A fracture is a break in the bone caused by direct or indirect force. There are different types of fractures including complete, incomplete, transverse, oblique, and comminuted. Fractures can be displaced by forces of injury, gravity, muscles, or patient age. Symptoms include pain, swelling, deformity, and loss of movement. Treatment depends on the fracture and may include splinting, casting, traction, or surgery. A dislocation occurs when bones at a joint are no longer in proper contact, most commonly in the shoulder, elbow, thumb, or knee. Signs include deformity, pain, swelling, and loss of function. Treatment focuses on RICE (rest, ice, compression, elevation

1. FLT LT (DR) YKKS BANDARA
SCHOOL MEDICAL OFFICER
SLAF CTS - DIYATALAWA

2. What is a Fracture?
• BREAK IN THE STRUCTURAL CONTINUITY OF A BONE
• If the overlying skin remains intact – closed (simple fracture)
• If skin or one of the body cavities is breached - open (compound
fracture)

3. Types
• Complete
• Incomplete

4. Complete fracture
• Bone is split into two or more fragments
• Transverse
• Oblique
• Impacted
• Comminute

6. Incomplete fracture
• The bone is incompletely divided and the periosteum remains in
continuity
• Greenstick
• Compressed

8. How fractures are displaced
• Force of the injury
• Effects of gravity
• Pull of muscles attached to the site
• Age of the Patient

9. Mechanism of injury
• Injury
• Repetitive stress
• Pathological fractures

10. Injury
• Direct force - With a direct force, the bone breaks at the point of
impact; the soft tissues also are damaged
• Indirect force - the bone breaks at a distance from where the force is
applied

11. Some fracture patterns suggest the causal mechanism:
(a) spiral pattern (twisting);
(b) Short oblique pattern (compression);
(c) triangular ‘butterfly’ fragment (bending)
(d) transverse pattern (tension).

13. Stress fractures / Fatigue
• Occur in normal bone, subject to repeated heavy loading, typically in
athletes, dancers or military personnel
• Drugs like steroids and methotrexate

14. Pathological fractures
• Occurs in a bone that is made weak by some disease

15. Symptoms
• A history of injury, followed by inability to use the injured limb
• Pain
• Bruising
• Swelling
• Deformity
• Numbness or Loss of movement
• Difficulty with breathing

16. Bone Healing
• Primary - Surgical
• Secondary – Non Surgical

17. FACTORS AFFECTING BONE HEALING
• Age: Fractures unite faster in children
• Type of bone: Faster union in flat and cancellous bone
• Pattern of fracture: Spiral # > oblique # > transverse # > comminute #
• Disturbed pathoanatomic: soft tissue interposition and ischaemic #
prevent faster healing
• Type of reduction: good apposition of fracture results in faster healing
• Immobilisation: depends on the fracture site eg. Fracture ribs and
scapula do not require immobilisation
• Open fractures: often go into delayed union and non-union

18. Complications
• Organ Injuries
• Blood vessel Injuries
• Blood clots
• Nerve Injuries
• Tendon / Muscle injuries
• Infections
• Deformity
• Shortening of limbs
• Movements limitation

19. Treatment
• Assess
• Call for help
• Immobilize
• Splint
• POP Cast
• Traction
• Surgery if necessary

20. What is a Dislocation
• When the bones at a joint are no longer in proper contact
• Can be caused by severe twisting or indirect force, or even a muscular
contraction
• Most frequently dislocated joints
• Shoulder
• Elbow
• Thumb
• Finger
• Jaw
• Knee

21. Signs and Symptoms
• Deformity or abnormal appearance
• Pain and tenderness aggravated by movement
• Loss of normal function
• Joint may be locked in one position
• Swelling of the joint
• Redness

23. Treatment
• Stop the activity.
• Survey the injured area.
• First Aid if qualified.
• Get help if not.
• Determine if additional medical attention is necessary

24. •R - Rest
•I - Ice
•C - Compression
•E - Elevate

25. Further Treatment
• Splint
• Cast
• Traction
• Surgery if necessary