IV - B.S.

Occupational
Therapy

OT 5 STR: FX

March 09, 2012

FRACTURE
DEFINITION
An interruption and/or disruption on the normal continuity of the bone that results from
excessive force/stress or pathology that has weakened the bone.
1. Open/compound fx: a fx where there is communication with the outside
environment.
2. Closed/simple fx: a fx where there is no communication with the outside
environment.
ETIOLOGY
A. Pathologic fx: occurs in the bones weakened by preexisting d/s, either local or
general.
B .Traumatic fx
1.Direct: fx at the site of impact
2.Indirect: fx caused by a force transmitted to the bone from some parts of the body.
3.Muscular traction: fx caused by a sudden contraction of a mm.
PATHOPHYSIOLOGY
Specific Types Of Fracture
1. Avulsion fracture caused of tearing away of bone fragment due to pull of strong
ligamentous/tendinous attachment.
2. Butterfly fracture a center fragment of 2 disruptions creates a triangular effect.
3. Chauffers fracture involves the distal styloid process; produced by snapping/
twisting injury.
4. Chip fracture usually involves a bony process and near a joint (+) small
fragmental fracture.
5. Compression fracture causes compaction of bone trabeculae which results in
shortening the width or length of the bone.
6. Condylar fracture fracture of round end of hinge joint, usually involves the
femur and humerus.
7. Epicondilar fracture- involves the epicondyle.
8. Epiphyseal fracture epiphyseal slip fracture / Salter Harris fracture
Types
a. involving the growth plate
b. metaphysis forms a triangular shape

Karen Abinsay

Jet Duria

IV - B.S. Occupational
Therapy

OT 5 STR: FX

March 09, 2012

c. involves both epiphysis and metaphysis

d. involves both epiphyseal plate and metaphysis
e. crushed fracture in growth plate
9. Greenstick fracture / Hickory Stick fracture / Willow fracture / infraperiosteal
fracture frequent
in children; this is because the periosteal covering of
the childrens bone are not yet fully developed.
10. Smiths fracture / reverse Colles fracture volar displacement at the fracture
site.
11. Subcapital fracture involves the distal part of the head of the bone; usually
occurring in the Humerus.
12. Supracondilar fracture involves the area above the condyles of femur and
Humerus Radius.
13. Bartons fracture involves the distal articular surface of radius which may be
accompanied by dorsal dislocation of carpus of the radius.
14. Colles fracture transverse fracture of the lower 3rd of the radius accompanied
by a breaking off of the ulnar styloid process.
Dinner fork / silver fork deformity dorsal angulation and shortening result
in a hump of the wrist.
15. Dupuytrens fracture / Galleazis fracture fracture of distal radius with dislocation
of distal ulna.
16. Moores fracture involves distal radius associated with dislocation of ulnar head.
17. Piedmont fracture oblique fracture of distal radius with fragments pulled into the
ulna.
18. Ulna
19. Monteggias fracture involves proximal 3rd of shaft of ulna associated with radial
dislocation or disruption of annular ligament.
Metacarpal
20. Bennetts fracture involves the first metacarpal bone that runs obliquely through
the base of the bone and CMC joint.
21. Boxers fracture involves 1 or more MC bone specially the 4 th and 5th.
Carpal
22. Quevairs fracture involves navicular bone with lunate bone dislocation.
Pelvis
23. Malgains fracture superior and inferior pubic rami with fracture dislocation of
sacroiliac joint.
Femur

Karen Abinsay

Jet Duria

IV - B.S. Occupational
Therapy

OT 5 STR: FX

March 09, 2012

24. Pillion fracture - T-shape fracture of distal femur with displacement of condyles
posterior to femoral shaft
25. Panurels fracture involves femoral nock on proximal side.
Tibia
26. Cottons fracture / Tri-malleoli fracture - medial and lateral malleoli and posterior
lip of tibia
27. Paratrooper fracture - involve the distal tibia and malleolus.
Fibula
28. Potts fracture involves fibular fracture a few inch above the ankle sometimes
accompanied by fracture of medial malleolus.
29. Montereoux fracture - involves the fibula with associated with diastasis
(separation) of ankle mortis (talus, tibia,fibula)
Metatarsal
30. March fracture stress fracture of 1 or more metatarsal shaft due to excessive
marching spine
31. Jeffersons fracture - burst fracture of ring of atlas
32. Hangmans fracture posterior elements of cervical vertebra with anterior
dislocation of C2 and C3.

Stages Of Fracture Healing

1. Fracture Hematoma begins within 24 hours
2. Granulation Tissue Formation proliferation of young fibroblast and ingrowths of
loose meshwork of capillaries; 24 hours 72 hours
3. Callus Formation complex structure formed by the granulation tissue,
osteoblasts are the type of cells that proliferates in this stage; at the end of this
stage, the two ends move as one but is not strong enough to withstand any
stress. 3 14 days
4. Consolidation broken bone ends are bridged; there is already a well formed
bone; 2 6 weeks
5. Remodeling Final stage of healing where broken bone fragments are absorbed;
6 2 years

Types Of Union

Karen Abinsay

Jet Duria

IV - B.S. Occupational
Therapy

OT 5 STR: FX

March 09, 2012

1. Delayed Union Occurs when fracture fails to consolidate in the time required for
union to take place.
- Healing process is retarded, however, forming a firm union is still
possible in sufficient length of time.
2. Malunion Union in poor position
3. Non-Union Present when process of bone repair have ceased after having
failed to form a firm union.

Karen Abinsay

Jet Duria