An impaction fracture is a type of bone break where the ends of the broken bone are forcefully driven or “jammed” into each other. This compression can cause the bone to become denser and potentially deformed at the site of impact.
Understanding Impaction Fractures
This type of fracture occurs when a strong compressive force causes one part of a bone to telescope or buckle into another, wedging the bone ends together. This differs from a simple break where bone fragments might separate or displace without significant compression.
These fractures are commonly seen in areas of the body that bear significant weight or are exposed to direct impact. Frequent sites include the heel bone (calcaneus), vertebrae in the spine, and the ends of long bones like the femur (thigh bone), tibia (shin bone), or humerus (upper arm bone). For example, a fall from height can cause impaction fractures in the heel or spine due to vertical force. A direct blow during a sports injury can also cause bones in the knee, such as the lateral femoral condyle, to impact each other.
Impaction fractures can also occur due to underlying conditions that weaken bones, such as osteoporosis, which makes bones more susceptible to breaks from minor trauma. Repetitive stress, common in athletes, can also contribute. Children are particularly prone to impaction fractures, sometimes called torus or buckle fractures, because their developing bones are softer and more malleable, making them more likely to compress rather than break completely.
Recognizing and Treating Impaction Fractures
Symptoms of an impaction fracture include severe pain, which may worsen with movement or weight-bearing on the affected area. Swelling and bruising around the injury site are common. Depending on the location and severity, there might be a noticeable deformity or an inability to move the affected limb or bear weight.
Diagnosis typically involves a physical examination and imaging studies. X-rays are the initial diagnostic tool, providing clear images of the bone structure and revealing compressed or wedged fragments. For a more detailed assessment, especially if the fracture is subtle or soft tissue damage is suspected, a CT scan offers cross-sectional views of the bone and surrounding tissues. An MRI scan may also be used to evaluate associated soft tissue injuries, such as damage to ligaments or tendons, or to detect bone marrow edema.
Treatment approaches vary based on the fracture’s location and severity. Less severe impaction fractures are often managed conservatively, focusing on pain relief with medications like acetaminophen or NSAIDs. Rest, activity modification, and immobilization using a cast or brace help stabilize the affected area.
For more severe cases, or if conservative methods are insufficient, surgical intervention may be necessary. Procedures like open reduction and internal fixation involve realigning bone fragments and stabilizing them with plates or screws. In vertebral compression fractures, vertebroplasty or kyphoplasty, which involve injecting bone cement, can stabilize the fracture. Professional medical evaluation is recommended for suspected fractures to ensure proper diagnosis and treatment.