Your SlideShare is downloading. ×
Classification of fractures in general
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Classification of fractures in general

740

Published on

fracture classifications in general orthopaedics

fracture classifications in general orthopaedics

Published in: Education
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
740
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
52
Comments
0
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1.  Define term the term fracture, dislocation and Subluxation  Identify the general causes, signs , symptoms of fractures  Classify the different types of fractures
  • 2. What is fracture(#)? common causes of fractures  Fall from a height  car accidents  Direct blow  Repetitive forces  Pathology a BREECH in the continuity of a bone
  • 3.  Swelling or OEDEMA  pain and tenderness  Numbness  Bleeding  Broken skin with bone protruding Limitation to move a limb Signs and Symptoms
  • 4. Why Classify? • As a treatment guide • To assist with prognosis • To speak a common language with other surgeons
  • 5. 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
  • 6. 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
  • 7. To Speak A Common Language • This will allow results to be compared • PROBLEM: Poor interobserver reliability with existing fracture classifications
  • 8. Intraobserver Reliability For a given fracture, each physician should produce the same classification
  • 9. CLASSIFICATION • Based on Relationship with the environment • Based on Displacement • Based on Fracture pattern • Based on Etiology
  • 10. CLASSIFICATION Based on relationship with the environment 1. CLOSED { Simple} 2. OPEN {Compound} – within _ without
  • 11. 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!
  • 12. Open Fractures • A break in the skin and underlying soft tissue leading to a communicating fracture hematoma
  • 13. Gustillo classification • The Gustillo classification is used to classify open fracture - ones in which the skin has been disrupted • Three grades that try to quantify the amount of soft tissue damage associated with the fracture Grade 1— <1cm wound Grade2 — >1cm wound Grade 3— subgrades A,B,C
  • 14. CLASSIFICATION Based on Displacement 1. UNDISPLACED 2. DISPLACED – • Initial impact • Pull of surrounding muscles / gravity
  • 15. 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
  • 16. Displacement - Angulation • Angulation is the amount of bend at a fracture described in degrees. Described with respect to the apex of the angle .
  • 17. Displacement - Shortening • Shortening is the amount a fracture is collapsed/ shifted proximally, expressed in centimeters.
  • 18. CLASSIFICATION Based on fracture pattern 1. Transverse 2. Oblique 3. Spiral 4. Comminuted 5. Segmental 6. Stellate
  • 19. Transverse Fracture A fracture in which the # line is perpendicular to the long axis of the bone . Oblique Fracture A fracture in which the # line is at oblique angle to the long axis of the bone. According to the Path of the # Line Fracture Types
  • 20. 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. According to the Path of the # Line Fracture Types
  • 21. Anatomical classification of fractures Fractures Comminuted # : The bone is broken into many fragments. Stellate fracture: This # occurs in the flat bones of the skull and in the patella, where the fracture lines run in various directions from one point.
  • 22. CLASSIFICATION Based on etiology 1. TRAUMATIC 2. PATHOLOGICAL
  • 23. CLASSIFICATION PATHOLOGICAL • --- Tumors • --- Bone cysts • --- Osteomyelitis • --- Osteoporosis • --- Osteogenesis imperfecta • --- Rickets etc
  • 24. AO/OTA Classification • Describing the fracture localization: bones and segments • 1Humerus • 2Radius/ulna • 3Femur • 4Tibia/fibula
  • 25. 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
  • 26. 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
  • 27. Anatomical classification of fractures Impacted fracture: This # where a vertical force drives the distal fragment of the fracture into the proximal fragment. Fracture Types Depressed fracture: This # occurs in the skull where a segment of bone gets depressed into the cranium.
  • 28. 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 Fracture Types Anatomical classification of fractures
  • 29. • 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
  • 30. History of Fracture Classification • 18th & 19th century – History based on clinical appearance of limb alone Colles Fracture Dinner Fork Deformity
  • 31. Salter-Harris Classification • Only used for pediatric fractures that involve the growth plate (physis) • Five types (I-V)
  • 32. Salter-Harris type I fracture • Type I fracture is when there is a fracture across the physis with no metaphysial or epiphysial injury
  • 33. Salter-Harris type II fracture • Type II fracture is when there is a fracture across the physis which extends into the metaphysis
  • 34. Salter-Harris type III fracture • Type III fracture is when there is a fracture across the physis which extends into the epiphysis
  • 35. Salter-Harris type IV fracture • Type IV fracture is when there is a fracture through metaphysis, physis, an d epiphysis
  • 36. Salter-Harris type V fracture • Type V fracture is when there is a crush injury to the physis
  • 37. What about CT scans & MRI ? • CT scanning can assist with fracture classification • Example: Sanders classification of calcaneal fractures
  • 38. What is Dislocation? Joints 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
  • 39. PIP Joint Subluxation Elbow joint Dislocation. Dislocation & Subluxation (Sample Radiographs)
  • 40. Thank You!

×