Types of fractures and their pattern vary according to the site of the

injury. For a physician classification of fractures is of utmost

importance. Not only it suggests the severity and mechanics of injury
that occurred, but also helps to formulate most suitable
treatment.There are many types of classifications which are available
to physicians. These classifications vary with type of bone involved
and the region of bone involved.

For this discussion we would stick to the basic and general

classification of the fractures of long bones. We have already
discussed closed and open fractures. That is one type of classification
according to absence or presence of wounds that communicate with
fracture.

Fractures are also classified according to the pattern in which bone

breaks. Let us take them one by one

Transverse Fracture

A fracture in which the break is across the bone, at a right angle to

the long axis of the bone. Adjoining figure would illustrate.

Oblique Fracture

Instead of break being at right angle, it goes in oblique direction to

the long axis of the bone.The fracture is confined to one plane. In
other words the bone has broken at an angle.
 Spiral Fracture

This fracture is easily confused with the oblique fracture. Instead of a

straight break as in oblique fracture that is only in one plane, the
break in this case traverses both the planes. To understand this you
need to imagine a three dimensional view of the bone.

If you take a stick and slice it at an angle so that it is divided in two,

it is similar to oblique fracture. But if you twist and break that stick
it would result in a break pattern that would start from one point,
move obliquely in on direction, reach the other end and then
continue in other side of the stick in a spiral fashion to meet the
original point.

Adjoining diagram would give you rough idea of what I am trying to

say. Compare it with the oblique fracture diagram and you would be
able to appreciate the difference.

Comminuted Fracture

If the injury results in multiple breaks in the bone, they are visible as
different fragments. These kind of fractures are called comminuted
fractures.
 Apart from this, fracture can be displaced or undisplaced.
If bone fragments stay together maintaining structural alignment of
the bone , it is called an undisplaced fracture. A hairline fracture is
an example of an undisplaced fracture.

But fragment of the bone may move from their original position
resulting separation of the fragments. Such a fracture is called a
displaced fracture. (See the figure)

Butterfly fragment is a 聽 popular term for a wedge-shaped

fragment of bone split from the main fragments,

Following xray would show a butterfly fragment

 Butterfly
fragment in fracture radius

Segmental

The bone is fractured at two distinct levels. Reduction of this fracture

is difficult and nonunion common as seen in following xray
 Segmental
Fracture Fibula with Fracture Tibia

Impacted Fracture

This is a fracture in which the ends are driven into each other.
Cancellous bone is typically involved, and union often occurs rapidly.
A torus fracture is a pediatric impaction fracture in which the cortex
of a long bone buckles, with no loss of corti
Compression Fracture

This occurs in cancellous bone, when an excessive axial load

compresses the bone beyond its limits. It typically occurs in the
verterbal bodies.

Depressed Fracture

This is a fracture of the cortical bone caused by a localized force that

breaks and depresses one segment below the level of surrounding
bone.
Additional Terms in Fractures

Incomplete/Complete Fractures

A fracture is complete if both cortices of the bone are interrupted

and incomplete if only one is involved. A greenstick fracture is an
incomplete 聽 fracture in children 聽 in which the cortex and
periosteum are broken on one side only.

Stable/Unstable Fracture

Unstable fracture are those that tend to displace after reduction,

whereas stable fractures remain in place after reduction.

Complicated/Uncomplicated Fracture

Complicated fractures are those in which there is significant soft

tissue damage to major nearby structures (nerves, vessels, ligaments,
and muscles). Uncomplicated fractures involve only minimal soft
tissue damage.

Extraarticular/Intraarticular Fracture

Intraarticular fractures are those in which the fracture line extends

into the joint space. Extraarticular fractures are those in which the
fracture line does not enter the joint space.

Open 聽 and Closed 聽 Fractures

A closed fracture is one in which the skin overlying the fracture site is
intact. An open fracture is one in which the skin over the fracture
site is broken. Open fractures may occur when a bone fragment from
within breaks out through the skin or when some outside force
penetrates both the skin and bone. The latter scenario has a poorer
prognosis, as there is often greater soft tissue damage and a greater
risk of contamination. Open fractrues are surgical emergencies, and
most require operative treatment.

Other Types of Fractures

Most of the fractures are caused by significant trauma. However

there are types of fractures are caused by insignificant trauma.
There may be several reasons to this.

Fractures resulting from trivial trauma because bone is weak, are

called 聽 insufficient fractures.