This document provides an overview of fractures, including definitions, related terms, causes, clinical features, classifications, and the healing process. It defines a fracture as a break or disruption in bone continuity. Fractures are classified based on etiology, soft tissue involvement, displacement, fracture pattern, and number of bone fragments. The healing process involves hematoma formation, granulation tissue growth, callus formation, ossification, consolidation, and remodeling over several months.

1. FRACTURE

2. REVIEW
DEFINATION
RELATED TERMS
CAUSES
CLINICAL FEATURES
CLASSIFICATION
HEALING OF FRACTURE

3. DEFINATION
Fracture : A fracture is a break or disruption
in the continuity of bone or it is a disruption
of the normal architecture of the bone.

4. RELATED TERMS
Sub-laxation : A joint is subluxated when its
articular surfaces retain some contact
between them.
Dislocation : A joint is dislocated when its
articular surfaces are so much displaced
that they loose contact with each other.
Sprain : A injury to ligament is known as
Sprain.
Strain : Stretching of a muscle/ its
attachment is known as Strain.

5. CAUSES
• Common Causes Of Fractures:
Fall From A Height
Car Accidents
Direct Blow
Repetitive Forces
Pathology

6. CLINICAL FEATURES
• Signs and Symptoms
Swelling or tenderness
pain
Numbness
Bleeding
Broken skin with bone protruding
Limitation or unwillingness to move a limb

7. CLASSIFICATION
I. According to etiology
1. Traumatic Fracture
2. Pathological Fracture
II. Based On Soft Tissue Involvement:
1. Simple/Closed fracture
2. Open fracture/Compound fracture
III. According to displacement
1. Displaced Fracture
2. Undisplaced Fracture

8. CLASSIFICATION
IV. Based On Fracture Pattern:
1. Linear fracture
2. Transverse fracture
3. Oblique fracture
4. Spiral fracture
5. Compression fracture/Wedge fracture
6. Impacted fracture
7. Avulsion fracture
8. Segmental fracture
9. Greenstick fracture

9. CLASSIFICATION
V. Based On Fragments :
1. Complete Fracture
2. Incomplete Fracture
3. Comminuted Fracture

10. I. According to etiology
1. Traumatic 2. Pathological
1. Traumatic Fracture – Fracture sustained due
to trauma.
Eg .- Fractures caused by a fall , RTA.
2. Pathologic Fracture – A fracture through a
bone which has been made weak by some
underlying bone disease.
Eg .- A fracture through a bone weakened by
metastasis or Osteoporosis.

11. PATHOLOGICAL #

12. II. Based On Soft Tissue Involvement:
1. Simple/Closed fracture
2. Open fracture/Compound fracture
1. Simple/Closed fracture: Those in which the
overlying skin and soft-tissues are intact.
2. Open fracture/Compound fracture: Involve
wounds that communicate with the fracture,
or where fracture hematoma is exposed, and
may thus expose bone to contamination.
Open injuries carry a higher risk of infection.

14. III. According to displacement
1. Displaced 2. Undisplaced
1.Undisplaced : None or minimal displacement of fracture
fragments.
2.Displaced : Depending on fracturing force , muscle pull on the
fracturing fragments and the gravity, the displacement may be
 Translation
 Angulation
 Rotatation
While describing the displacements of fracture , conventionally , it
is the displacement of the distal fragment in relation to the
proximal fragment which is mentioned.

16. IV. Based On Fracture Pattern:
1. Linear fracture
2. Transverse fracture
3. Oblique fracture
4. Spiral fracture
5. Compression fracture/Wedge fracture
6. Impacted fracture
7. Avulsion fracture
8. Segmental fracture
9. Greenstick fracture
10.Torus fracture :

17. 1. Linear fracture : A fracture that is parallel to the bone's
long axis.
2. Transverse fracture: A fracture line is at right angle to the
bone's long axis. Caused by tapping or bending force.
3. Oblique fracture: A fracture that is diagonal to a bone's
long axis. Caused by bending force in addition to force along
longaxis of the bone.
4. Spiral fracture: A fracture where at least one part of the
bone has been twisted. Fracture line runs spirally in more
than one plane. Caused by twisting force.
5. Compression fracture/Wedge fracture: usually occurs in
the vertebrae , for example when the front portion of a
vertebra in the spine collapses due to osteoporosis where

18. 6.Impacted fracture: A fracture caused when bone
fragments are driven into each other.
7.Avulsion fracture: A fracture where a fragment of bone is
separated from the main mass.
8.Segmental fracture : In this there are two fractures in one
bone, but at different levels
9. Greenstick fracture : A greenstick fracture is a fracture in
a young, soft bone in which the bone bends and breaks
10. Torus fracture : Torus fractures, also known as buckle
fractures, are incomplete fractures of the shaft of a long
bone that is characterized by bulging of the cortex.

20. Compression #

21. V. Based On Fragments :
1. Complete Fracture 2. Incomplete Fracture 3. Comminuted Fracture
1.Incomplete fracture: A fracture in which the bone
fragments are still partially joined. In such cases,
there is a crack in the osseous tissue that does
not completely traverse the width of the bone
2. Complete fracture: A fracture in which bone
fragments separate completely.
3. Comminuted fracture: A fracture in which the
bone has broken into several pieces.

22. FRACTURE HEALING
 Fracture hematoma: when a fracture occurs, bleeding
creates a hematoma, which surrounds the ends of the
fragments. (within 72 hours)
 Granulation tissue : active phagocytosis absorbs the
products of local necrosis. The hematoma converts to
granulation tissue. Granulation tissue produces the basis
for new bone substance called osteoid ( days 3 to 14 )
 Callus formation : As minerals and new bone matrix are
deposited in the osteoid, an unorganized network of bone is
formed. It usually appears by the end of the second week
after injury. Evidence of callus formation can be verified by
x-ray.

23.  Ossification : Ossification of the callus occurs from 3
weeks to 6 months after the fracture and continues
until the fracture has healed. During this stage of
clinical union the patient may be allowed limited
mobility or the cast may be removed.
 Consolidation : As callus continues to develop, the
distance between bone fragments diminishes and
eventually closes. This stage is called consolidation,
and ossification continues. It can be equated with
radiologic union.
FRACTURE HEALING

24. • Remodeling : Excess bone tissue is
reabsorbed in the final stage of bone healing,
and union is completed. Gradual return of the
injured bone to its pre injury structural
strength and shape occurs. Radiologic union
occurs when there is x-ray evidence of
complete bony union. This phase can occur
up to a year following injury.
FRACTURE HEALING