A chipped bone is an injury in which small fragments of a bone are chipped off from the main structure. It is also known as a chip fracture or an avulsion fraction. This type of injury usually occurs when too much force is applied to a bone and its ligaments or tendons pull off a small piece of the bone.
It is more likely to occur in children because the growth plate of the bone is weak and soft, and easily fractured. However, chipped bones also occur frequently in athletes because they often engage in activities that cause the muscles to contract strongly. If the bones can’t handle the strength of the contraction, they can chip. Chipped fractures commonly occur in the fingers and pelvis.
Chipped bones are typically caused by overextending the joints, applying extreme stress, strongly contracting the muscle, falling or slipping. If you chip a bone, you are likely to experience numbness, swelling, bruising, and pain when putting weight on the injured area.
The doctor will ask about your symptoms and how the injury occurred. He or she will then carry out a physical examination which will include stretching and flexing your muscles to see if any tendons or joints were injured.
X-rays can usually pick up chip fractures easily. However, an ultrasound may be used if the x-ray doesn’t clearly show the fragment and its distance from the main bone. MRIs are also used to detect whether any soft tissues were damaged.
Chipped Bone Variations
There are three types of chipped bone fractures.
In Type 1, the piece of bone which comes off is only slightly displaced from the main structure. This type of injury doesn’t require surgery and immobilizing the affected area in a cast should allow it to heal.
In Type 2, while the fragment is still quite close to the rest of the bone, the injury causes lesions on nearby tissues. Surgery is required in this instance.
Meanwhile, if the chipped fragment is more than two centimeters away from the rest of the bone, this is considered a Type 3 fracture. Surgery is required to either remove the fragment or re-attach it to the larger part of the bone.
Chipped Bone: Elbow
Bone chips in the elbow occur when small pieces of bone or cartilage loosen and begin to float around in the joint. Cartilage is the name given to the tissue that cushions the joint surface. In the case of a chipped bone, the pieces often come from the upper arm. This condition is called osteochondritis dissecans of the elbow. Chipped bones in the elbow are usually caused by an injury to the elbow or reduced blood supply to the bone. Athletes who throw a lot a may also be affected by the condition.
If you have a chipped bone, your elbow will most likely hurt when you move it. Alternatively, you it may lock into place and you may not be able to use it. You may also hear a clicking sound when you move the elbow or feel something inside the joint. Your elbow may also look swollen and you may not be able to straighten your arm fully.
Diagnosis and Treatment
Your doctor will examine you and ask questions about your medical history, symptoms and activity levels. They may send you to get an x-ray or an MRI to confirm the injury or rule out other conditions. Sometimes resting the elbow for 6 to 12 weeks and avoiding painful activities can be enough to help the injury heal. If the fragments are large, surgery may be required.
You should be sure to follow your doctor’s instructions carefully. They will tell you how long you should expect your recovery to take and what activities you should avoid. They will also inform you about how you should take care of yourself at home. If there are any symptoms of complications you should watch out for, your doctor will tell you about this as well.
Chipped Bone: Knee
Osteochondritis dissecans of the knee occurs the bones or cartilage of the knee joint are injured. It usually affects the cartilage covering the thighbone or patella. Pieces of bone become loose and drift around the knee joint. The condition is also called chondral fracture or osteochondral fracture. The fragments are sometimes called loose bodies or a joint mouse. The chips can happen because of one serious injury to the knee or due to repeated minor injuries. Reduced blood supply to the bone may also contribute to the condition.
If you have a chipped bone in the knee, the joint may lock up on occasion. You may also see bulges on the surface or feel the fragments. The knee is likely to be swollen and painful and you may be unable to bend or straighten the joint.
Diagnosis and Treatment
As with chipped bones of the elbow, osteochondritis dissecans of the knee is diagnosed through MRI and X-rays. The MRI is able to show more details pictures of the knee and the injury. Staying off the knee and resting until the symptoms go away will often heal minor chipped bones. However, serious cases may require surgery to repair the kneecap or thighbone.
Most chipped bones can be treated with ice, bandages and rest. The RICE method can be used at home or on the field until the injured person can see a doctor. This involves resting the area, applying ice, compressing the injured area and elevating it to reduce swelling. If the pain and swelling do not go away within two days, a visit to the doctor is in order.
Doctors have two options for non-surgical treatments. Depending on where the injury has occurred, casts, braces or hard-soled shoes may be used to immobilize the hurt area. The other option is bone stimulation. This is when an external device is attached to the bone internally and connected outside on the skin to keep the bones from moving. This also speeds up the healing process.
Surgery is the treatment of choice if the bone has been severely displaced or there are multiple breaks. It may also be the only option if the bone doesn’t heal properly following non-surgical treatment.
Recovery and Prevention
It can take more than two months to recover from a chipped bone. Rehabilitation may be required depending on the severity of the injury.
There are ways to prevent a chipped bone from occurring. These include warming up before high-intensity activities to reduce the chance of a powerful muscle contraction causing damage. Having children do basic exercises from early can help to improve their flexibility.