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FRACTURES DESCRIPTION |
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Fractures usually result from traumatic injury to a bone causing the
continuity of bone tissues or bony cartilage to be disrupted or
broken. Fracture classifications include simple, compound,
incomplete and complete. Simple (more recently termed closed
fractures) are not obvious on the surface as the skin has not been
ruptured and remains intact. Compound (now commonly referred to as
open fractures) rupture the skin, exposing bone and causing
additional soft tissue injury and possible infection. Single and
multiple fractures refer to the number of breaks in the same bone.
Fractures are termed complete if the break is completely through the
bone and described as incomplete or "greenstick" if the fracture
occurs partly across a bone shaft. This latter type of fracture is
often the result of bending or crushing mechanisms on the bone. Fractures are also named by the specific portion of the bone involved and the nature of the break. The identification of the fracture line can further classify fractures. Types include linear, oblique, transverse, longitudinal, and spiral fractures. Fractures can be further subdivided by the positions of bony fragments and are described as comminuted, non-displaced, impacted, overriding, angulated, displaced, avulsed, and segmental. Fractures line identification Linear fractures have a break that runs parallel to the bone's axis or direction of the bone's shaft. For example, a linear fracture of the arm bone could extend the entire length of the bone. Oblique and transverse fractures differ in that the oblique fracture crosses the bone at approximately a 45° angle to the bone's axis. In contrast, the transverse fracture crosses the bone's axis at a 90° angle. A longitudinal fracture is similar to a linear fracture. Its 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 described as crossing the bone at an oblique angle, creating a spiral pattern. This break usually occurs in the long bones of the body such as the arm bone (humerus) or the thigh bone (femur). Bony fragment position identification Comminuted fractures have two or more fragments broken into small pieces, in addition to the upper and lower halves of the fractured bone. Fragments of bone that maintain their normal alignment following a fracture are described as non-displaced. An impacted fracture is characterized as a bone fragment forced into or onto another fragment resulting from a compressive-type force. Overriding is a term used to describe bony fragments overlapping and shortening the total length of the bone. Angulated fragments result in pieces of bone being at angles to each other. A displaced bony fragment occurs from disruption of normal bone alignment with deformity of these segments separate from one another. An avulsed fragment occurs when bone fragments are pulled from their normal position by forceful muscle contractions or resistance from ligaments. Segmental fragmental positioning occurs if fractures in two adjacent areas happen with an isolated central segment. An example of segmental alignment is when the arm bone fractures in two separate places, with displacement of the mid section of bone. |
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