Fractures

• Fractures


  fracture = complete/incomplete break in the anatomic continuity of bone, which leads to mechanical instability of the bone
• Clinical Features of Fractures

  pain

  tenderness

  bruising

  swelling

  sometimes deformity/movement restriction
• Traumatic Causes


  traumatic causesnoccur when healthy bone is exposed to an overwhelming force - falls or car accidents ...
• Repetitive Sub-Maximal Loading


  often seen in running/jumping sports where there is a history of overload - stress fractures
• Pathological Causes


  may occur in bones weakened by focal lesions

  e.g. malignancy
• Specific Bone Conditions


  specific bone conditions can lead to decreased bone density/softness of the bone

  e.g. osteoporosis
• Types of Fractures


  fractures can be classified in a no of ways inc:

  their cause

  severity

  stability after reduction

  location + etc
• Closed vs Open Fracture

  closed - doesn't break the skin

  open - break the skin + they cause more injury to local soft tissues, inc the periosteum, higher risk of infection

  
• Displacement


  displacement describes the postion of the fracture fragments in relation to an anterior/posterior/medial/lateral plane
• Displaced vs Non-Displaced Fractures

  non-displaced (stable) - fracture ends r aligned

  displaced (unstable) - fracture ends r separate/misaligned

  
• Angulation


  angulation describes the position of the fracture fragments in relation to the longitudinal axis of the bone
• Complete Fractures


  complete fractures extend across the whole bone

  inc:

  transverse

  oblique

  spiral

  commminuted

  
• Transverse Fracture


  the fracture is in a straight line across the bone/perpendicular to the bone's axis

  
• Oblique Fracture


  a fracture that occurs at an angle to the bone's axis

  
• Spiral Fracture


  the fracture spirals around the bone

  caused by a rotational force

  usually occur at the diaphysis of long bones

  
• Comminuted Fracture


  the bone is fractured in 3 or more parts

  
• Incomplete Fractures


  incomplete fractures do not extend across the whole bone, so they r considered partial fractures

  more common in children inc:

  bowing

  buckle

  greenstick
• Bowing Fracture


  an incomplete fracture of tubular long pones that occur as a plastic response to longitudinal stress

  
• Buckle Fracture


  the cortex of the bone buckles in response to a direct axial load

  tend to occur in the long bones of children

  
• Greenstick Fracture


  the cortex + periosteum r interrupted on one side of the bone only

  
• Stress Fracture


  repeated stress/overuse leads to microscopic fractures