GENERAL PRINCIPLES OF FRACTURES
A fracture is a partial or complete interruption in the continuity of the bone. The most common cause is trauma, followed by diseases (e.g., osteoporosis) that result in weakened bone structure. The latter results in pathologic fractures, which are fractures that would not usually occur if the bone structure was not weakened.
Open fractures, in which the bone is exposed due to severe soft tissue injury, are associated with a significant risk of infection and poor wound healing.
Fracture management can be conservative (e.g., cast or splint) or surgical, and generally involves anatomic reduction, fixation, and/or immobilization.
Complications include acute nerve and vascular injury and compartment syndrome, as well as long-term complications such as avascular necrosis and nonunion.
FRACTURE CLASSIFICATION |
|
Type | Closed: Broken bone doesn’t break the skin Open: Ends of broken bone tears the skin |
Location | Proximal: Fracture at the upper part of the bone Distal: Fracture at the lower part of the bone |
Position | Diaphysis: Fracture at the mid-section of the bone Metaphysis: Fracture at the growth plate of the bone Epiphysis: Fracture at the rounded end of the long bone |
Extent | Complete: Bone gets crushed into two or more pieces Incomplete: Bone cracks without breaking all the way through |
Orientation | Transverse: Fracture is at the right angle to the long plane of the bone Oblique: Fracture is at an oblique angle to the long axis of the bone Spiral: Fracture that occurs when a long bone is broken by a twisting force |
Displacement | Nondisplaced: Bone maintains its proper alignment Displaced: The fracture segment does not maintain the bone alignment |
Fragmentation | Comminuted: Breaking of the bone into two or more fragments Segmental: Fracture composed of at least two fracture lines, isolating a bone segment |