There are two terms that are often misunderstood by the lay public when it comes to orthopaedic surgery – these words are “fracture” and “trauma”. Although these words are easily understood by those in the profession, the average person does not find our terminology very intuitive! We who are trained as orthopaedic trauma surgeons are specialized in the care of severely injured patients who often have very complex fractures.
A “fracture” is actually nothing more than a broken bone. It is as simple as that! In my experience, the lay public often considers a fracture as a “crack” in the bone that is difficult to see on x-ray and is therefore not very important. I will hear patients say “I thought it was only fractured, I didn’t know that it was really broken”. The word “fracture” is actually defined as a “separation of an object or material into two, or more, pieces under the action of stress” (Wikipedia), and is often used in engineering and materials research. So, when an orthopaedic surgeon refers to a bone as being fractured, he or she is describing that bone as being broken; whether it is a small break barely visible on x-ray or if the bone is highly shattered and displaced. In our minds, every “fracture” is a “broken bone”, and every “broken bone” is a “fracture”.
A sidebar to this is the term “dislocation”. When we as orthopaedic surgeons use the term “dislocation,” we are referring to a joint that is no longer intact or in place. Commonly dislocated joints include the shoulder or the joints in the fingers. From a purist standpoint, bones cannot be dislocated and joints cannot be fractured. Fractures only occur in bones and dislocations only occur in joints. The problem is that we often misuse the terms ourselves! Orthopaedic surgeons will often refer to someone as having a hip or wrist fracture when in reality the injury is more accurately called a femoral neck fracture or a distal radial fracture.
Another term that is often used in different contexts is “trauma”. To the lay public, the word “trauma” is often used in its correct form – that is that trauma refers to injury to a part of the human body. In orthopaedic terminology however, “trauma” is actually used to refer to severe injuries sustained by people who have had significant harm done to them. When we as orthopaedic surgeons refer to someone as a “trauma patient”, our minds conjure up an image of someone on the ventilator in the intensive care unit with severe fractures who may be clinging onto life itself. Often times, I will see patients with bumps and bruises after a motor vehicle accident who tells me “I was traumatized in a fender bender, and I know that you’re the right doctor for me!” Of course, we are happy to care for these patients, but it is always funny how the two words, “fracture” and “trauma” are used so entirely differently between people who otherwise speak the same language!
For more information on fractures visit Orthoinfo.org.