Common fractures

• Buckle fracture - cortex is buckled, often in distal radius
• Buckle fracture

  
• Greenstick fracture - the cortex is broken, but only on one side
• Greenstick fracture

  
• Transverse fracture - a fracture perpendicular to the axis of the bone
• Transverse fracture

  
• Oblique fracture - fracture orientated obliquely across the bone
• Oblique fracture
• Spiral fracture - a fracture that looks like a spiral staircase
• Spiral fracture

  
• Comminuted fracture - a fracture in more than two bits
• Comminuted fracture

  
• Salter-Harris fracture type 1

  
• Salter-Harris fracture type 2

  
• Salter-Harris fracture type 3

  
• Salter-Harris fracture type 4

  
• Salter-Harris fracture type 5

  
• Assessing fractures

  • location of fracture
  • probable mechanism of fracture
  • nearby blood vessels and nerve structures at risk of damage
  • identify clinical signs expected if neurovascular structures are injured
• Blood vessel damage

  • cool temperature
  • pale
  • prolonged capillary refill time
  • weak/loss of distal pulses
  • vascular necrosis
  • compartment syndrome
• Nerve damage

  • weakness or inability to contract muscles innervated
  • weak reflexes
  • loss of sensation
  • atrophy of muscles (longer term)
• Describe the location and type of fracture shown in this x-ray.

  Spiral mid-shaft humeral fracture

  
• Mid-shaft humeral fracture nearby structures:

  • radial nerve
  • deep brachial artery
• Brachial artery damage

  • cool, pale arm
  • prolonged capillary refill time
  • weak distal pulses
• Radial nerve damage

  • loss of sensation of dorsal aspect of hand
  • Weak elbow extension
  • Wrist drop
• Axillary artery supplies

  • axilla
  • upper limb
  • lateral thoracic region
• Brachial artery supplies

  • anterior compartment of upper arm
  • biceps, brachialis, coracobrachialis
  • triceps via brachi profundus
• Radial artery supplies

  • posterolateral aspect of forearm
• Ulnar artery supplies

  • anteromedial aspect of the forearm
• Femoral artery supplies anterior compartment of thigh
• Obturator artery supplies obturator externus and hip adductors
• Popliteal artery supplies most of distal leg muscles
• Anterior tibial artery supplies muscles of anterior compartment of leg
• Posterior tibial artery supplies soleus muscle, muscles of the posterior lower leg and muscles of sole of foot
• Peroneal artery supplies muscles of lateral compartment of lower leg