Essay 21- Fractures- general
What is a fracture?
- Any interruption in the integrity of a bone!
Types according to etiology
- Traumatic- occur under the influence of an external force
- Pathological- provoked by some disease
- Secondary to other pathology!
Quantitative differences
- Complete fracture- all layers of the bone are fractured - periosteum, corticalis and spongiosa
- Incomplete fracture- fracture line continues to a certain depth and does not completely interrupt the integrity of the bone - fissure
Qualitative differences
- Open fractures- the bone pokes through the skin and can be seen, or a deep wound exposes the bone through the skin
- Closed fractures- the bone is broken, but the skin is intact!
- Depending on location- diaphyseal, metaphyseal, intraarticular
- Depending on fragment position- dislocated, nondislocated
Mechanism of fractures
- Flexion mechanism: When 2 forces at the ends of a long bone are in the same direction occur which bend the bone like an arch,
- Torsion mechanism: Occurs during rotational twisting of one end of the bone towards the other parts of the bone, leaving a screw like fracture line on the bone
- Scissor mechanism: When 2 parallel forces act in opposite directions and they intersect to one another on points of the bone. They cause transverse fractures on the bone
- Fragmentary mechanism: occurs in the presence of pulling forces. When muscle is pulled from the areas of attachment (ligaments,
tendons etc), some bony particles may be ripped off
- Compression mechanism: When there is crushing of the spongy bone under the influence of a strong pressure.
- Impression mechanism: When the upper articular end is pressed against the lower articular end, the cartilage impresses in the underlying spongy bone
Types of fractures
- Avulsion Fracture- when a fragment of bone is separated from the main mass.
- Buckled Fracture (impacted)- ends are driven into each other; commonly seen in arm fractures in children.
- Comminuted Fracture: the bone breaks into several pieces.
- Compression or Wedge Fracture: usually involves the bones in the back (vertebrae).
- Greenstick Fracture: an incomplete fracture in which the bone is bent; occurs most often in children.
- Linear Fracture: the break is parallel to the bone’s long axis.
- Oblique Fracture: the break has a curved or sloped pattern.
- Pathologic Fracture: caused by a disease that weakens the bones.
- Spiral Fracture: one part of the bone has been twisted at the break point.
- Stress Fracture: a hairline crack.