This document provides an overview of orthopaedic trauma and fracture classification. It defines a fracture as a break in bone continuity and classifies fractures based on the fracture line (complete vs incomplete), appearance on radiology, mechanism of injury (direct vs indirect), bone fragment displacement (displaced vs undisplaced), communication with the external environment (closed vs open), and severity of soft tissue damage (Gustillo-Anderson classification for open fractures). The diagnosis involves a history, exam findings like pain, swelling and deformity, and investigations like x-rays, CT scans and MRIs. Management depends on whether the fracture is closed or open, with closed fractures often treated with closed reduction and casting while open fractures require debridement and may

1. ORTHOPAEDIC
TRAUMA
-General introduction
-Fracture classification
Dr. Anshu Sharma
Assistant Professor,
Dept. of Orthopaedics
GMCH,Udaipur

2. DEFINITION of FRACTURE –
A fracture is a break in the
continuity of bone (even a Single
cortex) with or without
displacement.

3. Classification:-
Based on fracture line:
-Complete,
-Incomplete
Incomplete usually occurs in children
-Periosteum in children is more thick and
strong than adult.
On radiology can be seen as
Greenstick fracture,
Torus fracture,
Hairline fracture.

4. Greenstick Fracture
of the radius and ulna .

5. Hairline Fracture

6. Incomplete Fractures

7. In adults complete fracture line leads
to complete loss of bone continuity.
➣ Trauma in adult produce fracture
line which result in to
-Transverse Fracture .
-Oblique Fracture.
-Spiral Fracture.
- Segmental F r a c t ure.
-Comminuted Fracture.

8. Transverse Fracture ObliqueFracture

9. Spiral Fracture
of the femoral shaft

10.  Based on etiology can be classified
as:-
-Traumatic fractures,
-Pathological fractures,
-Stress fractures,
-Fragility fractures.

11. Comminuted Fractures

12. Complete Fractures

13. According of mechanism of injury
➣Direct or indirect
➣Low or Height energy

14. A Direct blow (Bending Force) causes a
transverse fracture.

15. An indirect Twisting force causes a spiral fracture

16. Based on Bone Fragment
Displacement:
- Undisplaced Fractures,
- Displaced Fractures.

17. Fracture Displacements

18. Based on Communication with external
environment:
-Close Fracture:- No contact of Fracture
hematoma with external environment.
-Open Fracture:- Fracture hematoma is
in contact with external environment.

19. Gustillo Anderson Classification:-
G r a d e I : Wound 1cm or less and clean,
Fracture line transverse or oblique.
Grade II: Wound >1cm laceration, mild contamination,
Fracture line transversa, short oblique,
minimal comminution.

20. Grade III :
III-A:Extensive soft tissue damage,
Adequate Bone coverage,
Simple or Segmental fracture
III-B:Extensive soft tissue injury with
periosteal stripping and Bone exposed.
III-C: Any size of wound and any type of
fracture with Vascular injury.

21. Clinical Diagnosis
History of Trauma or RTA.
Complaints of Pain,
Swelling and
Deformity.
Systemic associated injury
-Neurological
-Abdominal
-Urology,
-Thorax.

22.  Local Sign :
-Look: Sweling, deformity, wound
-Feel: Tenderness, Crepitus, Pulse &
sensation.
-Move: Abnormal movement.

23. Investigations :
Laboratory:
-CBC,
-BT & CT,
-HHH.
Radiology:
-Xrays:-AP/Lateral/Oblique
-CT-Scan
- M R I

24. Management:
 ATLS Protocol: A, B, C.
 Closed Reduction and plaster
application.
 Open reduction with or without Internal
Fixation.

25. Management Open Fracture
Debridement:
-Wound cleaning by Pulse lavage,
-Surgery:Excise all dead and necrotic soft
tissue,
Remove all foreign body and
contamination.
TheGoal of treatment of an open fracture are
Prevention of infection,
Healing of the fracture and
Restoration of the function in the extremity.

26. Grade I – II after debridement
The bone can be fixed by internal fixation.
Grade III after debridement the bone can be
fixed by external fixation.
-Soft tissue closure may carried out immediately with
skingraft or flap(primaryrepair)
-if impossible to close the wound should be treated
by delayed repair.

30. Thank You.