Classification of fractures
Fracture
- Break in one cortex which exists from the opposite cortex
- Soft tissue envelope in which there happens to be a bone that is broken
- Intact skin - closed
- Torn skin - open (compound), high risk of infection, non-union of bone
| Force applied | Fracture characteristic |
|---|---|
| Twisting | Short spiral/oblique fracture line |
| Bending | Transverse fracture with a third fragment (bending wedge) |
| High energy | Comminuted fracture with many |
- Look at x-rays to learn about the personality of fracture
- How fracture occurred
- Leads to optimal management for healing of bone and soft tissues
- Predictions of final outcome (prognosis)
- Compare outcome with other surgeons
Personality
- What bone
- What sort of fracture
AO classification
- Fixing fractures > treating in plaster casts
- Arbeitsgemeinschaft für Osteosynthesefragen
- Commonly fractures bones numbered (1 is most common):
- Humerus
- Forearm
- Femur
- Tibia
- Spine
- Pelvis
- Hand
- Foot
- Where was it fractured:
- Top (proximal)
- Middle
- Bottom (distal)
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Type of fracture
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A - simple (side to side), B - wedge (3 parts), C - complex (oh)
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Used for research purposes mostly
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Don't need to learn this thanks
X-ray
- Must read the name of patient
- With the patient and their wrist band, confirm date of birth
- Read hospital number
- Date of x-ray
- Part of region - left or right
- Standing or weight bearing
Ankle fractures
- Below syndesmosis - in plaster, no operation
- At or above syndesmosis - operation is best
Femoral fractures
- Intertrochanteric or per trochanteric - red zone
- Any fracture from greater to lesser trochanter is an intertrochanteric fracture
- Sub capital/intracapsular - blue zone
- Grade I/II - undisplaced or minimal
- Grade III/IV - displaced, replace femoral head
- Deep femoral artery
- Medial/lateral circumflex femoral artery
- Retincular vessels supply femoral head
- Artery in ligamentum teres small - insignificant in adults
- Reduce and fix with dynamic hip screw for all ages
Young and elderly
- Young: emergency for all grades, operating theatre within 6 hours
- Careful reduction
- Reduced perfectly
- Elderly: operate within 6 hours
Salter-Harris fractures
- In children
| Mneumonic | Fracture |
|---|---|
| Straight |  |
| Above |  |
| Below |  |
| Through |  |
| Crushed |  |