Fractures #1

What is a Fracture?
A break in the continuity of the bone, which also results in damage to the surrounding soft tissue.

Types of fracture

Open fracture (compound) - where the surface wound communicates with the fracture itself, allowing for the possibility of contamination and infection.
Closed fracture - The skin or wound has an intact surface.
Intra-articular fracture
Extra-articular fracture
Displaced fracture
Undisplaced fracture

Transverse
Oblique
Spiral
Multifragmentary/Comminuted - >2 fragments
Avulsion - bony fragment torn off by tendon/ligament

Compression/Crush - crumpling of cancellous bone (calcaneum, vertebral)
Stress - repeated stress = bone fatigue
Greenstick - cortex has buckled on one side through bending rather than breaking, children
Pathological - fracture in a bone already weakened by disease. Through generalised bone disease (OP)/localised abnormality (mets)

OP fractures - *spine & femoral neck

Displacement of fractures
Impaction - fragments are driven into each other, causing shortening
Angulation/Alignment - fragments are in angle with each other. Describe in degrees & distal fragment,
Opposition - lateral displacement
Rotation - observed with mismatched widths of distal and proximal fragments.

Dislocation - complete loss of congruity between the articular surfaces of a joint.
Subluxation - partial loss of contact between two joint surfaces.

Fracture Healing

1) Bleeding into fracture
2) Inflammatory Reaction
3) Cell Proliferation, callus formed
4) Consolidation, lamellar bone
5) Remodelling under stress

Plastering
UL - 6 weeks
LL - 12 weeks