Diastatic fractures occur when the fracture line transverses

one or more sutures of the skull causing a widening of the suture. While this type of fracture is usually seen in infants and young children as the sutures are not yet fused it can also occur in adults. When a diastatic fracture occurs in adults it usually affects the lambdoidal suture as this suture does not fully fuse in adults until about the age of 60.

Diastatic fractures can occur with different types of fractures and it is also possible for diastasis of the cranial sutures to occur without a concomitant fracture. Sutural diastasis may also occur in various congenital disorders such as cleidocranial dysplasia and osteogenesis imperfecta.

A history of a broken bone is usually apparent. The patient complains of persistent pain at the fracture site and may also notice abnormal movement or clicking at the level of the fracture. An x-ray plate of the fractured bone shows a persistent radiolucent line at the fracture. Callus formation may be evident but callus does not bridge across the fracture. If there is doubt about the interpretation of the x-ray, stress x-rays, tomograms or CT scan may be used for confirmation.

Basilar skull fractures are linear fractures that occur in the floor of the cranial vault (skull base), which require more force to cause than other areas of the neurocranium. Thus they are rare, occurring as the only fracture in only 4% of severe head injury patients.

Basilar fractures have characteristic signs: blood in the sinuses; a clear fluid called cerebrospinal fluid (CSF) leaking from the nose (rhinorrhea) or ears (otorrhea); periorbital ecchymosis often called 'raccoon eyes' (bruising of the orbits of the eyes that result from blood collecting there as it leaks from the fracture site); and retroauricular ecchymosis known as "Battle's sign" (bruising over the mastoid process).

In orthopedic medicine, fractures are classified in various ways. Historically they are named after the physician who first described the fracture conditions, however, there are more systematic classifications in place currently.

Pediatric fractures can be classified as complete and incomplete:

- Incomplete: there are three basic forms of incomplete fractures:

- The first is the greenstick fracture, a transverse fracture of the cortex which extends into the midportion of the bone and becomes oriented along the longitudinal axis of the bone without disrupting the opposite cortex.

- The second form is a torus or buckling fracture, caused by impaction. They are usually the result of a force acting on the longitudinal axis of the bone: they are typically a consequence of a fall on an outstretched arm, so they mainly involve the distal radial metaphysis. The word torus is derived from the Latin word 'torus,' meaning swelling or protuberance.

- The third is a bow fracture in which the bone becomes curved along its longitudinal axis.

- Complete fractures

There are also physeal fractures (fractures involving the physis, the growth plate, which is not present in adults). The Salter-Harris classification is the most used to describe these fractures.

Even though symptoms vary widely after experiencing a bone fracture, the most common fracture symptoms include:

- pain in the fractured area

- swelling in the fractured area

- obvious deformity in the fractured area

- not being able to use or move the fractured area in a normal manner

- bruising, warmth, or redness in the fractured area

After a humerus fracture, pain is immediate, enduring, and exacerbated with the slightest movements. The affected region swells, with bruising appearing a day or two after the fracture. The fracture is typically accompanied by a discoloration of the skin at the site of the fracture. A crackling or rattling sound may also be present, caused by the fractured humerus pressing against itself. In cases in which the nerves are affected, then there will be a loss of control or sensation in the arm below the fracture. If the fracture affects the blood supply, then the patient will have a diminished pulse at the wrist. Displaced fractures of the humerus shaft will often cause deformity and a shortening of the length of the upper arm. Distal fractures may also cause deformity, and they typically limit the ability to flex the elbow.

Nonunion is permanent failure of healing following a broken bone unless intervention (such as surgery) is performed. A fracture with nonunion generally forms a structural resemblance to a fibrous joint, and is therefore often called a "false joint" or pseudoarthrosis (the Greek stem "pseudo-" means false and "arthrosis" means joint). The diagnosis is generally made when there is no healing between two sets of X-ray. This is generally after 6-8 months.

Nonunion is a serious complication of a fracture and may occur when the fracture moves too much, has a poor blood supply or gets infected. Patients who smoke have a higher incidence of nonunion. The normal process of bone healing is interrupted or stalled.

Since the process of bone healing is quite variable, a nonunion may go on to heal without intervention in a very few cases. In general, if a nonunion is still evident at 6 months post injury it will remain unhealed without specific treatment, usually orthopedic surgery. A non-union which does go on to heal is called a delayed union.

A clavicle fracture, also known as a broken collarbone, is a bone fracture of the clavicle. Symptoms typically include pain at the site of the break and a decreased ability to move the affected arm. Complications can include a collection of air in the pleural space surrounding the lung (pneumothorax), injury to the nerves or blood vessels in the area, and an unpleasant appearance.

It is often caused by a fall onto a shoulder, outstretched arm, or direct trauma. The fracture can also occur in a baby during childbirth. The middle section of the clavicle is most often involved. Diagnosis is typically based on symptoms and confirmed with X-rays.

Clavicle fractures are typically treated by putting the arm in a sling for one or two weeks. Pain medication such as paracetamol (acetaminophen) may be useful. It can take up to five months for the strength of the bone to return to normal. Reasons for surgical repair include an open fracture, involvement of the nerves or blood vessels, or shortening of the clavicle by more than 1.5 cm in a young person.

Clavicle fractures most commonly occur in people under the age of 25 and those over the age of 70. Among the younger group males are more often affected than females. In adults they make up about 5% of all fractures while in children they represent about 13% of fractures.

Some clinical features of a greenstick fracture are similar to those of a standard long bone fracture - greenstick fractures normally cause pain at the injured area. As these fractures are specifically a pediatric problem, an older child will be protective of the fractured part and babies may cry inconsolably. As per a standard fracture, the area may be swollen and either red or bruised. Greenstick fractures are stable fractures as a part of the bone remains intact and unbroken so this type of fracture normally causes a bend to the injured part, rather than a distinct deformity, which is problematic.

A humerus fracture is a break of the humerus bone in the upper arm. Fractures of the humerus may be classified by the location into proximal region, which is near the shoulder, the middle region or shaft, and the distal region, which is near the elbow. These locations can further be divided based on the extent of the fracture and the specific areas of each of the three regions affected. Humerus fractures usually occur after physical trauma, falls, excess physical stress, or pathological conditions such as tumors. Falls are the most common cause of proximal and shaft fractures, and those who experience a fracture from a fall usually have an underlying risk factor for bone fracture. Distal fractures occur most frequently in children who attempt to break a fall with an outstretched hand.

Symptoms of fracture are pain, swelling, and discoloration of the skin at the site of the fracture. Bruising appears a few days after the fracture. The neurovascular bundle of the arm may be affected in severe cases, which will cause loss of nerve function and diminished blood supply beneath the fracture. Proximal and distal fractures will often cause a loss of shoulder or elbow function. Displaced shaft and distal fractures may cause deformity, and such shaft fractures will often shorten the length of the upper arm. Most humerus fractures are nondisplaced and will heal within a few weeks if the arm is immobilized. Severe displaced humerus fractures and complications often require surgical intervention. In most cases, normal function to the arm returns after the fracture is healed. In severe cases, however, function of the arm may be diminished after recovery.

Individuals with Jefferson fractures usually experience pain in the upper neck but no neurological signs. The fracture may also cause damage to the arteries in the neck, resulting in lateral medullary syndrome, Horner's syndrome, ataxia, and the inability to sense pain or temperature.

In rare cases, congenital abnormality may cause the same symptoms as a Jefferson fracture.

People usually present with a history of an injury and localized pain. There is often a deformity in the wrist with associated swelling. Numbness of the hand can occur because of compression on the median nerve across the wrist (carpal tunnel syndrome). The wrist deformity often limits motion of the fingers.

A "corner fracture" or "bucket-handle fracture" is fragmentation of the distal end of one or both femurs, with the loose piece appearing at the bone margins as an osseous density paralleling the metaphysis. The term "bucket-handle fracture" is used where the loose bone is rather wide at the distal end, making it end in a crescent shape. These types of fractures are characteristic of child abuse-related injuries.

As with other types of fractures, scapular fracture may be associated with pain localized to the area of the fracture, tenderness, swelling, and crepitus (the crunching sound of bone ends grinding together). Since scapular fractures impair the motion of the shoulder, a person with a scapular fracture has a reduced ability to move the shoulder joint. Signs and symptoms may be masked by other injuries that accompany the scapular fracture.

Swelling, deformity, tenderness and loss of wrist motion are normal features on examination of a person with a distal radius fracture. Examination should rule out a skin wound which might suggest an open fracture. It is imperative to check for loss of sensation, loss of circulation to the hand, and more proximal injuries to the forearm, elbow and shoulder. The most common associated neurological finding is decreased sensation over the thenar eminence due to associated median nerve injury.

A classic "dinner fork" deformity may be seen in dorsally angulated fractures due to dorsal displacement of the carpus. The reverse deformity may be seen in volarly angulated fractures.

The most common symptom is pain over the heel area, especially when the heel is palpated or squeezed. Patients usually have a history of recent trauma to the area or fall from a height. Other symptoms include: inability to bear weight over the involved foot, limited mobility of the foot, and limping. Upon inspection, the examiner may notice swelling, redness, and hematomas. A hematoma extending to the sole of the foot is called "Mondor Sign", and is pathognomonic for calcaneal fracture. The heel may also become widened with associated edema due to displacement of lateral calcaneal border. Involvement of soft tissue (tendons, skin, etc.,) should be evaluated because soft tissue injury has been associated to serious complications (see below).

The classic clinical presentation of a hip fracture is an elderly patient who sustained a low-energy fall and now has groin pain and is unable to bear weight. Pain may be referred to the supracondylar knee. On examination, the affected extremity is often shortened and unnaturally, externally rotated compared to the unaffected leg.

A zygoma fracture (zygomatic fracture) is a form of facial fracture caused by a fracture of the zygomatic bone. A zygoma fracture is often the result of facial trauma such as violence, falls or automobile accidents.

Symptoms include flattening of the face, trismus (reduced opening of the jaw) and lateral subconjunctival hemorrhage.

The term "Colles fracture" is classically used to describe a fracture at the distal end of the radius, at its cortico-cancellous junction. However, now the term tends to be used loosely to describe any fracture of the distal radius, with or without involvement of the ulna, that has dorsal displacement of the fracture fragments. Colles himself described it as a fracture that “takes place at about an inch and a half (38mm) above the carpal extremity of the radius” and “the carpus and the base of metacarpus appears to be thrown backward”. The fracture is sometimes referred to as a "dinner fork" or "bayonet" deformity due to the shape of the resultant forearm.

Colles' fractures can be categorized according to several systems including Frykman, Gartland & Werley, Lidström, Nissen-Lie and the Older's classifications.

Although bone tissue itself contains no nociceptors, bone fracture is painful for several reasons:

- Breaking in the continuity of the periosteum, with or without similar discontinuity in endosteum, as both contain multiple pain receptors

- Edema of nearby soft tissues caused by bleeding of torn periosteal blood vessels evokes pressure pain

- Muscle spasms trying to hold bone fragments in place. Sometimes also followed by cramping

Damage to adjacent structures such as nerves or vessels, spinal cord, and nerve roots (for spine fractures), or cranial contents (for skull fractures) may cause other specific signs and symptoms.

A calcaneal fracture is a break of the calcaneus (heel bone). Symptoms may include pain, bruising, trouble walking, and deformity of the heel. It may be associated with breaks of the hip or back.

It usually occurs when a person lands on their feet following a fall from a height or during a motor vehicle collision. Diagnosis is suspected based on symptoms and confirmed by X-rays or CT scaning.

If the bones remain normally aligned treatment may be by casting without weight bearing for around eights weeks. If the bones are not properly aligned surgery is generally required. Returning the bones to their normal position results in better outcomes. Surgery may be delayed a few days as long as the skin remained intact.

About 2% of all fractures are calcaneal fractures, however, they make up 60% of fractures of the mid foot bones. Undisplaced fractures may heal in around three months while more significant fractures can take two years. Difficulties such as arthritis and decreased range of motion of the foot may remain.

A Smith Fracture is a named vertebral fracture occurring most commonly in the lumbar spine. It is similar to that of a Chance fracture and is associated with seat belt injuries. This fracture represents a fracture through the posterior elements including the superior articular processes but not the spinous process, as well as an avulsion fracture of the vertebral body. This fracture is not to be confused with the more commonly referred to Smith's fracture of the wrist.

A Smith's fracture, also sometimes known as a reverse Colles' fracture or Goyrand-Smith's, is a fracture of the distal radius. It is caused by a direct blow to the dorsal forearm or falling onto flexed wrists, as opposed to a Colles' fracture which occurs as a result of falling onto wrists in extension. Smith's fractures are less common than Colles' fractures.

The distal fracture fragment is displaced volarly (ventrally), as opposed to a Colles' fracture which the fragment is displaced dorsally. Depending on the severity of the impact, there may be one or many fragments and it may or may not involve the articular surface of the wrist joint.

This fracture is named after the orthopedic surgeon, Robert William Smith (1807–1873) in his book "A Treatise on Fractures in the Vicinity of Joints, and on certain forms of Accidents and Congenital Dislocations" published in 1847.