Fracture and its classification

Hello students and friends, today we are going to discuss what is a fracture and its classification. So let's discuss first what is a fracture.
There are 206 bones in the body.
A fracture is a breach within the continuity of a bone.
Here we discuss different types of fractures according to their classification.

Types of fractures

The fracture can be classified as:

Based on Aetiology

Traumatic fracture

• A traumatic fracture is defined as a continuous fracture of bone due to trauma.
  
• Due to excessive force, the normal bone can break as in the case of an accident or when a person is hit by a heavy object.
• Traumatic fracture includes day to day practice fall.
• Fracture caused by a fall, road traffic accident, etc. is included in a traumatic fracture.

Pathological fracture-

• A pathological fracture is defined as a fracture of a bone which has been made weak by some underlying disease.

• This fracture is caused due to pathological factors, there is no force required to cause such type of fracture.

• For example fracture through a bone that gets weakened by metastasis.

• The most familiar cause of pathological fracture is osteoporosis.

• Some other factors are-

• Tumors

• Bone cyst

• Osteomyelitis

• Osteoporosis

• Rickets

Stress fracture-

a stress fracture is defined as the fracture occurring at a site in the bone which is subjected to repeated minor stresses/injury causing a break in bony trabeculae over a while.

• If there is a condition of osteoporosis but the person uses the bone repeatedly then the condition of stress fracture may occur.

• Repetitive force and overuse of bone may lead to a stress fracture and tiny cracks in the bone may occur.

• Pain is there but stress fracture may not be visible on X-Ray.

Based on displacements

Undisplaced fracture: there is a breakage of bone in which the bone remains aligned and these fractures are easy to identify by the absence of vital displacement.

Displaced fracture: there is a breakage in the bone in which the fragments are not aligned.

• In displaced fracture fragments are separated and fracture may be displaced.

Factors which are responsible for displacement are:

• Fracturing force

• Muscle pull on the fracture fragment

• Gravity

• Displacement of the distal fragment to the proximal fragment occurs.

The displacement can exist in the form of-

• Angulation

• Shift

• Rotation

Based on the association with the external environment

Open fracture: open fracture is defined as a fracture with a break in the overlying skin and soft tissue which then leads to the fracture communicating with the external environment.

• The open or compound fracture includes wounds that communicate with the fracture or where the fracture hematoma is exposed.

• Contamination occurs at the site where fracture hematoma is exposed.

Open lesions carry a higher risk of infection.

a) Internally open fracture- internally open fractures are sharp fracture end pierces the skin from within.

b) Externally open fracture- fracture by an object which tears the skin and soft tissue over the bone, as the object breaks then this fracture resulting in an open fracture.

Closed fracture: in closed fracture, the overlying skin and soft tissue structures are intact with each other and the fracture is not communicating with the external environment.

Based on the complexity of treatment

Simple fracture: simple fracture is easy to treat and it can be defined as a fracture in two pieces.

Eg. Transverse fracture of the humerus.

Complex fracture: complex fracture is usually difficult to treat and it can be defined as a fracture in multiple pieces.

Eg. Comminuted fracture of the tibia.

Based on the amount of force causing a fracture

High-velocity injury: These are fractures sustained as a result of severe trauma force, as in road traffic accidents.

• In these fractures, there is severe soft tissue damage (periosteal and muscle injury).

• Such fractures are often unstable, and slow to heal because there is extensive devascularisation of fracture ends.

Low-velocity injury: These fractures are sustained as a result of mild fracture force.

• For example when a person falls.
• These fractures often heal as expected because there is little soft tissue injury.
• Later, there is a change in the pattern of fracture due to shifting from low velocity to high-velocity injuries.
• More complex fractures are arises which are difficult to treat.

Based on pattern

Transverse fracture: In the transverse fracture, the line is perpendicular to the long axis of the bone.

• Tapping or bending force results in such type of fracture.

Oblique fracture: The fracture in which the fracture line is at an oblique angle to the long axis of the bone.

• Bending force results in such type of fracture.

Spiral fracture: An important form of oblique fracture in which the fracture line rotates along the long axis of the bone.

• In this fracture, the fracture line goes spirally in more than one plane.
• The primary twisting force results in such type of fracture.
• This fracture occurs secondary to the rotational force.

Comminuted fracture: In comminuted fracture, the bone is broken into many fragments.

• A comminuted fracture is caused by crushing or compression force along the long axis of the bone.

Segmental fracture: When there are two fractures in one bone, but these fractures are at a different level then the fracture is termed as a segmental fracture.

OTHER FRACTURES:

GREENSTICK FRACTURES: Fracture in the young bone of children.

MONTEGGIA FRACTURE- DISLOCATION: It is the fracture of the proximal third of the ulna with dislocation of the head of the radius.

SMITHS FRACTURE: This fracture happens in adults, at the cortico-cancellous junction of the distal end of the radius with ventral tilt and other displacements.

COLLE'S FRACTURE: This fracture occurs in adults, at cotico- cancellous junction of the ventral end of the radius with dorsal tilt and other displacements.

RONALDO FRACTURE: It is the fracture of the base of the 1st metacarpal.

MARCH FRACTURE: Fracture of the distal 1/3rd of the metatarsals head.

HANGMAN'S FRACTURE: It is a fracture through the pedicle and lamina of the C2 vertebra, with partial dislocation of C2 over C3, and sustain hanging.

POTT'S FRACTURE: In this fracture, one or both malleoli are affected.

MASSONIASE FRACTURE: Fracture of the ankle occurs, there is a fracture of the neck of the fibula.

Hope you all find this helpful for you, if you have any query related to this topic or any other topic then you all are free to contact me via contact us or you can also ask your doubts on the comment box. Thank you! 

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