Comminuted Fracture · What Is It, Examples, and More

A comminuted fracture describes a bone that has been broken in three or more places. In general, if a bone is broken in more than four places it can be considered highly comminuted. Comminuted fractures include a complete fracture of the bone, unlike other types of fractures, like a greenstick fracture, which is when a bone cracks, but does not completely separate. 

Comminuted fractures most commonly occur in the long bones of arms and legs and are often accompanied by pain and limited movement of the fractured bone. Depending on the location of the fracture, surrounding tissue or organs can be damaged. For instance, a comminuted fracture of one or more ribs can cause a pneumothorax (i.e., air around the lungs) if a piece of bone penetrates the pleural space of the lung. Sometimes, comminuted fractures of extremities can cause internal bleeding, which increases the pressure in the surrounding muscles, inducing compartment syndrome, which is a painful condition where pressure within muscles increases to dangerous levels. Left untreated, this can cause death to surrounding tissue, and therefore requires immediate medical attention. 

The first step to repairing a comminuted fracture is diagnosis with physical examination followed by imaging, such as an x-ray, to confirm the fractures.

Repairs for a comminuted fracture depend on the bone that is fractured and the type of fracture. However, most do require surgery. Typically, surgery involves open reduction where the bones are put back in place and fixated internally with screws and rods.