Fractures – Broken Bone Cases

The medical term for a broken bone is a fracture. Many factors must be considered to determine the severity of a fracture and the proper medical approach to treatment. Generally speaking, there are twelve types of fractures diagnosed by physicians:

• Avulsion Fracture — Ligaments connect muscle to bone at the joint and the ligament motivates joint movement with muscle contraction. An avulsion fracture occurs when the ligament is pulled away from its anchor to the bone such that the bone is cracked or broken through.
• Comminuted Fracture — These are more severe fractures where the bone is broken in more than two places or is broken into fragments.
• Complete Fracture — The bone has cleanly broken into two pieces.
• Compression Fracture — This break is caused when the structure of the bone collapses, typically under traumatic force and sudden pressure.
• Greenstick Fracture — An incomplete fracture typically caused by twisting of the bone resulting in a small and narrow crack on one side of the bone.
• Hairline Fracture — A slight/minimal break in the bone with no significant bone displacement or damage.
• Impacted Fracture — The edge of two bones become wedged together by traumatic force.
• Oblique Fracture — The bone breaks at an angle and the fracture extends across the length of the structure of the bone.
• Spiral Fracture — The break involved in a severe twisting injury has a spiral or corkscrew-like appearance across the surface/shaft of the bone.
• Stress Fracture — Small cracks or hairline fractures in the bones arising from sports, heavy activity, repetitive trauma, and overuse.
• Transverse Fracture — A break straight across the affected bone.
• Intra-Articular Fracture — A break in the bones that occurs across the pivotal section of a joint and affects the function of the joint.

Treatment of the fracture will depend on the location and severity of the bone damage. An intra-articular fracture is a fracture across the midline of a joint. These injuries often require surgical intervention and repair, and orthopedic hardware is commonly used to stabilize and repair the fracture. In such cases, a high risk of arthritic changes exists for the patient. Osteolysis (disintegration or degradation of the bone) can also occur where screws or fasteners attach plates to bones. Careful attention must be given to the potential costs involved for future surgery to repair or remove orthopedic hardware. Also, long-term care needs, including arthritis medication and other pain management, should be considered in every serious fracture case. The victim deserves compensation to cover all potential future medical needs.

Growth-plate fractures in children also require careful medical and legal consideration. Fractured bones in children present long-term implications because their bones are still growing and have not fully matured. Until this process is complete, a child’s bones continue to expand in length and shape at the area near the ends of the long bones. This region is called the growth plate, or physis.

The growth plate is the weakest part of the child’s skeleton. Thus, an injury to a growing child’s joint is more likely to cause harm to the bone’s growth plate than to the surrounding ligaments and connective tissues. In these cases, the child’s bones may grow unequally after the fracture so that the injured leg or arm may grow to a different length than the unaffected limb. Growth-plate fractures make up 15 percent of all fractures in children. Always look at the potential long-term effects of joint and growth-plate fractures when considering the fair value of a minor child’s personal injury claim.

When presenting an injury claim involving a broken bone, the case presentation should carefully demonstrate the location and extent of all fractures. Medical diagrams are excellent tools to graphically show the steps involved in the complicated surgeries conducted by orthopedic surgeons. X-rays should also be provided with the demand brochure to show pre-repair and post-surgical appearance of the fracture. A negative image of the X-ray (which is itself a film negative) can be created to best show the detailed condition of the injured bones and the placement and presence of plates/screws/rods and other hardware. Orthopedic narrative reports help to prove the full extent of the fracture, the severity of all symptoms and physical limitations, permanency of injury, and all potential future medical problems the fracture might impose. A life care plan may also be necessary to prove the cost of future medical treatment needed by the patient. If multiple fractures arise from a single accident, the cumulative effects of all injuries must be shown to motivate proper payment for the victim’s pain and suffering.