Bone Fracture: Complications

The following are the main conditions or complications that can be caused by a fracture (broken bone): Direct complications:

  • Ligament injuries
  • Blood loss/hemorrhagic shock – fracture hematoma or hypovolemic shock resulting from blood loss.
  • Fat embolism – especially in fractures of long tubular bones (eg, femur fracture – femur fracture), it may come to the entrainment of fatty tissue from the medullary canal into the vascular system with embolization.
  • Hematothorax (accumulation of blood in the thorax / chest).
  • Skin and soft tissue injuries
  • Nerve or vascular injuries – circulatory disturbances/disorders of motor function and sensitivity
  • Pneumothorax – fractures of the ribs or clavicle may injure the pleura

Indirect complications:

  • Fracture healing disorders – e.g. pseudoarthrosis.
  • Fatigue fracture
  • Infections – The risk of infection is greatly increased in open fractures.
  • Fracture
  • Compartment syndrome – The so-called lodge syndrome is a hemorrhage in a muscle lodge, which leads to an increase in pressure. The pressure can not escape and it comes to neuromuscular disorders or tissue and organ damage.
  • Complex regional pain syndrome (CRPS); synonyms: Algoneurodystrophy, Sudeck’s disease, Sudeck’s dystrophy, Sudeck-Leriche syndrome, sympathetic reflex dystrophy (SRD)) – neurological-orthopedic clinical picture, which is based on an inflammatory reaction after injury to an extremity and in addition, the central pain processing is involved in the event; represents a symptomatology in which there are severe circulatory disturbances, edema (fluid retention) and functional restrictions after the intervention, as well as hypersensitivity to touch or pain stimuli; Occur in up to five percent of patients after distal radius fractures, but also after fractures or minor trauma to the lower extremity; early functional treatment (physical and occupational therapy), with medications for neuropathic pain (“nerve pain) and with topical (“local”) therapies lead to better long-term results.
  • Embolic syndrome (perioperative).
  • Osteomyelitis (bone marrow inflammation)
  • Post-traumatic osteoarthritis
  • Myositis ossificans

Consequential diseases of bone fracture (direct and indirect complications)

Respiratory system (J00-J99)

  • Embolic syndrome (perioperative) – thromboembolism seen as a result of surgery.
  • Pneumothorax – Fractures of the ribs or clavicle (collarbone) can injure the pleura (pleura), allowing air to enter the pleural cavity and collapse the lung

Infectious and parasitic diseases (A00-B99).

  • Infections – in open fractures, the risk of infection is greatly increased

Musculoskeletal system and connective tissue (M00-M99).

  • Fracture healing disorders – e.g., pseudarthrosis (joint deformity).
  • Fatigue fracture (fatigue fracture).
  • Osteomyelitis (bone marrow inflammation)
  • Post-traumatic osteoarthritis (joint wear and tear occurring after an injury).
  • Myositis ossificans – ossification of the muscles due to pathological calcification after trauma.

Psyche – nervous system (F00-F99; G00-G99)

  • Complex regional pain syndrome (CRPS); synonyms: Algoneurodystrophy, Sudeck’s disease, Sudeck’s dystrophy, Sudeck-Leriche syndrome, sympathetic reflex dystrophy (SRD)) – neurologic-orthopedic clinical picture that is based on an inflammatory reaction after injury to an extremity and in which central pain processing is also involved in the event; represents a symptomatology in which there are severe circulatory disturbances, edema (fluid retention) and functional restrictions after the intervention, as well as hypersensitivity to touch or pain stimuli; Occur in up to five percent of patients after distal radius fractures, but also after fractures or minor trauma to the lower extremity; early functional treatment (physical and occupational therapy), with medications for neuropathic pain (“nerve pain) and with topical (“local”) therapies lead to better long-term results.

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Blood loss/hemorrhagic shock – fracture hematoma or hypovolemic shock resulting from blood loss.
  • Chronic pain in multiple body regions (“Chronic Widespread Pain”, CWP): pain that persists for more than three months and affects the axial skeleton, right and left sides of the body, and regions above and below the waist:
    • Vertebral fractures: 2.7- in men, 2.1-fold increase in CWP in women.
    • Hip fractures in women:2.2-fold CWP increase.

Injuries, poisonings, and other consequences of external causes (S00-T98).

  • Ligament injuries
  • Fat embolism – especially in fractures of long tubular bones (eg, femur fracture – femur fracture), there may be carryover of fatty tissue from the medullary canal into the vascular system with embolization.
  • Skin and soft tissue injuries
  • Nerve or vascular injuries – circulatory disturbances/disorders of motor function and sensitivity
  • Refracture (recurrence of a bone fracture).
  • Compartment syndrome – The so-called lodge syndrome is a hemorrhage in a muscle lodge (muscle compartment delimited by fascia), which leads to an increase in pressure. The pressure can not escape and it comes to neuromuscular disorders or tissue and organ damage.

Prognostic factors