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1. FRACTURE AND ITS CLASSIFICATIONS
Presenter-
Dr.Raunit Thakur
(PGY-1)
Orthopedics
Moderator
Asso.Prof. Dr. Mukesh pd.
Kushwaha

2. Objectives
 Definition
 Basic principle of classifications
 Types
 Conclusions

3. Fracture
Definition-a fracture is a break in the continuity of a bone

4. Why classify the fractures?
 To assist treatment guide
 To prognosticate the pathology
 To speak a universal common
language

5. CLASSIFICATION
 Based on relationship with external environment
 Based on displacement
 Based on etiology
 Based on complexity of treatment
 Based on force causing fracture
 Based on basis of site

6. Based on relationship with external environment
• Closed fracture-fracture not communicating with external
environment

7. 2.Open fracture: communication with external environment;
break in the skin and underlying soft tissue communicates
directly with the fracture and its hematoma

8.  Internally open: sharp fracture end pierces the skin from
within
 Externally open: object causing the fracture lacerates the
skin and soft tissues over the bone

9. OPEN FRACTURE CLASSIFICATION

10. Based on displacement
• Displaced fracture-factors responsible for
displacement are:
 Muscle pull on the fracture fragments
 The gravity
 The fracturing force

11. The displacement can be in the form of
• shift,
• angulations or
• rotation

12. • Undisplaced fracture-these fractures are easy to identify
by the absence of significant displacement

13. Based on etiology
• Traumatic
• Pathological
• Stress fracture

14. Based on complexity of treatment
• Simple fracture-fracture in two pieces, usually easy to treat
• Complex fracture: fracture in multiple pieces, usually
difficult to treat

15. Basis of force causing fracture
• High velocity force: fracture sustained as a result of severe
trauma force
• Low velocity force: fracture sustained as a result of mild
trauma force

16. Basis of fracture site
1. Epiphyseal fractures
2. Metaphyseal fracture
3. Diaphyseal fractures
 Proximal third
 Middle third
 Distal third
 Junctional fractures

17. Basis of pattern
• Transverse fracture: the fracture line is perpendicular to
the long axis of the bone
• Caused by tapping or bending

18. Basis of pattern
• Oblique fracture: fracture line is oblique to long axis of
bone
• Caused by bending force

19. Basis of pattern
• Spiral fracture: fracture line runs spirally in more than one
plane
• Caused by primarily twisting force

20. Basis of pattern
• Comminuted fracture: fracture with multiple fragements
• Caused by crushing or compression force

21. Basis of pattern
• Segmental fracture: there are two fractures in one bone,
but at different levels
• Fracture may have combinations of two or more patterns

22. • Impacted fractures: fractures where a vertical force drives
the distal fragment of the fracture into the proximal fragment

23. • Depressed fractures: fracture occurs in the skull where a
segment of bone gets depressed into the cranium

24. • Avulsion fracture: chip of bone is avulsed by the sudden
and unexpected contraction of a powerful muscle from its
point of insertion

25. AO classification system
• The first number relates to
the bone
(Humerus is 1, Radius and ulna
are 2, Femur is 3 and tibia and
fibula are 4)
The second number relates to
the position of the fracture on
the bone
(1 is proximal, 2 is diaphyseal , 3
is distal and 4 is malleolar)

26. AO classification system
• The position number is followed
by a letter which defines severity
of the fractures
 For proximal and distal fractures (type
1& 2):
- A is extra articular
- B is partial articular
- C is intra articular
 For diaphyseal fractures (type 2):
- A is simple fracture
- B is wedge or butterfly type
- C is communited fracture

27. Conclusion
 Fracture classification being a universal coding system,has
helped for global understanding about the disease
 Help to plan for management of specific features
 Preoperative counseling regarding morbidity and mortality to
patient has becomes much easy
 Improvising the old and giving new classification model is a
continuous process which increases the accuracy of outcomes

28. References
 Hand book of fractures
 Classifications of fractures and dislocation in orthopedics