FRACTURES
Fractures are classified into different types based on the location and type of cut made to the bone. The terminology is very important in these cases so play close attention to the wording of the fractures, words such as open, closed , compound etc all have special meanings in orthopedics and require different treatments. The way the fracture axis splits the bone helps further classify fractures. Types include linear, oblique, transverse, longitudinal, and spiral fractures.
Types of Fractures
Comminuted fracture – the bone is shattered into small pieces. This implies that the bone is cracked completely into two separate pieces .
Simple fracture – or ‘closed’ fracture. The broken bone hasn’t pierced the skin.
Compound fracture – or ‘open’ fracture. The broken bone juts through the skin, or a wound leads to the fracture site. The risk of infection is higher with this type of fracture.
Compression fracture – occurs when two bones are forced against each other. The bones of the spine, called vertebrae, are prone to this type of fracture. Elderly people, particularly those with osteoporosis, are at increased risk. THESE ARE SEEN IN PATINTS WITH OSTEOPOROSIS, The Vertebral bones get compressed and break due to the fact the the bone is so brittle it breaks on its own weight.
Pathological fracture – bones weakened by various diseases () tend to break with very little force. These are due to diseases of the bone such as osteogenesis imperfecta
Greenstick fracture Is a special type of fracture where only one side of the bone is broken and the other side remains intact. Kind of like breaking a wet stick. ONLY ONE SIDE CRACKS the other remains intact.
Avulsion fracture – muscles are anchored to bone with tendons, a type of connective tissue. Powerful muscle contractions can wrench the tendon free, and pull out pieces of bone. COMMON IN KNEE AND SHOULDER JOINTS.
Stress Fractures- These are due to Low impact constant pressure and predominantly involve the lower extremities. They are due to over usage, classic example is a parade band person who complains of pain in his foot and X-rays are negative. The X-RAYS will usually not SHOW ANYTHING.
Fractures identification
Linear fractures- have a break that runs parallel to the bone’s main axis or in the direction of the bone’s shaft.
Oblique fracture- crosses a bone at approximately a 45° angle to the bone’s axis
transverse fracture- crosses a bone’s axis at a 90° angle.
longitudinal fracture – The fracture line extends along the shaft but is more irregular in shape and does not run parallel to the bone’s axis.
Spiral fractures- Are due to torsion or twisting forces which crossing a bone at an oblique angle, creating a spiral pattern. This break usually occurs in the long bones of the body such as the upper arm bone (humerus) or the thigh bone (femur).
Diagnosis
X-Ray involves at least two views of the area to confirm the presence of the fracture because not all fractures are apparent on a single x ray. Some fractures are often difficult to see and may require several views at different angles to see clear fracture lines. In some cases, CT, MRI or other imaging tests are required to demonstrate fracture. Sometimes, especially with children, the initial x ray may not show any fractures but repeat seven to 14 days later may show changes in the bone(s) of the affected area. If a fracture is open and occurs in conjunction with soft tissue injury, further laboratory studies are often conducted to determine if blood loss has occurred.
Tuning Fork Test In the event EXERCISE RELATED STRESS FRACTURES (micro-fractures due to excessive stress) ., a tuning fork can provide a simple, inexpensive test. The tuning fork is a metal instrument with a stem and two prongs that vibrate when struck. If an individual has increased pain when the tuning fork is placed on a bone, such as the tibia or shinbone, the likelihood of a stress fracture is high. Bone scans also are helpful in detecting stress fractures.
Treatment of Fractures
Just as there are different types of fractures there are various ways to treat them. Casting, Figure 8 Device, ORIF ( open reduction internal fixation ) , Closed Reduction External Fixation, etc. So it is important to know what treatment is used for what injury .
If you have questions concerning your specific case, contact us to schedule a 2nd opinion consultation with our expert orthothopedic surgeon.
