Introduction

A bone fracture can be described simply as a crack or break in the bone. It can be caused by injury, trauma, or excessive pressure on the bone. Fractures vary in locations within

the body such as the leg, arm, collar, spine, ribs, head, pelvis, and neck. They can also differ in severity and care needed. Fractures can be intense and may break the skin,  which are referred to as open fractures.  Fractures that do not break the skin are called closed fractures.

Instances where there is a break in the bone can cause severe tissue, nerve, muscle, and organ damage, warranting immediate medical intervention.

Types of fractures

Outlined below are the most common categories of fractures:

• Compound: This type of fracture occurs when the broken bone protrudes out of the skin, also known as an open fracture
• Avulsion: This is when a portion of the bone detaches from a ligament or tendon
• Buckled: This type of fracture commonly occurs with children in the wrist. The bones in this instance are not broken, but rather squashed due to their lack of development
• Stable: Here the broken bones stay lined up and in place, with the crack centred within the bone
• Wedge: This fracture occurs when the vertebrae (a complex cluster of small bones that surrounds the spine) are damaged
• Stress: This is a small crack in the bone, also called a hairline fracture due to its size
• Greenstick: This fracture occurs when the bone is bent and not broken
• Linear: This fracture occurs when the break in the bone runs vertically downwards
• Transverse: This type of fracture occurs when the break in the bone is at a horizontal angle
• Pathologic: This fracture is caused by weak and deteriorating bones which eventually snap

Definition of transverse fracture

Transverse fractures occur from an intense injury, pressure, or collision, causing the bone to crack or break straight across the bone. In more extreme cases, the bone can penetrate the skin, exposing it. This is known as a compound fracture and must be treated as an emergency to avoid any chance of infection.

Transverse fractures are commonly seen in long bones in the body such as the thigh, shin, upper arm, spine, forearm, and collar bone. 

Characteristics of transverse fractures

• Swelling
• Pain
• Limited mobility
• Deformity
• Bruising
• Numbness
• Tingling

Causes of transverse fractures

Transverse fractures can be caused by a variety of factors, including:

• Trauma: Seen normally in sudden impact or car accidents
• Constant stress: Activities that apply a lot of pressure and stress on a bone over time can lead to a transverse fracture. Some examples include jogging, running and jumping
• Osteoarthritis: Softening of the bones due to its brittleness can increase the risk of transverse fractures
• Peripheral Neuropathy: Certain types of chemo-induced neuropathy can weaken the bones, making them more susceptible to fractures
• Falls: Frequent falls and injuries that can affect the density of the bone and increase the risk of fractures

Risk factors for transverse fractures

• Sex: Biological females are more likely than biological males to develop fractures due to their weaker bone density⁵
• Medical conditions: Some conditions that can mitigate fractures include bone cancer, arthritis, peripheral neuropathy, and autoimmune disorders which may weaken bone density
• Lifestyle factors: Lack of exercise, poor nutrition, diet, and excessive smoking can increase the chance of a fracture
• Age: As we age, our bones become weaker, brittle, and more susceptible to fractures
• Medications: Long-term use of chemotherapy medications and corticosteroids can weaken the bones and increase the risk of fractures

Types of transverse fractures

There are four major types of transverse fractures:

• Oblique: This is a type of fracture thatoccurs when the bone breaks at a 45-degree angle on a long bone
• Comminuted: This fracture occurs when there is a crack in the bone and not a clean break. High-force impact from a car accident or a fall can cause the bone to break like this, into multiple fragments
• Simple: This type of fracture occurs when the bone breaks in a straight horizontal line, with the skin remaining intact
• Spiral: This type of fracture occurs when the bone breaks in a spiral-shaped form caused by twisting of the bone

Diagnosis and imaging

It is critical to seek medical attention from a doctor as soon as possible for a physical assessment to determine the severity of the fracture. Several imaging tests include an X-ray, a CT scan, or an MRI to confirm the diagnosis and the severity of the fracture.

Treatment and management

The primary focus of treatment upon diagnosis of transverse fractures is pain management and reducingswelling of the injured area. The focus is mostly on repositioning the bone and keeping it in place to avoid displacement. Treatment options include:

• Pain medication: Non-steroidal anti-inflammatory (NSAIDS) such as Ibuprofen, diclofenac etc, and opiates such as morphine, are initial choices to help alleviate pain and discomfort
• Mobility Restriction: Through the use of a brace, splint, or cast is the best practice to prevent aggravating the injury
• Referral to an orthopaedic specialist: required in people with severe fractures. Some may require external fixation which requires the insertion of metal rods and pins to hold the bone in place while it heals 
• Internal fixation devices: Including plates, rods, or screws, may also be used to help position the fractured bone in place while healing 
• Physiotherapy: During the healing phase, it is recommended to restore mobility, flexibility, muscle strength, and functionality

Summary

Transverse fractures are fractures that travel across the width of the bone typically affect the long bones of the body. They may take up to a few weeks or months to heal depending on the extent of damage. Immediate medical attention is required to accurately identify the type of fracture to provide the required therapy of choice. Some fractures can have a long-term impact and may require physical therapy with some cases requiring surgery as well. 

FAQs

How do I prevent transverse fractures?

• Exercise regularly by walking, running, and resistance training to maintain bone density and strength. Also, add weight-bearing exercises
• Calcium and vitamin D-rich diets such as dairy, leafy green vegetables, fatty fish etc. 
• Avoid excessive smoking and alcohol

How long does it take for transverse fractures to heal?

It could take several weeks to a month, depending on the severity of the damage to the bone

What type of medical professional do I see for my transverse fracture?

An orthopaedic surgeon