Fractured vs. Broken

[docB]

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Why does every patient in my town think there is a difference between a break and a fracture? And they differ on which is "the bad kind" and what each means. Is this some form of stupidity exclusive to Vegas or is it everywhere?

 

[dchristismi]

It's everywhere. I make a point to say, "fractured, as in broken" these days.

I figure the bad kind usually means a bone sticking out, but yeah, that does vary.

 

[edinOH]

Yep, it's everywhere.

I just kind of go with it. "So doc, is it broken or fractured?"

"Thankfully neither." is usually my reply.

 

[Apollyon]

Specifically, it is "cracked" ribs vs broken. "I cracked two ribs after I beat this guy up (with my chest into his foot, I'm thinking) two weeks ago". "So you broke them?" "No, they're just cracked."

 

[Tiger26]

Specifically, it is "cracked" ribs vs broken. "I cracked two ribs after I beat this guy up (with my chest into his foot, I'm thinking) two weeks ago". "So you broke them?" "No, they're just cracked."

You get "cracked ribs" when that cracka' ***** cop gone violated yo' civil libertes when you was sellin' crack to that broke'dick cousin' a yos'

 

[DrJosephKim]

This really gets at the root of basic health literacy issues. So many patients are misinformed by medical terminology. Health literacy and cultural competency are important issues that often get overlooked during the medical school curriculum.

 

[EM2BE]

I remember vaguely hearing something about this when I was younger. If I remember correctly, the difference thought to exist was that a fracture was just a crack in a bone (still have to get a cast, but healed faster) and a break was that there were 2 bones when there should be one. Wish I could draw a picture...hope the words make some sense.

Edit: No, I don't hold these beliefs myself.

 

[RxnMan]

Why does every patient in my town think there is a difference between a break and a fracture? And they differ on which is "the bad kind" and what each means. Is this some form of stupidity exclusive to Vegas or is it everywhere?

Wait - you mean there isn't a difference? 😱

Guess I'd better get the 90-day refund on my MD from this guy.

 

[Doctor Bob]

Guess I'd better get the 90-day refund on my MD from this guy.

Ohhhhh that article made my day.

 

[abbaroodle]

Wait - you mean there isn't a difference? 😱

Guess I'd better get the 90-day refund on my MD from this guy.

Dang it! Thats the only doctor in town my insurance will pay for me to see. I knew the name sounded familiar.

 

[dchristismi]

Actually, I thought he opened up one of those cash-only boutique practices...

 

[Drawing Dead]

I'm still trying to figure out what the "good kind" of break or fracture is.

 

[Arcan57]

The kind where it doesn't really hurt or impair you, but you still get excused from any societal responsibilities for 6-8 weeks.

 

[firecoins]

Oh boy! I never knew people had a problem with this. Learn something new everyday.

 

[The Tolf]

I was told today on my Ortho rotation that a clavicle fracture is the "good kind." We were seeing a trauma in the ED who "cracked some ribs" and had a "good fracture" to the clavicle! He also got a chest tube from the pneumo he had!

Also, I learned that Ortho people tease EM docs about "fracture" vs "broke." They like to say "well, that's a fracture, but it's not broken" just to be trouble makers.

Oh I can't wait for March 16/19!!!!!!!! EM baby!

 

[docB]

It's a little bit of a necrobump but I had this conversation with a patient yesterday:

Me: Ma'am I'm sorry to tell you that you did break your hip so we're going to admit you and call the ortho surgeon.

Patient: Oh, so it's just broken but not fractured. Thank goodness!

Me: A break and a fracture are the same thing, ma'am.

Patient: No they're not.

Me: Oh. Then what's the difference?

Patient: How should I know. You're the doctor. You're supposed to know these things.

Me: 🙄

Can't wait to see my Gallup score for that one.

 

[Arcan57]

Unless Gallup is different than PG, since the patient is admitted then it won't count. I'd actually be ok with fractured as different from broken if people were just consistent about it. Like fracture meant surgery but break meant splint. At least with medical ebonics, once you've cracked the code you can translate it back into doctor-speak.

 

[anonymousEM]

Me: 🙄

Can't wait to see my Gallup score for that one.[/QUOTE]

On a tangentially related subject--Do you get Gallup scores on admitted patients? I thought only discharged pts are surveyed

Nevermind, posting at the same time

 

[docB]

Our hospitals use Gallup for a lot of stuff, not just for us, so it goes to a lot of patients but has limited reliability for whatever they're looking at. In other words they use it but they know it's poor for admitted patients. HCAHPS on the other hand...

 

[WilcoWorld]

I'm just imagining the possible "talk" with the admins:

Admin: Dr. B, we received a complaint about you. This patient was upset that you do not know the difference between a break and a fracture.

Doc B: There is no difference. I explained that to the patient.

Admin: A-hem, umm... are you sure?

Doc B: Yep, I'm sure. I even stopped the chairman of Orthopedics in the hall on my way in here for confirmation. It made him laugh that I would even ask.

Admin: Well, next time just pretend there's a difference, OK?

 

[Stitch]

I'm just imagining the possible "talk" with the admins:

Admin: Dr. B, we received a complaint about you. This patient was upset that you do not know the difference between a break and a fracture.

Doc B: There is no difference. I explained that to the patient.

Admin: A-hem, umm... are you sure?

Doc B: Yep, I'm sure. I even stopped the chairman of Orthopedics in the hall on my way in here for confirmation. It made him laugh that I would even ask.

Admin: Well, next time just pretend there's a difference, OK?

Scary, though, because I could see it happen...

 

[Hamhock]

Anyone have more of these? (common illness/injury with two names that patients think are different things)

I have started asking friends and family (most of whom would be considered very well "educated" by most standards) what the difference between a fractured bone and a broken bone is. Great fun!

I have also started to ask these same people what a heart attack is...not subendocardial ischemia, just "heart attack". The answers are shocking and hilarious. Kinda like a party game...

I recommend it for fun...but it also reminds me how ridiculous so much of "informed consent" is. I am sure there are folks on here who would say my experience should teach me that I need to focus more on communicating on a level my patients will understand and taking more time with "informed consent" (and to a small extent, I agree), but I say trying to explain contrast-induced nephropathy to get "informed consent" before a CT A/P is a waste of time...we need some paternalism is medicine. [Yes, one of my hospitals now requires ED docs to get "informed consent" prior to contrast studies]

...but back to the original topic: anyone know of other fracture vs. broken misunderstandings?

Ask your friends and family - it's good, healthy fun.

HH

 

[med2UCC]

In response to the original question, in my part of Canada we also get the whole fractured versus broken question, and I heard it while I was in Ireland as well so it seems to be world-wide. Or at least western world-wide. Cheers,
M

 

[Birdstrike]

Pt - "So if it ain't fractured, and it ain't broke...are you sayin' I 'sprung it'?"

Dr - "Yes, sir you sprung it I mean sprained it."

Pt - "A sprain can hurt us as bad as a break, right"?

Dr - "Uh, no. Well, yes, I guess so."

Pt - "So that means I can have some of those buycodins, right?"