws, or rods, to hold the fragments securely together beneath the skin.
Bone healing is a biological process that follows a predictable series of stages, including the formation of a blood clot, the development of soft tissue known as callus, and the eventual conversion into solid bone. The time required for a complete fracture to heal varies widely, depending on the severity, the specific bone involved, and the patient’s overall health. While a cast may be removed after several weeks, the bone continues to remodel and regain full strength for many months, often requiring physical therapy to restore movement and function.