Published September 22, 2011 | 
Many people do not know what is an occult fracture,this fracture is mysterious but it is common.
What is occult fracture?
An occult fracture is just as it sounds. It means that you may have symptoms, but the fracture is not visible radiographically. This can happen for a number of reasons. Commonly the fracture is small and the plane of fracture is parallel tp the x-ray beam. An occult fracture is suspected because of the physical signs of a fracture. Most occult fractures are visible on X-ray at 2 weeks.
Occult Fracture
Occasionally patients present with an occult fracture of one or more of the metatarsals known as a March fracture. named because soldiers are prone to them from too much marching. These are undisplaced fractures, which are either very difficult or impossible to see. Generally, if the fracture is not seen on the initial visit to hospital, the patient will return after a few days with continuing pain and is re-x-rayed. At this time it is important to check for the signs of healing which will confirm the diagnosis.
Similarly, an occult fracture may be mistakenly considered a mild or moderately sprained wrist. If left untreated, the broken bone may not heal and will require a surgery that could have been avoided with early, appropriate treatment. The most common example of this is an occult fracture of the scaphoid bone.
How to diagnose occult fracture
X-rays will generally show if a fracture involves the growth plate. Occasionally the initial x-rays will not show a fracture even when one is present, which causes confusion for parents and patients. If the child is tender over the area of the growth plate, or bone, children will be treated for a growth plate injury, or occult fracture. Sprains are extremely rare in young children.
Occult fracture rate
Occult fracture rate is of the order of 7%. About 12 % of these will develop non-union. Interestingly most of the studies had a rate of occult ‘other wrist fractures’ of double that of true occult Scaphoid fractures, bringing the number of occult fractures up to about 1 in 5. Proponents of the traditional conservative approach would suggest that even if there isn’t an occult fracture, there is likely to be an ill-defined ligamentous injury that would benefit from a period of immobilsation anyway. Isotope bone scanning does appear to be close to 100% sensitive for the detection of?Scaphoid?fractures, but is only about 90% specific -?apparently even less so in the first few days due to the occurrence of traumatic synovitis.
Some authors suggest that a positive fat pad sign could be indicative of an occult fracture and that non-routine methods are needed to demonstrate fractures. A subtle radial head fracture is 1 such example. This type of fracture can be hard to demonstrate because of the overlapping nature of the radial head and ulna on an anteriorposterior projection. This is further complicated for a patient who cannot extend the elbow joint. Obtaining the traditional external oblique can prove frustrating and difficult for the radiographer to position. As a result, axial lateral projections are beneficial in this type of scenario.
I hope this article about Occult Fracture is useful .you can find more information about other bone fracture treatment,thank you for reading.
