Classification of Fractures

Question 1

What are the basic steps in classifying a fracture?

Answer 1

• Side of the body - Name of the bone that is fractured - Part of the bone that is fractured (e.g. mid-shaft) - Fracture pattern (e.g. transverse) - Joint is involved (articular) or not (extra-articular). - Fragments are displaced/not

Question 2

What are the anatomical classes of bone?

Answer 2

Long, short, flat and irregular.

Question 3

How do you describe a long bone franc tyre?

Answer 3

Long bone fractures are described with reference to the direction of the fracture line in relation to the shaft of the bone. For example, a fracture passing perpendicular across the bone shaft is described as ‘transverse’. Other fractures passing across a long bone include, ‘oblique’ and ‘spiral’ fractures

Question 4

How do you describe a fracture that passes along the shaft of the bone?

Answer 4

It can be described with reference to the plane in which it passes, for example coronal or sagittal.

Question 5

What are irregular bone fractures?

Answer 5

A fracture of a short, flat or irregular bone requires a description determined by its direction through the bone. Useful terms include - horizontal, vertical, coronal, sagittal and axial.

Question 6

What is a comminuted fracture?

Answer 6

A bone injury that results in more than 2 separate bone components due to two or more breaks in the bone. Some comminuted fractures have specific names such as ‘butterfly fragment’ or ‘segmental fracture’.

Question 7

What is a transverse fracture?

Answer 7

A fracture in which the break is across the bone, at a right angle to the long axis of the bone. Adjoining figure would illustrate.

Question 8

What is an oblique fracture?

Answer 8

Instead of break being at right angle, it goes in oblique direction to the long axis of the bone.The fracture is confined to one plane. In other words the bone has broken at an angle.

Question 9

What is a spiral fracture?

Answer 9

Instead of a straight break as in oblique fracture that is only in one plane, the break in this case traverses both the planes. To understand this you need to imagine a three dimensional view of the bone. If you take a stick and slice it at an angle so that it is divided in two, it is similar to oblique fracture. But if you twist and break that stick it would result in a break pattern that would start from one point, move obliquely in on direction, reach the other end and then continue in other side of the stick in a spiral fashion to meet the original point.

Question 10

What is the difference between a displaced and undisplaced fracture?

Answer 10

If bone fragments stay together maintaining structural alignment of the bone , it is called an undisplaced fracture.

Question 11

What is a displaced fracture?

Answer 11

When fragment of the bone move from their original position resulting separation of the fragments.

Question 12

What is a butterfly fragment?

Answer 12

Butterfly fragment is a popular term for a wedge-shaped fragment of bone split from the main fragments.

Question 13

What is a segmental fracture?

Answer 13

The bone is fractured at two distinct levels. Reduction of this fracture is difficult and nonunion common as seen in following X-ray.

Question 14

What is an impacted fracture?

Answer 14

This is a fracture in which the ends are driven into each other. Cancellous bone is typically involved, and union often occurs rapidly.

Question 15

What is a compression fracture?

Answer 15

This occurs in cancellous bone, when an excessive axial load compresses the bone beyond its limits. It typically occurs in the verterbal bodies.

Question 16

What is a depressed fracture?

Answer 16

This is a fracture of the cortical bone caused by a localized force that breaks and depresses one segment below the level of surrounding bone.

Question 17

What is the difference between a complete and incomplete fracture?

Answer 17

A fracture is complete if both cortices of the bone are interrupted and incomplete if only one is involved.

Question 18

What is the difference between unstable and stable fractures?

Answer 18

Unstable fracture are those that tend to displace after reduction, whereas stable fractures remain in place after reduction.

Question 19

What is the difference between complicated and uncomplicated fractures?

Answer 19

Complicated fractures are those in which there is significant soft tissue damage to major nearby structures (nerves, vessels, ligaments, and muscles). Uncomplicated fractures involve only minimal soft tissue damage.

Question 20

What is the difference between an open and closed fracture?

Answer 20

A closed fracture is one in which the skin overlying the fracture site is intact. An open fracture is one in which the skin over the fracture site is broken. Open fractrues are surgical emergencies, and most require operative treatment.

Question 21

What is a hairline fracture?

Answer 21

A hairline fracture is an example of an undisplaced fracture.

Question 22

What is a torus fracture?

Answer 22

A torus fracture is a pediatric impaction fracture in which the cortex of a long bone buckles, with no loss of corti

Question 23

What is a greenstick fracture?

Answer 23

A greenstick fracture is an incomplete fracture in children in which the cortex and periosteum are broken on one side only.

Question 24

What causes an open fracture?

Answer 24

Open fractures may occur when a bone fragment from within breaks out through the skin or when some outside force penetrates both the skin and bone. The latter scenario has a poorer prognosis, as there is often greater soft tissue damage and a greater risk of contamination.