FRACTURE

DEFINITION
A fracture is a complete or incomplete break in the continuity of bone. This will be accompanied by varying degrees of injury to surrounding soft tissues.

WHAT CAUSES FRACTURE?

DIRECT TRAUMA

HARD HIT

ACCIDENTS FALL

INDIRECT TRAUMA

Pathologic glands osteoporosis

osteomyelitis

TWISTING FORCE

SEVERE TWISTING

OVER STRETCHING

FATIGUE AND STRESS

PROLONGED MARCHING

JOGGING

POWERFUL MUSCLE CONTRACTION

GRAND MAL SIZURE

GENERAL SIGNS AND SYMPTOMS

A. Break in the continuity of the bone cause:

1.BLEEDING

2. ABNORMAL MOBILITY

3. CREPITUS

-abnormal sound created due to friction of fractured area as the bones are moved

B. DISPLACEMENT OF FRAGMENT CAUSES:

1. DEFORMITY

2. LOSS OF FUNCTION

C. DAMAGE TO THE SOFT PART CAUSES:

1. SKIN WOUND

2. HEMATOMA

3. PAIN 3. SWELLING 4. PARALYSIS

CLASSIFICATION OF FRACTURES

BROAD CLASSIFICATION
A. CLOSED/SIMPLE FRACTURE

 when the break in the bone has no communication in the outside

B. OPEN/COMPOUND FRACTURE

 when the break in the bone comes out through the skin or there is communication of the bone to the outside

CLASSIFICATION AS TO EXTENT

COMPLETE

INCOMPLETE

CLASSIFICATION AS TO PATTERN

TRANSVERSE


OBLIQUE

SPIRAL

break that runs across the bone  break runs in slanting direction on bone  break coils around the bone

CLASSIFICATION AS TO APPEARANCE

GREENSTICK

FISSURED

COMMINUTED

 bone splintered and the breaks  is in incomplete, into fragments occurs at the convex surface of the bend in the bone  involves an incomplete longitudinal break

COMPRESSION

DEPRESSION

AVULSION

 A  is one inof bone, which is the the of  usually occurs in the skull, with site fragment which bone, typically a insertion of acollapsestendon or ligament, is broken bone muscle, on itself vertebra, driven inward detached as the result of excessive tension

CLASSIFICATION AS TO LOCATION

PROXIMAL

MEDIAL

DISTAL

CLASSIFICATION IN RELATION TO THE JOINT

Synovial fluid Joint capsule Head Articular cartilage

INTRA-CAPSULAR

Femur

Joint capsule

EXTRA-CAPSULAR

VARIOUS FRACTURES:
ITS CLINICAL MANIFESTATION AND MANAGEMENT

MANDIBULAR FRACTURES
FACIAL DISTORTION

MALOCCLUSION OF THE TEETH

FACIAL DISTORTION

TREATMENT
IMMOBILIZATION

INTERDENTAL WIRING

2-PC LORENZ SCREW

BARTONS BANDAGE

OPEN REDUCTION INTERNAL FIXATION

FRACTURE IN THE THORACIC CAGE TRUE RIBS

RESPIRATION PROBLEMS

HEMO/ PNEUMOTHORAX

HEMATOMA FALSE RIBS

TENDERNESS

TREATMENT
 CHEST

STRAPPING IS CONTRAINDICATED

It reduces respiratory expansion

 PULMONARY  STOVE-IN STOVE-

TOILET

CHEST TRACTION

Skeletal traction for multiple ribs fracture

FRACTURES OF THE UPPER EXTREMETIES AND SHOULDER GIRDLE HEAD OF THE

HUMERUS SCAPULAE

CLAVICLE

CLAVICLE FRACTURE

TRIANGULAR BANDAGE FALL WITH STRETCHED ARMS

CLAVICLE FRACTURE SHOULDER SPICA

FRACTURE OF THE HUMERUS

Anatomical neck Head Greater tubercle Surgical neck

Deltoid tuberosity shaft Groove for Radial nerve Posterior view Medial aspect Medial epicondyle Groove for ulnar nerve Lateral aspect Olecranon fossa Lateral epicondyle trochlea

HUMERUS

OPEN FRACTURE OF THE PROXIMAL HUMERUS

FRACTURE OF THE HUMERUS SHAFT

MELCH TYPE

SUPRACONDYLAR FRACTURE OF THE HUMERUS

TREATMENT
CASTING
Closed Fracture in the humerus shaft OPEN Fracture in the humerus shaft

HANGING CAST FUNCTIONAL CAST with callus formation

SUGAR TONG

TRACTION OVERHEAD TRACTION -Skeletal kind of traction used for supracondylar fracture of the humerus ZERO-DEGREE TRACTION -Skin kind of traction used for fracture of the neck of the humerus DUNLOPS TRACTION -skin traction used for supracondylar fracture of the humerus

FRACTURES OF THE RADIUS AND ULNA

GALLEAZI FRACTURE

COLLES FRACTURE

SMITH FRACTURE

BARTONS FRACTURE

FRACTURES OF THE SHAFT

TREATMENT

CASTING
    

LONG ARM CIRCULAR CAST SHORT ARM CIRCULAR CAST LONG ARM POSTERIOR MOLD SHORT ARM POSTERIOR MOLD MUNSTER CAST

PELVIC FRACTURES

MALGAIGNE FRACTURE

TREATMENT


CASTING
HIP SPICA
      

DOUBLE HIP SPICA 1-1/2 HIP SPICA SINGLE HIP SPICA DOUBLE HIP SPICA POSTERIOR MOLD 1-1/2 HIP SPICA POSTERIOR MOLD SINGLE HIP SPICA POSTERIOR MOLD FROG KCAST

TRACTION
SKIN TRACTION
  

BUCKS TRACTION HAMMOCK SUSPENSION BRYANTS TRACTION

SKELETAL TRACTION


BALANCED SKELETAL TRACTION

HOFFMANS EXTERNAL FIXATOR SCREWING

PLATING

FRACTURES OF THE FEMUR

GREATER TROCHANTER Head Lesser Trochanter Intertrochanteric Crest Gluteal Tuberosity

Intercondylar Fossa

Medial condyle

Lateral Condyle

FEMORAL NECK FRACTURE GARDENS CLASSIFICATION

 incomplete and nondisplaced

complete and partially displaced

complete and nondisplaced

 complete and totally displaced

INTERTROCHANTERIC FRACTURES EVANS CLASSIFICATION

SUBTROCHANTERIC FRACTURES RUSSEL-TAYLORS CLASSIFICATION

 FRACTURES DO NOT EXTEND INTO THE PINFORMIS FOSSA

 FRACTURES EXTEND INTO THE GREATER TROCHANTER AND INVOLVES THE PINFORMIS FOSSA

TYPE 1

TYPE 2

TREATMENT


CASTING
 

 

HIP SPICA QUADRILATERAL/ ISCHIAL WEIGHT BEARING BASKET CAST CAST BRACE

TRACTION


  

 

BALANCE SKELETAL TRACTION BRYANT S TRACTION BUCKS TRACTION 9090-90 DEGREE TRACTION BOOT LEG TRACTION RUSSEL TRACTION

FRACTURES OF THE LOWER LEG

POTTS FRACTURE

SHATZNERS FRACTURE

TREATMENT
 CASTING
 LONG LEG CIRCULAR CAST  SHORT LEG CIRCULAR CAST  LONG LEG POSTERIOR MOLD  SHORT LEG POSTERIOR MOLD  PATELLAR-TENDON PATELLARBEARING  WALKING CAST  DELVIT CAST  CYLINDRICAL CAST

1. HEMATOMA FORMATION

 the clot begins 24 hours  when a bone is fractured, after the fracture occurs. This blood extravagates into the clot serves as fibrin network area between and around the fragments and the bone marrow

CELLULAR PROLIFERATION

The combination of  takes place and periosteal elevationafterthe granulation tissue containing several days. blood vessel, fibroblast and osteoblasts produce a substance called osteoids

CALLUS FORMATION

After the following weeks, minerals are being deposited in the osteoid forming a large mass of differentiated tissue bridging the fractured called callus

OSSIFICATION

Final laying down of bone, is the stage in which fracture ends knit together

CONSOLIDATION

The primary cancellous When the consolidation is bone is remodelled, compact completed the excess cells bone being formed according to are absorbed stress patterns

COMPLICATIONS

Interruptions in the sequence of healing are caused by:

       

DEBRIDEMENT LACK OF VITAMIN D INFECTION LOSS OF CIRCULATION IMPROPER IMMOBILIZATION INADEQUATE FIXATION NECROSIS DUE TO FIXATION DEVICES METABOLIC DISTURBANCE

AVASCULAR NECROSIS
a joint is injured, as in a fracture or dislocation, the blood vessels may be damaged. This can interfere with the blood circulation to the bone and lead to traumatrauma-related avascular necrosis.
When

SIGNS AND SYMPTOMS

PAIN ON BEARING WEIGHT PAIN

CREPITUS ON ROTATION

TREATMENT
 

SURGICAL TREATMENT CONSERVATIVE TREATMENT

     

CORE DECOMPRESSION acids Medicines to reduced fatty  This surgical procedure removes the inner layer of bone, Reduced weight pressure within the bone, increases blood which reduces bearing Range ofto the bone,exercise more blood vessels to form flow motion and allows Electrical stimulation to induced bone growth OSTEOTOMY


This surgical procedure reshapes the bone to reduce stress on the affected area

BONE GRAFT

OTHER COMPLICATIONS
    

PNEUMONIA BED SORES INFECTION CONTRACTURES COMPRESSION SYNDROME