M2-FRACTURES

CLOSED FRACTURE

One where the skin is unbroken. There is less chance of infection

OPEN/COMPOUND FRACTURE

One in which the bone has broken the skin. This creates an open wound, through which bacteria can enter the body and cause an infection

COMPLETE FRACTURE

the fracture line extends all the way through the bone.  A complete fracture is considered to be an unstable fracture as there is a greater chance of the fragments dislocating.

INCOMPLETE FRACTURE

the fracture line does not extend through the entire thickness of the bone.  The bone is broken only on one side, causing buckling or bending which results in an angular deformity.

DISPLACED FRACTURE

the fracture fragments have moved away from one another.

UNDISPLACED FRACTURE

the bone fractures but the fragments do not separate.

AVULSION FRACTURE

DESC: occurs at the corners or in the areas of soft tissue attachment of a long bone, at the ligament insertion point.

ETI: occurs when a portion of the bone is torn away by a muscle or ligament at the point of attachment, that is, by a forceful contraction of the muscle or ligament on the bone.

TREAT: Immobilization of the injured part until the fracture is healed. Surgical pinning may be required to stabilize the fragment and prevent it from moving.

COMP: The fragment can impinge a nerve or blood vessel

BLOWOUT FRACTURE

DESC: fractures of the orbital floor.

ETI: occur when blunt force trauma is applied to the face

TREAT: surgery is required to repair the bone and stabilize the pressure in the eye

COMP: Infection, diplopia (double vision), scarring of muscles of the eye

COMMINUTED FRACTURE

DESC: fracture in which the bone has been broken into multiple fragments.

ETI: Trauma due to axial loading.

TREAT: Surgical intervention is required to stabilize the fragments.

COMP: Poor healing can be a result due to the many fracture lines.

COMMINUTED T AND Y FRACTURE

DESC: seen as intercondylar fractures of the distal humerus and distal femur.

ETI: Trauma to the area by high energy forces or direct blows,

TREAT: Surgical intervention is often required to realign and stabilize the fragments.

COMP: Deformity of the bone from poor apposition of fragments. Vascular and/or nerve damage.

MULTIPLE FRACTURES

DESC: When there is more than one fracture separated by normal bone, and the fractures are all a result of the same injury

ETI: Trauma

TREAT: Surgical intervention is often required to stabilize the fragments.

COMP: Poor healing can be a result due to the many fracture lines.

CONTRECOUP FRACTURE

DESC: usually seen in the pelvis, tibia, skull and mandible, in conjunction with an initial injury

ETI: occurs at the site opposite the point of initial injury or site of impact

TREAT: Surgical intervention is often required.

COMP: Poor healing and deformity of bone.

DISPLACED FRACTURE

DESC: one in which the fragments are not aligned.

ETI: Trauma to the area.

TREAT: A reduction is required to re-align bony fragments and immobilization is required to maintain good apposition. Surgical intervention may also be indicated.

COMP: Deformity of the bone resulting in shortening of the limb and decreased mobility.

STRESS FRACTURE

DESC: Seen where there is a repetitive strain on the bone. These types of fractures are usually seen in athletes.

ETI: result of microfractures caused by repetitive movements. They are usually found in weight bearing bones.

TREAT: Reduction in repetitive activity.

COMP: Ongoing pain. Poor healing. Early onset of arthritis.

DEPRESSED FRACTURE

DESC: one whereby a piece of bone is pushed inward or indented

ETI: results of an impaction injury.

TREAT: Surgical intervention is required.

COMP: Fragments can affect nerves and blood vessels and even cause soft tissue damage.

IMPACTED FRACTURE

DESC: one portion of the bone is driven into its adjacent segment

ETI: Trauma or fall.

TREAT: Reduction of the fracture and immobilization of the injured part.

COMP: Poor healing and/or deformity of the bone.

LINEAR FRACTURE

DESC: one in which the fracture line is parallel to the long axis of the bone

ETI: Trauma

TREAT: Immobilization of the part.

COMP: Poor healing of fracture site.

LONGITUDINAL FRACTURE

DESC: the fracture line runs along the shaft, not parallel to LA of bone

ETI: Trauma

TREAT: Immobilization of the part.

COMP: Poor healing of fracture site.

TRANSVERSE FRACTURE

DESC: one in which the fracture line is at 90 degrees to the long axis of the bone.

ETI: Trauma

TREAT: Immobilization of the fracture site.

COMP: Poor healing. Deformity of the bone.

OBLIQUE FRACTURE

DESC: Any fracture line which runs at an angle over 25 degrees

ETI: Trauma

TREAT: Immobilization of the fracture is required.

COMP: Poor healing of the fracture.

SPIRAL FRACTURE

DESC: These are fractures in which the fracture line is helical around a long bone

ETI: Trauma caused by rotational force. For example, a skier who falls and their ski rotates forcefully causing a twisting motion

TREAT: Surgical intervention is usually required to provide good apposition of the fragments.

COMP: Deformity of the bone, fragments can cause further damage to nerves, blood vessels and soft tissues

STELLATE FRACTURE

DESC: fracture lines radiating from a central point of impact

ETI: Trauma; usually a direct blow to the bone.

TREAT: Surgical intervention is usually required. If the patella is overly fragmented, the surgeon may remove it

COMP: Fracture fragments can impinge on nerves and blood vessels and cause further damage

PATHALOGICAL FRACTURE

DESC: A fracture of the bone which already has been affected by a pathological disease

ETI: Trauma

TREAT: Depends on location of the fracture. Usually, surgical intervention is required

COMP: Ongoing pain. Decreased mobility and deformity of long bones.

ARTICULAR FRACTURE

DESC: Identified by its location, involves a joint

ETI: Trauma

TREAT: Reduction if required and immobilization of the fracture site.

COMP: Fractures which involve the joint space can result in post-traumatic arthritis.

SUPRACONDYLAR FRACTURE

DESC: Involves the area between condyles of femur and humerus

ETI: Femoral injury is from impact to bent knee, humeral is result of trauma or falling

TREAT: Surgical intervention is usually required.

COMP: Poor healing and deformity of the bone.

TORUS/BUCKLE FRACTURE

DESC: incomplete fracture of a long bone which results in buckling or folding and is the most common pediatric fracture type

ETI: The mechanism of injury is a FOOSH or a direct trauma to the forearm.

TREAT: Immobilization with a short arm cast.

COMP: None

GREENSTICK FRACTURE

DESC: The long bone is bent but does not break completely

ETI: The mechanism of injury is a FOOSH or a direct blow to the arm

TREAT: Manual manipulation to ensure alignment of fracture fragments. Immobilization of the injured part, usually a cast.

COMP: These fractures tend to heal well and are seen primarily in children under 10 years of age.

BOW/PLASTIC DEFORMITY

DESC: seen in the long bones of children and results in a bowing or bending deformity

ETI: The mechanism of injury is a force applied to the long bone that bends the bone.

TREAT: Immobilization with a cast.

COMP: None.

EPIPHYSEAL FRACTURE

DESC: There is a high incidence of this type of fracture in children over 10 years old. As a result, it is often considered a “teenage colles fracture” that can disrupt the growth pattern.

ETI: FOOSH — a fall on an outstretched hand.

TREAT: Reduction and immobilization

COMP: Deformity of the bone and possible mal-union. Nerve damage.

SALTER-HARRIS 1

DESC: there is complete separation of the epiphyseal plate due to a transverse fracture through the epiphyseal plate (or growth plate).

ETI: Trauma. Six percent of Salter-Harris fractures in young children

TREAT: Reduction and immobilization of fracture site.

COMP: Rare

SALTER-HARRIS 2

DESC: a fracture through the growth plate and metaphysis with a small triangular fragment of the metaphyseal base, creating a “corner sign”.

ETI: Trauma. This is the most common type of Salter-Harris fracture – 75%

TREAT: The prognosis is good for this type of fracture and treatment is usually closed reduction with immobilization.

COMP: Rare. Problems with the growth plate if any.

SALTER-HARRIS 3

DESC: one which has a fracture through the epiphysis with another horizontal fracture through the epiphyseal plate. There is a partial separation of the epiphysis and there is articular involvement

ETI: Trauma. This type of fracture occurs in 8% of fractures.

TREAT: Closed reduction with immobilization usually gives good outcomes.

COMP: Rare. Problems with the growth plate if any.

SALTER-HARRIS 4

DESC: vertical fracture through the epiphysis, the epiphyseal plate and the metaphysis. It is a combination of type 2 and type 3.

ETI: Trauma. There is a 10% incidence of these fracture types.

TREAT: An effective reduction is required to avoid premature physeal fusion. Sometimes surgical repair is required to improve the outcome.

COMP: Premature physeal fusion.

SALTER-HARRIS 5

DESC: there is a compression injury to the epiphyseal plate and blood supply.

ETI: Trauma. 1% of fractures

TREAT: Treatment choices depend on the extent of the injury. If the bone is angled, then realignment is required. The extent of damage to the growth plate has to be evaluated to determine further treatment

COMP: Problems with premature fusion of growth plate. Limb shortening results.