Early complications of bone fracture

Complications of fractures tend to be classified according to whether they are local or systemic and when they occur - early or late. Early complications occur at the time of the fracture (immediate) or soon after. Early local complications tend to affect mainly the soft tissues.
Early local complication:

• Vascular injury causing haemorrhage, internal or external
• Visceral injury causing damage to structures such as brain, lung or bladder
• Damage to surrounding tissue, nerves or skin
• Haemarthrosis
• Compartment syndrome
• Wound Infection, more common for open fracture

Compartment syndrome:
Increase in pressure inside a particular enclosed space. Then, it will cause blood vessels and nerve compression. Also, it can be caused by surgery. Long-term (chronic) compartment syndrome can be caused by repetitive activities, such as running, which increase the pressure in a compartment only during that activity. Permanent nerve injury and loss of muscle function can result if the diagnosis is delayed.

Early systemic complications:

• Fat embolism
• Shock
• Thromboembolism (pulmonary or venous)
• Exacerbation of underlying diseases such as diabetes
• Pneumonia

Fat embolism:
This is a relatively uncommon disorder that occurs in the first few days following trauma. Fat drops are thought to be released mechanically from bone marrow following fracture, coalesce and form emboli in the pulmonary capillary beds and brain, with a secondary inflammatory cascade and platelet aggregation. An alternative theory suggests that free fatty acids are released as chylomicrons following hormonal changes due to trauma or sepsis.

Diabetes:
Diabetic patients often experience low bone density which increased the risk of bone fractures and delays fracture repair. Researchers found out that there is an increased levels of inflammatory molecules, including TNF-a during fracture healing. Rapid loss of cartilage in the healing bones, which was due to increased numbers of osteoclasts, cells that remove bone and cartilage.

References:
http://www.patient.co.uk/doctor/Complications-From-Fractures.htm
http://www.nlm.nih.gov/medlineplus/ency/article/001224.htm
http://www.huliq.com/11/87003/diabetes-contributes-bone-fracture-healing
http://timesofindia.indiatimes.com/life-style/health-fitness/health/Diabetes-can-delay-bone-fracture-healing/articleshow/5064456.cms