FXR, Fx, Fx, #

FRACTURE

Latin word, Frangere, to break Any disruption in the normal continuity of a bone Classified according to their character and location

Etiology and Risk Factors

Fx results from mechanical overload of the bone May result DIRECTLY or INDIRECTLY

Pathophysiology

Clinical Manifestations

DEFORMITY SWELLING BRUISING MUSCLE SPASM PAIN TENDERNESS LOSS OF FUNCTION ABNORMAL MOBILITY and CREPITUS NEUROVASCULAR CHANGES

Dx Evaluation

History taking Physical Examination RADIOGRAPHY

BEFORE fracture reduction, AFTER reduction,

periodically DURING bone healing

CT Scan

Fracture Classification
CLOSED FRACTURE: has intact skin over the site of injury OPEN FRACTURE: break in the over the bone injury

GRADE 1: wound is smaller than 1cm; contamination

is minimal GRADE 2: The wound is larger than 1 cm; contamination is moderate GRADE 3: wound exceeds 6 to 8cm; there is extensive damage to soft tissue, nerve and tendon; high degree of contamination *risk for infection

Different Types of Fracture

Appearance

BURST: -multiple pieces of bone -often occurs at bone ends or vertebrae COMMINUTED: -more than 1 fracture line; more than 2 bone fragments (may be splintered or crushed) COMPLETE: -break across the entire section of bone= two distinct fragments; often displaced

DISPLACED: -fragments out of normal position INCOMPLETE: -Fx only occurs through only one cortex of bone; usually non displaced LINEAR: -Fx line is intact; Fx is caused by a direct minor to moderate force

LONGITUDINAL: -Fx line extends in direction of bones longitudinal axis NONDISPLACED: -Fragments aligned at fx site OBLIQUE: -Fx line occurs at approximately 45 degree angle across longitudinal axis of bone

SPIRAL: -Fx line results from twisting force; forms a spiral encircling bone STELLATE: -Fx line radiate from one central point TRANSVERSE: -Fx line occurs at a 90 degree angle to longitudinal axis of bone

General Description
AVULSION: -Bone fragments are torn away from body of bone at site of attachment of a ligament or tendon COMPRESSION: -Bone buckles and eventually cracks as a result of unusual loading force applied to its longitudinal axis

GREENSTICK: -incomplete fracture in which one side of cortex is broken and the other side is flexed but intact IMPACTED: -telescoped fx, with one fragment driven into another

COLLES: -Fx w/in last inch of distal radius; distal fragment is displaced in a position of dorsal and medial deviation POTTs: -Fx of distal fibula, seriously disrupting tibiofibular articulation

Managemet