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Fracture 1

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Gaurav Sangam

This document provides an overview of fractures, including definitions, related terms, causes, clinical features, classifications, and the healing process. It defines a fracture as a break or disruption in bone continuity. Fractures are classified based on etiology, soft tissue involvement, displacement, fracture pattern, and number of bone fragments. The healing process involves hematoma formation, granulation tissue growth, callus formation, ossification, consolidation, and remodeling over several months.

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FRACTURE
REVIEW DEFINATION RELATED TERMS CAUSES CLINICAL FEATURES CLASSIFICATION HEALING OF FRACTURE
DEFINATION Fracture : A fracture is a break or disruption in the continuity of bone or it is a disruption of the normal architecture of the bone.
RELATED TERMS Sub-laxation : A joint is subluxated when its articular surfaces retain some contact between them. Dislocation : A joint is dislocated when its articular surfaces are so much displaced that they loose contact with each other. Sprain : A injury to ligament is known as Sprain. Strain : Stretching of a muscle/ its attachment is known as Strain.
CAUSES Common Causes Of Fractures: Fall From A Height Car Accidents Direct Blow Repetitive Forces Pathology
CLINICAL FEATURES Signs and Symptoms Swelling or tenderness pain Numbness Bleeding Broken skin with bone protruding Limitation or unwillingness to move a limb
CLASSIFICATION I. According to etiology 1. Traumatic Fracture 2. Pathological Fracture II. Based On Soft Tissue Involvement: 1. Simple/Closed fracture 2. Open fracture/Compound fracture III. According to displacement 1. Displaced Fracture 2. Undisplaced Fracture
CLASSIFICATION IV. Based On Fracture Pattern: 1. Linear fracture 2. Transverse fracture 3. Oblique fracture 4. Spiral fracture 5. Compression fracture/Wedge fracture 6. Impacted fracture 7. Avulsion fracture 8. Segmental fracture 9. Greenstick fracture
CLASSIFICATION V. Based On Fragments : 1. Complete Fracture 2. Incomplete Fracture 3. Comminuted Fracture
I. According to etiology 1. Traumatic 2. Pathological 1. Traumatic Fracture Fracture sustained due to trauma. Eg .- Fractures caused by a fall , RTA. 2. Pathologic Fracture A fracture through a bone which has been made weak by some underlying bone disease. Eg .- A fracture through a bone weakened by metastasis or Osteoporosis.
PATHOLOGICAL #
II. Based On Soft Tissue Involvement: 1. Simple/Closed fracture 2. Open fracture/Compound fracture 1. Simple/Closed fracture: Those in which the overlying skin and soft-tissues are intact. 2. Open fracture/Compound fracture: Involve wounds that communicate with the fracture, or where fracture hematoma is exposed, and may thus expose bone to contamination. Open injuries carry a higher risk of infection.
Fracture 1
III. According to displacement 1. Displaced 2. Undisplaced 1.Undisplaced : None or minimal displacement of fracture fragments. 2.Displaced : Depending on fracturing force , muscle pull on the fracturing fragments and the gravity, the displacement may be Translation Angulation Rotatation While describing the displacements of fracture , conventionally , it is the displacement of the distal fragment in relation to the proximal fragment which is mentioned.
Fracture 1
IV. Based On Fracture Pattern: 1. Linear fracture 2. Transverse fracture 3. Oblique fracture 4. Spiral fracture 5. Compression fracture/Wedge fracture 6. Impacted fracture 7. Avulsion fracture 8. Segmental fracture 9. Greenstick fracture 10.Torus fracture :
1. Linear fracture : A fracture that is parallel to the bone's long axis. 2. Transverse fracture: A fracture line is at right angle to the bone's long axis. Caused by tapping or bending force. 3. Oblique fracture: A fracture that is diagonal to a bone's long axis. Caused by bending force in addition to force along longaxis of the bone. 4. Spiral fracture: A fracture where at least one part of the bone has been twisted. Fracture line runs spirally in more than one plane. Caused by twisting force. 5. Compression fracture/Wedge fracture: usually occurs in the vertebrae , for example when the front portion of a vertebra in the spine collapses due to osteoporosis where
6.Impacted fracture: A fracture caused when bone fragments are driven into each other. 7.Avulsion fracture: A fracture where a fragment of bone is separated from the main mass. 8.Segmental fracture : In this there are two fractures in one bone, but at different levels 9. Greenstick fracture : A greenstick fracture is a fracture in a young, soft bone in which the bone bends and breaks 10. Torus fracture : Torus fractures, also known as buckle fractures, are incomplete fractures of the shaft of a long bone that is characterized by bulging of the cortex.
Fracture 1
Compression #
V. Based On Fragments : 1. Complete Fracture 2. Incomplete Fracture 3. Comminuted Fracture 1.Incomplete fracture: A fracture in which the bone fragments are still partially joined. In such cases, there is a crack in the osseous tissue that does not completely traverse the width of the bone 2. Complete fracture: A fracture in which bone fragments separate completely. 3. Comminuted fracture: A fracture in which the bone has broken into several pieces.
FRACTURE HEALING Fracture hematoma: when a fracture occurs, bleeding creates a hematoma, which surrounds the ends of the fragments. (within 72 hours) Granulation tissue : active phagocytosis absorbs the products of local necrosis. The hematoma converts to granulation tissue. Granulation tissue produces the basis for new bone substance called osteoid ( days 3 to 14 ) Callus formation : As minerals and new bone matrix are deposited in the osteoid, an unorganized network of bone is formed. It usually appears by the end of the second week after injury. Evidence of callus formation can be verified by x-ray.
Ossification : Ossification of the callus occurs from 3 weeks to 6 months after the fracture and continues until the fracture has healed. During this stage of clinical union the patient may be allowed limited mobility or the cast may be removed. Consolidation : As callus continues to develop, the distance between bone fragments diminishes and eventually closes. This stage is called consolidation, and ossification continues. It can be equated with radiologic union. FRACTURE HEALING
Remodeling : Excess bone tissue is reabsorbed in the final stage of bone healing, and union is completed. Gradual return of the injured bone to its pre injury structural strength and shape occurs. Radiologic union occurs when there is x-ray evidence of complete bony union. This phase can occur up to a year following injury. FRACTURE HEALING
Fracture 1
Fracture 1

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Fracture 1

  • 3. DEFINATION Fracture : A fracture is a break or disruption in the continuity of bone or it is a disruption of the normal architecture of the bone.
  • 4. RELATED TERMS Sub-laxation : A joint is subluxated when its articular surfaces retain some contact between them. Dislocation : A joint is dislocated when its articular surfaces are so much displaced that they loose contact with each other. Sprain : A injury to ligament is known as Sprain. Strain : Stretching of a muscle/ its attachment is known as Strain.
  • 5. CAUSES Common Causes Of Fractures: Fall From A Height Car Accidents Direct Blow Repetitive Forces Pathology
  • 6. CLINICAL FEATURES Signs and Symptoms Swelling or tenderness pain Numbness Bleeding Broken skin with bone protruding Limitation or unwillingness to move a limb
  • 7. CLASSIFICATION I. According to etiology 1. Traumatic Fracture 2. Pathological Fracture II. Based On Soft Tissue Involvement: 1. Simple/Closed fracture 2. Open fracture/Compound fracture III. According to displacement 1. Displaced Fracture 2. Undisplaced Fracture
  • 8. CLASSIFICATION IV. Based On Fracture Pattern: 1. Linear fracture 2. Transverse fracture 3. Oblique fracture 4. Spiral fracture 5. Compression fracture/Wedge fracture 6. Impacted fracture 7. Avulsion fracture 8. Segmental fracture 9. Greenstick fracture
  • 9. CLASSIFICATION V. Based On Fragments : 1. Complete Fracture 2. Incomplete Fracture 3. Comminuted Fracture
  • 10. I. According to etiology 1. Traumatic 2. Pathological 1. Traumatic Fracture Fracture sustained due to trauma. Eg .- Fractures caused by a fall , RTA. 2. Pathologic Fracture A fracture through a bone which has been made weak by some underlying bone disease. Eg .- A fracture through a bone weakened by metastasis or Osteoporosis.
  • 12. II. Based On Soft Tissue Involvement: 1. Simple/Closed fracture 2. Open fracture/Compound fracture 1. Simple/Closed fracture: Those in which the overlying skin and soft-tissues are intact. 2. Open fracture/Compound fracture: Involve wounds that communicate with the fracture, or where fracture hematoma is exposed, and may thus expose bone to contamination. Open injuries carry a higher risk of infection.
  • 14. III. According to displacement 1. Displaced 2. Undisplaced 1.Undisplaced : None or minimal displacement of fracture fragments. 2.Displaced : Depending on fracturing force , muscle pull on the fracturing fragments and the gravity, the displacement may be Translation Angulation Rotatation While describing the displacements of fracture , conventionally , it is the displacement of the distal fragment in relation to the proximal fragment which is mentioned.
  • 16. IV. Based On Fracture Pattern: 1. Linear fracture 2. Transverse fracture 3. Oblique fracture 4. Spiral fracture 5. Compression fracture/Wedge fracture 6. Impacted fracture 7. Avulsion fracture 8. Segmental fracture 9. Greenstick fracture 10.Torus fracture :
  • 17. 1. Linear fracture : A fracture that is parallel to the bone's long axis. 2. Transverse fracture: A fracture line is at right angle to the bone's long axis. Caused by tapping or bending force. 3. Oblique fracture: A fracture that is diagonal to a bone's long axis. Caused by bending force in addition to force along longaxis of the bone. 4. Spiral fracture: A fracture where at least one part of the bone has been twisted. Fracture line runs spirally in more than one plane. Caused by twisting force. 5. Compression fracture/Wedge fracture: usually occurs in the vertebrae , for example when the front portion of a vertebra in the spine collapses due to osteoporosis where
  • 18. 6.Impacted fracture: A fracture caused when bone fragments are driven into each other. 7.Avulsion fracture: A fracture where a fragment of bone is separated from the main mass. 8.Segmental fracture : In this there are two fractures in one bone, but at different levels 9. Greenstick fracture : A greenstick fracture is a fracture in a young, soft bone in which the bone bends and breaks 10. Torus fracture : Torus fractures, also known as buckle fractures, are incomplete fractures of the shaft of a long bone that is characterized by bulging of the cortex.
  • 21. V. Based On Fragments : 1. Complete Fracture 2. Incomplete Fracture 3. Comminuted Fracture 1.Incomplete fracture: A fracture in which the bone fragments are still partially joined. In such cases, there is a crack in the osseous tissue that does not completely traverse the width of the bone 2. Complete fracture: A fracture in which bone fragments separate completely. 3. Comminuted fracture: A fracture in which the bone has broken into several pieces.
  • 22. FRACTURE HEALING Fracture hematoma: when a fracture occurs, bleeding creates a hematoma, which surrounds the ends of the fragments. (within 72 hours) Granulation tissue : active phagocytosis absorbs the products of local necrosis. The hematoma converts to granulation tissue. Granulation tissue produces the basis for new bone substance called osteoid ( days 3 to 14 ) Callus formation : As minerals and new bone matrix are deposited in the osteoid, an unorganized network of bone is formed. It usually appears by the end of the second week after injury. Evidence of callus formation can be verified by x-ray.
  • 23. Ossification : Ossification of the callus occurs from 3 weeks to 6 months after the fracture and continues until the fracture has healed. During this stage of clinical union the patient may be allowed limited mobility or the cast may be removed. Consolidation : As callus continues to develop, the distance between bone fragments diminishes and eventually closes. This stage is called consolidation, and ossification continues. It can be equated with radiologic union. FRACTURE HEALING
  • 24. Remodeling : Excess bone tissue is reabsorbed in the final stage of bone healing, and union is completed. Gradual return of the injured bone to its pre injury structural strength and shape occurs. Radiologic union occurs when there is x-ray evidence of complete bony union. This phase can occur up to a year following injury. FRACTURE HEALING