This document discusses fractures, including their definition, causes, clinical features, types, principles of management, healing process, and complications. It defines a fracture as a break in bone continuity. The types of fractures covered are traumatic (closed, open, stress, birth), pathological (correctable and uncorrectable), and anatomical classifications based on the fracture line and bone involvement (transverse, oblique, spiral, longitudinal, comminuted, stellate, impacted, depressed, avulsion). The principles of fracture management focus on immediate first aid, transport, assessment, imaging, reduction, and immobilization techniques like external and internal fixation. Factors that can enhance or inhibit bone healing are also outlined. Potential complications are divided into immediate

1. FRACTURE & IT'S
MANAGEMENT
Dr. REDWAN MAHMUD
INTERN DOCTOR, 250 BEDDED GENERAL HOSPITAL,
NOAKHALI.

2. LEARNING OBJECTIVES
● Definition of fracture.
● Identify the general causes & clinical features of fracture.
● Classify different type of fracture.
● Discuss the general principles of management of fracture.
● Describe the role of radiography in the management of radiography.
● Process of fracture healing.
● Complications of healing.

3. DEFINITION OF FRACTURE
A break in the continuity of a bone or cartilage.
COMMON CAUSES OF FRACTURE
1. Fall from height.
2. Car Accident.
3. Direct blow.
4. Repetitive force.
5. Pathology

4. CLINICAL FEATURES OF FRACTURE
1. Swelling.
2. Pain or tenderness.
3. Numbness.
4. Bleeding.
5. Broken skin with bone protruding.
6. Limitations of movement.

5. TYPES OF FRACTURE
A.Traumatic fracture:
● Closed fracture: A closed fracture is one where the fracture
hematoma does not communicate with the outside.
● Open fracture : A closed fracture is one where the fracture
hematoma communicate with the outside.
● Stress fracture: It is a fracture occurring at a site in the bone subject
to repeated minor stress over a period of time.
● Birth fracture: It is a fracture in newborn children due to injury during
delivery.

6. TYPES OF FRACTURE
B.Pathological:
● Causes:
○ Correctable:
■ Renal osteodystrophy.
■ Hyperparathyroidism.
■ Osteomalacia.
○ Uncorrectable
■ Osteogenic imperfecta.
■ Postmenopausal osteoporosis.
■ Osteoporosis.
■ Paget disease.

7. TYPES OF FRACTURE
● According to the path of fracture line:
○ Transverse fracture:
○ Oblique fracture:

8. TYPES OF FRACTURE
● Spiral fracture. ● Longitudinal fracture :

9. TYPES OF FRACTURE
● Anatomical Classification of fracture:
○ Comminuted fracture
○ Stellate fracture.

10. TYPES OF FRACTURE
● Anatomical classification of fracture :
○ Impacted fracture.
○ Depressed fracture.

11. TYPES OF FRACTURE
● Anatomical classification of fracture :
○ Avulsion fracture:

12. PRINCIPLE OF MANAGEMENT
● Aims:
○ Safe life.
○ Save the limb.
○ Save the function.

13. PRINCIPLE OF MANAGEMENT
1. Efficient first aid.
2. Safe transport.
3. Assessment of condition.
4. Assessment of local condition.
5. Resuscitation.
6. Radiography of the affected part.
7. Reduction of fracture.
8. Immobilization.
a. External fixation.
b. Internal fixation.

14. FACTORS AFFECTING THE BONE HEALING
● Enhancing:
○ Youth.
○ Early immobilization of
fracture fragment.
○ Bone fragments contact.
○ Adequate blood supply.
○ Proper nutrition.
○ Adequate hormone:
■ GH.
■ Thyroxin.
■ Calcitonin.
● Inhibiting:
○ Age.
○ Extensive local soft
tissue trauma.
○ Bome loss due severity
of the fracture.
○ Inadequate
immobilization.
○ Infection.
○ Avascular necrosis.

15. FRACTURE COMPLICATIONS
● Immediate complication :
○ Hemorrhage.
○ Damage to the internal structure.
○ Skin.
○ Shock.
○ Nerve damage.

16. FRACTURE COMPLICATIONS
● Local complications:
○ Tissue necrosis.
○ Local wound infection.
○ Loss of alignment.
○ Delayed & malunion.
○ Joint stiffness.
● General complications :
○ Deep vein thrombosis.
○ Pulmonary embolism.
○ Osteoarthritis.
● Delayed complications