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classificationof-140310050139-phpapp02

The document provides an overview of fractures, including their definitions, causes, signs, and symptoms. It discusses the classification of fractures based on various criteria such as relationship with the environment, displacement, fracture pattern, and etiology. Additionally, it covers dislocations and their classifications, emphasizing the importance of understanding fractures for treatment and prognosis.

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6 views31 pages

classificationof-140310050139-phpapp02

The document provides an overview of fractures, including their definitions, causes, signs, and symptoms. It discusses the classification of fractures based on various criteria such as relationship with the environment, displacement, fracture pattern, and etiology. Additionally, it covers dislocations and their classifications, emphasizing the importance of understanding fractures for treatment and prognosis.

Uploaded by

stroked064
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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CLASSIFICATION OF FRACTURE

By Prof. Dr. Rajeev Shukla


What is fracture(#)?
a BREECH in the continuity of a bone

common causes of
fractures:
 Fall from a height
 car accidents
 Direct blow
 Repetitive forces
 Pathology
Signs and Symptoms
 Swelling or OEDEMA
 pain and tenderness
 Numbness
 Bleeding
 Broken skin with bone protruding
 Limitation to move a limb
Why Classify?
• As a treatment guide
• To assist with
prognosis
• To speak a common
language with other
surgeons
As a Treatment Guide
• If the same bone is
broken, the surgeon
can use a standard
treatment
• PROBLEM: fracture
personality and
variation with
equipment and
experience
To Assist with Prognosis
• You can tell the
patient what to expect
with the results
• PROBLEM: Does not
consider the soft
tissues or other
compounding factors
Intraobserver Reliability

For a given fracture, each physician


should produce the same classification
CLASSIFICATION
• Based on Relationship with the environment
• Based on Displacement
• Based on Fracture pattern
• Based on Etiology
CLASSIFICATION

Based on relationship with the environment

1. CLOSED { Simple}
2. OPEN {Compound} – within
_ without
Closed Fractures
• Fracture is not exposed to the environment

• All fractures have some degree of soft tissue


injury

• Don’t underestimate the soft tissue injury as


this affects treatment and outcome!
Open Fractures

• A break in the skin and


underlying soft tissue
leading to a
communicating
fracture hematoma
CLASSIFICATION
Based on Displacement

1. UNDISPLACED
2. DISPLACED –
• Initial impact
• Pull of surrounding muscles / gravity
Displacement - Translation
• Translation is sideways
motion of the fracture -
usually described as a
percentage of movement
when compared to the
diameter of the bone --
----------direction of distal
fragment decides
Displacement - Angulation
• Angulation is the
amount of bend at a
fracture described in
degrees. Described
with respect to the
apex of the angle .
Displacement - Shortening
• Shortening is the
amount a fracture is
collapsed/ shifted
proximally, expressed
in centimeters.
CLASSIFICATION
Based on fracture pattern
1. Transverse
2. Oblique
3. Spiral
4. Comminuted
5. Segmental
6. Stellate
Fracture Types
According to the Path of the # Line

Transverse Fracture Oblique Fracture


A fracture in which the # line is A fracture in which the # line is at oblique
perpendicular to the long axis of the angle to the long axis of the bone.
bone .
Fracture Types
According to the Path of the # Line
Spiral Fracture
A severe form of oblique fracture in
which the # plane rotates along the long
axis of the bone. These #s occur
secondary to rotational force.
Fractures
Anatomical classification of fractures
Comminuted # : Stellate fracture:
The bone is broken into many This # occurs in the flat bones of the skull
fragments. and in the patella, where the fracture lines
run in various directions from one point.
CLASSIFICATION
Based on etiology

1. TRAUMATIC
2. PATHOLOGICAL
CLASSIFICATION
PATHOLOGICAL
• --- Tumors
• --- Bone cysts
• --- Osteomyelitis
• --- Osteoporosis
• --- Osteogenesis imperfecta
• --- Rickets etc
AO/OTA Classification
• Describing the fracture localization: bones
and segments

• 1Humerus
• 2Radius/ulna
• 3Femur
• 4Tibia/fibula
AO/OTA Classification
• The identification of the respective segment
needs a little more consideration. Each long
bone has three segments:
• 1 Proximal end segment
• 2 Diaphyseal segment
• 3 Distal end segment
CLASSIFICATION
Based on eponyms :
• Colles’ # :: Dinner fork deformity
• Monteggia # D/L :: # proximal 1/3 shaft ulna
with dislocation of head of radius
• Galeazzi # D/L :: # Distal 1/3 shaft Radius with
dislocation of distal radioulnar joint
• Jone’s # :: Avulsion # of base of 5th metatarsal
• Green stick # :: unicortical # with bent bones in
children
Fracture Types
Anatomical classification of fractures
Impacted fracture: Depressed fracture:
This # where a vertical force drives the This # occurs in the skull where a
distal fragment of the fracture into the segment of bone gets depressed into
proximal fragment. the cranium.
Fracture Types
Anatomical classification of fractures
Avulsion fracture:
This is one, where a chip of bone is avulsed by the sudden and unexpected contraction
of a powerful muscle from its point of insertion,
Examples
1. ASIS Avulsion
2. JONE’S 5th MT base Avulsion
• Stress fracture :
• It is a fracture occurring at a site in the bone subject to
repeated minor stresses over a period of time.

• Birth fracture:
• It is a fracture in the new born
children due to injury during
birth
What about CT scans & MRI ?
• CT scanning can
assist with fracture
classification
• Example: Sanders
classification of
calcaneal fractures
Joints Dislocation
What is Dislocation?
Is the total displacement of the articular end of a bone from the joint cavity.

Subluxation : Is an incomplete displacement.


Reduction : Is the restoration of the normal alignment of the bones.
Classification:
Dislocations are classified
as follows:
A. Congenital
B. Traumatic
C. Pathological
D. Paralytic
Dislocation & Subluxation
(Sample Radiographs)

PIP Joint Subluxation Elbow joint Dislocation.


Thank You!

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