A fracture is defined simply as a break or a crack in a bone. While the human skeletal system is resilient, it is susceptible to injury from trauma or repetitive stress. Understanding which bones are most frequently injured offers insight into common accident mechanisms and preventative measures. This article explores the most common bone breaks, vulnerabilities across age groups, and the general steps involved in fracture care.
The Single Most Common Fracture
The most frequently broken bone across the general population is the distal radius, which is the larger of the two forearm bones located near the wrist. A fracture of this bone is so common that it accounts for a significant percentage of all fractures seen in emergency departments. This break often occurs about an inch from the end of the bone where it meets the wrist joint.
The classic mechanism of injury is a fall onto an outstretched hand, commonly abbreviated as FOOSH. When a person falls forward, they instinctively extend their arm to brace for impact, transferring the entire force of the fall directly to the wrist bones. This forceful impact often results in a fracture pattern known as a Colles’ fracture.
A Colles’ fracture is characterized by the broken fragment of the radius tilting backward, or dorsally. This can create a distinct deformity at the wrist sometimes described as a “dinner-fork” appearance. While high-energy trauma causes this injury in younger people, older adults with low bone density (osteoporosis) can sustain a distal radius fracture from a simple fall from a standing height. The wrist’s exposed position makes the distal radius uniquely vulnerable to this specific type of traumatic injury.
How Fracture Frequency Varies by Age
The most common fracture changes dramatically depending on a person’s stage of life, reflecting different levels of physical activity and bone maturity. In children, bone is more flexible than in adults, leading to unique fracture patterns. The most common breaks in children often involve the forearm bones, including the distal radius, with the most frequent pattern being a torus or “buckle” fracture.
A torus fracture is an incomplete break where the bone compresses and bulges outward but does not fully crack through. Another common injury is the greenstick fracture, where one side of the bone breaks while the other side only bends. The collarbone, or clavicle, is also a common fracture site in children and adolescents, often due to sports injuries or falls.
In the elderly population, fractures are often categorized as fragility fractures, meaning they result from a fall from a standing height or less. The loss of bone mass due to osteoporosis makes the bones brittle and highly susceptible to breaks. The hip, specifically the proximal femur, becomes the most frequent and serious fracture in older adults, often requiring surgery. Other common fragility fractures include compression fractures of the vertebrae and breaks of the proximal humerus (upper arm bone near the shoulder).
General Approach to Fracture Care
When a bone is suspected to be broken, the medical process begins with a diagnosis, typically using an X-ray to visualize the fracture and determine its type and severity. The primary goal of treatment is to ensure the fractured bone heals in a position that allows for the return of maximal function. Pain relief is a foundational part of initial care, often managed with medication.
If the bone fragments are misaligned, a procedure known as closed reduction may be performed, which involves a healthcare provider manually manipulating the bone back into place without surgery. Once the bone is properly aligned, the next step is immobilization, commonly achieved with a plaster or fiberglass cast, or a splint, to hold the fragments stable while the body’s natural healing process forms new bone. For complex or severely displaced fractures, surgical intervention, called open reduction and internal fixation, may be necessary to stabilize the bone with plates, screws, or rods.
Following the period of immobilization, rehabilitation is a necessary phase to regain strength and mobility. Physical therapy helps to address the stiffness, weakness, and loss of range of motion that result from having a limb immobilized for several weeks. The entire treatment plan focuses on restoring the overall health of the injured limb to facilitate the best possible long-term outcome.