3 Common Fractures: Comminuted, Spiral, and Greenstick

2. 3 Common Fractures

3. 3 Common Fractures

4. 3 Common Fractures

5. 3 Common Fractures

6. 3 Common Fractures
and what you need to know about them!
By: Casey Bishop

7. Spiral Fractures

8. Spiral Fractures
AKA a torsion fracture

9. Spiral Fractures
AKA a torsion fracture
Results from opposing torque
applied along the axis of the
bone and compression

10. Spiral Fractures
AKA a torsion fracture
Results from opposing torque
applied along the axis of the
bone and compression
Common sports injury or
possible sign of abuse in
children (arm fxs, specifically)

11. Spiral Fractures
AKA a torsion fracture
Results from opposing torque
applied along the axis of the
bone and compression
Common sports injury or
possible sign of abuse in
children (arm fxs, specifically)
Looks similar to oblique
fractures until x-rays are
taken

12. Spiral Fxs (Cont.)

13. Spiral Fxs (Cont.)
Most common in the lower leg

14. Spiral Fxs (Cont.)
Most common in the lower leg
Very slow to heal, 6+ months

15. Spiral Fxs (Cont.)
Most common in the lower leg
Very slow to heal, 6+ months
Varied treatment depending
upon:
severity of injury
number of bones affected

16. Spiral Fxs (Cont.)
Most common in the lower leg
Very slow to heal, 6+ months
Varied treatment depending
upon:
severity of injury
number of bones affected
Surgical repair and fixation of
bone is often needed

17. Spiral Fxs (Cont.)
Most common in the lower leg
Very slow to heal, 6+ months
Varied treatment depending
upon:
severity of injury
number of bones affected
Surgical repair and fixation of
bone is often needed
Casts are also common

18. Comminuted Fractures

19. Comminuted Fractures
AKA multi-fragmentary fractures

20. Comminuted Fractures
AKA multi-fragmentary fractures
Fx in which bone is shattered or
crushed into many pieces

21. Comminuted Fractures
AKA multi-fragmentary fractures
Fx in which bone is shattered or
crushed into many pieces
At least three pieces to be
considered comminuted

22. Comminuted Fractures
AKA multi-fragmentary fractures
Fx in which bone is shattered or
crushed into many pieces
At least three pieces to be
considered comminuted
Common amongst elderly patients
and as a pathological fx

23. Comminuted Fractures
AKA multi-fragmentary fractures
Fx in which bone is shattered or
crushed into many pieces
At least three pieces to be
considered comminuted
Common amongst elderly patients
and as a pathological fx
Osteogenesis imperfecta and
certain osteomas are common
pathological culprits

24. Comminuted Fxs (Cont.)

25. Comminuted Fxs (Cont.)
High incidence of open fxs which
leads to risk of infection

26. Comminuted Fxs (Cont.)
High incidence of open fxs which
leads to risk of infection
Surgical repair and fixation of
bones almost always necessary

27. Comminuted Fxs (Cont.)
High incidence of open fxs which
leads to risk of infection
Surgical repair and fixation of
bones almost always necessary
Extremely long healing process
(6+ months) that is heavily
monitored by one’s physician due
to many potential complications
such as:

28. Comminuted Fxs (Cont.)
High incidence of open fxs which
leads to risk of infection
Surgical repair and fixation of
bones almost always necessary
Extremely long healing process
(6+ months) that is heavily
monitored by one’s physician due
to many potential complications
such as:
non-union of bone tissue

29. Comminuted Fxs (Cont.)
High incidence of open fxs which
leads to risk of infection
Surgical repair and fixation of
bones almost always necessary
Extremely long healing process
(6+ months) that is heavily
monitored by one’s physician due
to many potential complications
such as:
non-union of bone tissue
vascular necrosis

30. Comminuted Fxs (Cont.)
High incidence of open fxs which
leads to risk of infection
Surgical repair and fixation of
bones almost always necessary
Extremely long healing process
(6+ months) that is heavily
monitored by one’s physician due
to many potential complications
such as:
non-union of bone tissue
vascular necrosis
compartment syndrome

31. Greenstick Fractures

32. Greenstick Fractures
AKA a torus fracture

33. Greenstick Fractures
AKA a torus fracture
Discovered by British-
American orthopedist, John
Insall, and Polish-American
orthpedist, Michael Slupecki

34. Greenstick Fractures
AKA a torus fracture
Discovered by British-
American orthopedist, John
Insall, and Polish-American
orthpedist, Michael Slupecki
Named for its resemblance to
the behavior of green (or
fresh) wood

35. Greenstick Fractures
AKA a torus fracture
Discovered by British-
American orthopedist, John
Insall, and Polish-American
orthpedist, Michael Slupecki
Named for its resemblance to
the behavior of green (or
fresh) wood
Common among children, as
their bones have not yet fully
calcified

36. Greenstick Fxs (Cont.)

37. Greenstick Fxs (Cont.)
Three types

38. Greenstick Fxs (Cont.)
Three types
Bow (curves along
longitudinal axis)

39. Greenstick Fxs (Cont.)
Three types
Bow (curves along
longitudinal axis)
Impaction (buckling fx)

40. Greenstick Fxs (Cont.)
Three types
Bow (curves along
longitudinal axis)
Impaction (buckling fx)
Transverse (in the cortex of
the bone)

41. Greenstick Fxs (Cont.)
Three types
Bow (curves along
longitudinal axis)
Impaction (buckling fx)
Transverse (in the cortex of
the bone)
Usually treated by casting or
splinting, though the fx is not
always noticeable