Bone fractures

A broken bone or bone fracture occurs when a force exerted against a bone is stronger than it can structurally withstand.

Bones are a form of connective tissue, reinforced with calcium and bone cells. Bones have a softer centre, called marrow, where blood cells are made. The main functions of the skeleton include support, movement and protection of vulnerable internal organs.

Symptoms
The symptoms of a bone fracture depend on the particular bone and the severity of the injury, but may include:

• Pain
• Swelling
• Bruising
• Deformity
• Inability to use the limb.

Different types of fracture
The different types of bone fracture include:

• Greenstick fracture – the bone sustains a small, slender crack. This type of fracture is more common in children, due to the comparative flexibility of their bones.
• Comminuted fracture – the bone is shattered into small pieces. This type of complicated fracture tends to heal at a slower rate.
• Simple fracture – or ‘closed’ fracture. The broken bone hasn’t pierced the skin.
• Compound fracture – or ‘open’ fracture. The broken bone juts through the skin, or a wound leads to the fracture site. The risk of infection is higher with this type of fracture.
• Pathological fracture – bones weakened by various diseases (such as osteoporosis or cancer) tend to break with very little force.
• Avulsion fracture – muscles are anchored to bone with tendons, a type of connective tissue. Powerful muscle contractions can wrench the tendon free and pull out pieces of bone. This type of fracture is more common in the knee and shoulder joints.
• Compression fracture – occurs when two bones are forced against each other. The bones of the spine, called vertebrae, are prone to this type of fracture. Elderly people, particularly those with osteoporosis, are at increased risk.

Back pain - schoolbags

Around 70 per cent of Australian schoolchildren may be damaging their spines by carrying schoolbags. For example, a heavy bag that’s slung over one shoulder can, over the 12 years of schooling, cause chronic back problems that linger into adulthood. Risks include muscle strain, distortion of the natural ‘S’ curve of the spine and rounding of the shoulders. Parents can reduce the risk in many ways, such as buying the child an appropriately sized backpack and making sure the load isn’t too heavy.

Schoolbag risk factors
Risk factors for spinal damage include:

• A schoolbag that weighs more than 10 per cent of the child’s weight
• Holding the bag in one hand by its straps
• Carrying the bag over one shoulder
• An incorrectly packed backpack
• An incorrectly fitted backpack.

Australian study into backpacks
A recent study published in the Australian Spine journal investigated the link between backpacks and back pain in schoolchildren. Selected statistics include:

• The weight of the average backpack is heavier, proportionally, than the legal load-bearing limit for adults.
• 79.1 per cent of children say their backpacks feel heavy.
• 65.7 per cent report feeling fatigued by the weight of their backpack.
• 46.1 per cent report back pain caused by their backpack.

Ways to reduce the risk
Risk reduction strategies include:

• Buy the right kind of backpack.
• Make sure it is packed correctly.
• Show your child correct lifting and carrying techniques.

Buy the right kind of backpack
Your child should have a backpack, rather than a traditional schoolbag with handles. Suggestions include:

• Look for a backpack endorsed by an Australian professional organisation, such as the Australian Physiotherapy Association or the Chiropractors’ Association of Australia.
• Don’t try to save money by buying the biggest backpack you can find – make sure the backpack is appropriate to your child’s size.
• Choose a backpack with a moulded frame and/or adjustable hip strap, so that the weight of the filled backpack will rest on your child’s pelvis instead of their shoulders and spine.
• The shoulder straps should be adjustable, and the rear of the backpack padded for comfort.
• To help with packing, the backpack should have a few separate compartments.
• Canvas backpacks are lighter than leather varieties.
• Consider buying a backpack with built-in wheels.
• Children are fashion conscious and vulnerable to peer pressure, so make sure you take your child with you when buying their backpack. If the style you choose is ‘uncool’, your child may compensate by carrying the backpack in a ‘cool’ way, such as over one shoulder.