A comminuted fracture is a fracture in which the bone involved in the fracture is broken into several pieces. At least three separate pieces of bone must be present for a fracture to be classified as comminuted. This type of fracture can be challenging to treat due to the complexity of the break, and it can be especially complicated if the fracture is open, meaning that the bone is protruding outside the skin. Open fractures are at a very high risk of infection and they typically take longer to heal.
Comminuted fractures are also sometimes known as multi-fragmentary fractures. This type of fracture often involves crushing or splintering of the bone, and it can occur anywhere along the length of the bone. This type of fracture is most common in elderly people or in people with conditions which weaken the bones, such as osteogenesis imperfecta or cancer. A comminuted fracture can also occur as the result of tremendous force, such as a car accident or a severe fall.
Like many other types of fracture, comminuted fractures are associated with very distinctive symptoms which usually lead people to seek medical treatment. The patient usually experiences tremendous pain at the site of the fracture, and he or she may even pass out at the time that the break occurs as a result of the pain. The area around the break will also swell, and it may become warm to the touch. Typically the patient cannot bear any weight on the fracture without experiencing significant pain.
This type of fracture is usually easy to diagnose with an X-ray to look at the site of the suspected fracture. When the fracture is X-rayed, the doctor can use the image to gather more about the orientation of the pieces of bone and the location of the fracture to determine the best possible treatment. It may be necessary to pin the fracture with surgery so that the pieces will have a chance to knit together.
Complications of comminuted fractures can include infection, compartment syndrome, vascular necrosis, and nonunion, in which the pieces of bone fail to join together. Usually someone with a comminuted fracture will need to attend several follow up appointments at the office of an orthopedic doctor to confirm that the fracture has been set properly, and that it is healing appropriately. If the healing does not appear to be progressing as desired, the doctor can intervene to address the issue.