1. Define term the term fracture, dislocation and Subluxation
Identify the general causes, signs , symptoms of fractures
Classify the different types of fractures
2. What is fracture(#)?
common causes of
fractures
Fall from a height
car accidents
Direct blow
Repetitive forces
Pathology
a BREECH in the continuity of a bone
3. Swelling or OEDEMA
pain and tenderness
Numbness
Bleeding
Broken skin with bone protruding
Limitation to move a limb
Signs and Symptoms
4.
5. Why Classify?
• As a treatment guide
• To assist with
prognosis
• To speak a common
language with other
surgeons
6. As a Treatment Guide
• If the same bone is
broken, the surgeon
can use a standard
treatment
• PROBLEM: fracture
personality and
variation with
equipment and
experience
7. To Assist with Prognosis
• You can tell the
patient what to expect
with the results
• PROBLEM: Does not
consider the soft
tissues or other
compounding factors
8. To Speak A Common Language
• This will allow results
to be compared
• PROBLEM: Poor
interobserver
reliability with existing
fracture classifications
12. Closed Fractures
• Fracture is not exposed to the environment
• All fractures have some degree of soft tissue
injury
• Don’t underestimate the soft tissue injury as
this affects treatment and outcome!
13. Open Fractures
• A break in the skin
and underlying soft
tissue leading to a
communicating
fracture hematoma
14. Gustillo classification
• The Gustillo classification is used to classify open
fracture - ones in which the skin has been disrupted
• Three grades that try to quantify the amount of soft
tissue damage associated with the fracture
Grade 1— <1cm wound
Grade2 — >1cm wound
Grade 3— subgrades A,B,C
16. Displacement - Translation
• Translation is sideways
motion of the fracture -
usually described as a
percentage of movement
when compared to the
diameter of the bone -- ---
-------direction of distal
fragment decides
17. Displacement - Angulation
• Angulation is the
amount of bend at a
fracture described in
degrees. Described
with respect to the
apex of the angle .
18. Displacement - Shortening
• Shortening is the
amount a fracture is
collapsed/ shifted
proximally, expressed
in centimeters.
20. Transverse Fracture
A fracture in which the # line is
perpendicular to the long axis of the
bone .
Oblique Fracture
A fracture in which the # line is at oblique
angle to the long axis of the bone.
According to the Path of the # Line
Fracture Types
21. Spiral Fracture
A severe form of oblique fracture in
which the # plane rotates along the long
axis of the bone. These #s occur
secondary to rotational force.
According to the Path of the # Line
Fracture Types
22. Anatomical classification of fractures
Fractures
Comminuted # :
The bone is broken into many
fragments.
Stellate fracture:
This # occurs in the flat bones of the skull
and in the patella, where the fracture lines
run in various directions from one point.
26. AO/OTA Classification
• The identification of the respective segment
needs a little more consideration. Each long
bone has three segments:
• 1 Proximal end segment
• 2 Diaphyseal segment
• 3 Distal end segment
27.
28. CLASSIFICATION
Based on eponyms :
• Colles’ # :: Dinner fork deformity
• Monteggia # D/L :: # proximal 1/3 shaft ulna with
dislocation of head of radius
• Galeazzi # D/L :: # Distal 1/3 shaft Radius with
dislocation of distal radioulnar joint
• Jone’s # :: Avulsion # of base of 5th metatarsal
• Green stick # :: unicortical # with bent bones in
children
29. Anatomical classification of fractures
Impacted fracture:
This # where a vertical force drives the
distal fragment of the fracture into the
proximal fragment.
Fracture Types
Depressed fracture:
This # occurs in the skull where a
segment of bone gets depressed into
the cranium.
30. Avulsion fracture:
This is one, where a chip of bone is avulsed by the sudden and unexpected contraction
of a powerful muscle from its point of insertion,
Examples
1. ASIS Avulsion
2. JONE’S 5th MT base Avulsion
Fracture Types
Anatomical classification of fractures
31. • Stress fracture :
• It is a fracture occurring at a site in the bone subject to
repeated minor stresses over a period of time.
• Birth fracture:
• It is a fracture in the new born
children due to injury during
birth
32. History of Fracture Classification
• 18th & 19th century
– History based on
clinical appearance
of limb alone
Colles Fracture Dinner Fork Deformity
34. Salter-Harris type I fracture
• Type I fracture is
when there is a
fracture across the
physis with no
metaphysial or
epiphysial injury
35. Salter-Harris type II fracture
• Type II fracture is
when there is a
fracture across the
physis which extends
into the metaphysis
36. Salter-Harris type III fracture
• Type III fracture is
when there is a
fracture across the
physis which extends
into the epiphysis
37. Salter-Harris type IV fracture
• Type IV fracture is
when there is a
fracture through
metaphysis, physis, an
d epiphysis
38. Salter-Harris type V fracture
• Type V fracture is
when there is a crush
injury to the physis
39. What about CT scans & MRI ?
• CT scanning can
assist with fracture
classification
• Example: Sanders
classification of
calcaneal fractures
40. What is Dislocation?
Joints Dislocation
Is the total displacement of the articular end of a bone from the joint cavity.
Subluxation : Is an incomplete displacement.
Reduction : Is the restoration of the normal alignment of the bones.
Classification:
Dislocations are classified
as follows:
A. Congenital
B. Traumatic
C. Pathological
D. Paralytic
