This document discusses fracture and dislocation, including definitions and radiological evaluation. It defines a fracture as a complete disruption of bone continuity and a dislocation as a complete disruption of a joint. The radiological evaluation of fractures considers the site, type, alignment, direction, and associated abnormalities. Common fracture types include complete, incomplete, transverse, oblique, and comminuted. Alignment is assessed for displacement, angulation, rotation, distraction, and foreshortening. Potential complications of fractures are also outlined.

1. FRACTURE AND
DISLOCATION
DR ANIL RATHVA M.D.
PROFESSOR AND HEAD OF
DEPARTMENT OF RADIOLOGY

2. FRACTURE AND DISLOCATION
•FRACTURE:- is a complete disruption in the
continuity of a bone. if only some of the bony
trabeculae are completely severed while others are
bent or remain intact then fracture is incomplete.
•DISLOCATION:-is a complete disruption of a joint;
articular surfaces are no longer in contact
•SUBLUXATION:-is a minor disruption of a joint
where some articular contact remains

3. COMPLETE FRACTURE

4. INCOMPLETE FRACTURE(GREEN STICK)

5. DISLOCATION

6. SUBLUXATION
Subluxation of third
MCP joint.

7. RADIOLOGICAL EVALUATIONOF FRACTURE
1)SITE AND EXTENT
•EPIPHYSIS
•METAPHYSIS
•DIPHYSIS
2)TYPE
•COMPLETE
•INCOMPLETE
3)ALIGNMENT
•DISPLACEMENT
•ANGULATION
•ROTATION
•DISTRACTION
•FORESHORTENING

8. 4)DIRECTION
5)SPECIAL FEATURES
•IMPACTION
•DEPRESSION
•COMPRESSION
6)ASSOCIATED ABNORMALITIES
•DISLOCATION
•DIASTASIS

9. 1) SITE
•Yellow arrow shows epiphysis
fracture
• white arrow shows metaphysis
fracture

10. DIPHYSIS FRACTURE

11. 2) TYPE
Left :- complete fracture
Right :- incomplete fracture

12. TRANSVERSE FRACTURE

13. OBLIQUE FRACTURE

14. SPIRAL FRACTURE

15. COMMINUTED FRACTURE

16. SEGMENTAL FRACTURE

17. COMPOUND FRACTURE(OPEN
FRACTURE)

18. 3)ALIGNMENT
Medial displacement

19. LEFT SHOWS:- DISLOCATION
RIGHT SHOWS:- DIASTASIS

20. SALTER HARRIS CLASSIFICATION
is useful classification of
injuries affecting the all
physis ,epiphysis ,
metaphysis

21. INDIRECT SIGN OF FRACTURE
1) SOFT TISSUE SWELLING
2)DISPLACEMENT OF FAT SRIPES
3)PERIOSTEAL AND ENDOSTEAL REACTION
4)JOINT EFFUSION
5)INTRACAPSULAR FAT - FLUID LEVEL
6)DOUBLE CORTICAL LINE
7)BUCKLING OF THE CORTEX
8)IRREGULAR METAPHYSEAL CORNERS

22. SOFT TISSUE SWELLING
All cases of acute fracture has radiographic evidence of soft tissue swelling
at the fracture site

23. BUCKLING OF THE CORTEX
Known as TORUS fracture.

24. FRACTURE HEALING
DEPENDS ON MANY FACTORS:
1)AGE
2)SITE
3)TYPE OF FRACTURE
4)POSITION OF FRAGMENTS
5)STATUS OF BLOOD SUPPLY
6)IMMOBILIZATION OR FIXATION
7)ASSOCIATED ABNORMALITIES –infection , osteonecrosis
Most fracture heal by endosteal and periosteal callus.
•PRIMARY UNION:- when blood supply is adequate
,undisplaced fractures and anatomically reduced fractures
immbolized with adequate compression heal by primary union.
•SECONDARY UNION:- displaced fractures ,not anatomically
aligned or with a gap between fragments heal by secondary
union.

25. RADIOGRAPHIC UNION :-As primary ,temporarily radiolucent callus is
gradually converted by the process of endochondral ossificatin to more
mature lamellar bone it is seen on films as dense bridge known as
radiographic union.

26. COMPLICATIONS
1)DELAYED UNION (FAIL TO UNITE WITHI 16 TO 18 WEEKS)
2)NON UNION
3)MAL UNION
4)PSEUDOARTHROSIS
5)DISUSE OSTEOPOROSIS
6)REFLEX SYMPATHETIC DYSTROPHY SYNDROME
7)VOLKMAN ISCHEMIC CONTRACTURE
8)POST TRAUMATIC MYOSITIS OSSIFICANS
9)OSTEONECROSIS
10)GROWTH DISTURBANCE
11)POSTTRAUMATIC ARTHRITIS
12)MAJOR VESSELS INJURY

27. THANK YOU