epäjatkuvammat

Epäjatkuvammat, Finnish for incomplete fractures, refer to breaks in bone where the cortical shell is not fully perforated. The bone remains in continuity, often with a small fragment or a buckle of cortical bone. Common examples are stress fractures, buckle (greenstick) fractures in children, and osteoporosis‑related incomplete fractures that may precede complete breaks. These injuries arise from repetitive micro‑trauma, sudden overload, or bone‑weakening conditions such as osteoporosis, osteomalacia, or chronic corticosteroid use.

Clinical presentation typically includes localized pain that worsens with activity and may be accompanied by swelling or tenderness. Diagnosis is usually made through a combination of history, physical examination, and imaging. Plain radiographs are often the first step; inadequate for stressed bone, MRI or CT can reveal bone marrow oedema and micro‑fractures not visible on X‑ray. Bone scan, while more sensitive, is rarely needed unless the diagnosis is unclear.

Management focuses on mechanical off‑loading of the affected area, allowing bone remodeling. For stress fractures, rest and activity modification for 4–6 weeks, protective footwear, and gradual return to load are common. Buckle fractures are treated with casting or splinting for 4–6 weeks, after which progressive physiotherapy is initiated. Osteoporosis‑associated incomplete fractures may require pharmacologic bone‑strengthening agents in addition to immobilisation.

Prognosis is generally favourable if the injury is recognised early and adequately treated; most patients regain normal function within several weeks. Delayed treatment or continued loading can lead to progression to a complete fracture, prolonged pain, or chronic stress fracture.