it is a short description of fracture according to modern medicine and Unani medicine

1. Dr. MSM Shiffa

2. Definitions
 A fracture is a break in the continuity of a bone

3. Types
Fractures may be transverse, oblique or spiral in shape.
 In a greenstick fracture, only one side of the bone is
fractured, the other simply bends (usually immature
bones).
 A comminuted fracture is one in which there are more
than two fragments of bone.
 In a complicated fracture, some other structure is also
damaged (e.g. a nerve or blood vessel).
 In a compound fracture, there is a break in the
overlying skin (or nearby viscera) with potential
contamination of the bone ends.
 A pathological fracture is one through a bone weakened
by disease, e.g. a metastasis.

4. Common causes
 Fractures occur when excessive force is applied to a
normal bone
 or moderate force to a diseased bone, e.g. osteoporosis

5. Clinical features
• Pain.
• Loss of function.
• Deformity, tenderness and swelling.
• Discoloration or bruising.
• (Crepitus, not to be elicited!)

6. Investigations
• Radiographs in two planes (look for lucencies and
discontinuity in the cortex of the bone).
• Tomography, CT scan, MRI scan (rarely).
• Ultrasonography and radioisotope bone scanning.
(Bone scan is particularly useful when radiographs/CT
scanning are negative in clinically suspect fracture.)

7. Complications
Early
• Blood loss.
• Infection.
• Fat embolism.
• DVT and PE.
• Renal failure.
• Compartment syndrome.

8. Late
• Non-union.
• Delayed union.
• Malunion.
• Growth arrest.
• Arthritis.
• Post-traumatic sympathetic (reflex) dystrophy.

9. ESSENTIAL MANAGEMENT
General
• Look for shock/haemorrhage and check ABC
• Look for injury in other areas at risk (head and spine,
ribs and pneumothorax, femoral and pelvic injury).

10. The fracture
Immediate
• Relieve pain (opiates i.v., nerve blocks, splints,
traction).
• Establish good i.v. access and send blood for group and
crossmatch.
• Open (compound) fractures require debridement,
antibiotics and tetanus prophylaxis.

11. Definitive
• Reduction (closed or open).
• Immobilization (casting, functional bracing, internal
fixation, external fixation, traction).
• Rehabilitation (aim to restore the patient to pre-injury
level of function with physiotherapy and occupational
therapy).

12. Kasar
 It is a tafarruk-e-itisal of a bone, i.e. discontinuity of
the bone
 One bone is broken into two or more pieces

13. Asbab
 Asbab-e-Sabiqa
Cause in the bone itself
 Asbab-e-Waasila
External impact

14. Asbab-e-Sabiqa
 Structure and the location of the bone
 Dominant side
 Long bone
 Thin bone
 Close to the body surface
 Age
 2-4 yrs, 5-6 yrs, 55- 80 yrs
 Sex
 2-5 more in girls, 5-15 Boys, elderly - females
 Diseases
 Niqras, Sartan, Khanazir, bone diseases

15. Asbab-e-Waasila
 External Impact
 Direct Fracture
 Indirect Fracture
 Muscle action

16. Types
 Kasar baseet – Simple #
 K. muraqqab – Compound #
 K. Mustaqeem – Direct
 K. munharif – Indirect
 K. Kamil – Complete
 K. Naqis – Incomplete
 K. Juzu’ee – Partial
 K. Suqubi – Perforated
 K. Inkhifazi – depressed
 K. inshiqaqi – fissured/ cracked
 K. mutauddad – comminuted
 K. qaleel – small
 K. azeem - large

17. Usool-e-Ilaj
 Splinting
 Reduction
 Immobilisation
 Maintaining Nutrition
 Fasad
 Mulayyint
 Muhallilat
 Musakkinat

18. Ilaj
 Ghiza
Galeez and lazjat producing food (thick and viscous)
 Goat
 Calf leg
 Cow’s fat
 Egg
 Rice
 Fresh fish
 Galeez sharab
Do not give barid sabziyan, bird’s flesh, baby goat’s
mutton in the initial stage

19. K. qaleel
 Light massage
 Oil application – R.gul
 Zimad
 Bandage – not too tight
 Safoof-e-as

20. Kasar Azeem
 Rabat/ Bandaging
 3-4 layers of bandage
 1st – on the # site
 2nd – distal to proximal
 3rd- keep small stick and apply third layer
 If it is necessary 4th layer can be applied
Every day bandage can be changed if pain exist or open
wound is there otherwise every other day
 Apply zimad
 Mom zard khalis 35 g