one Fructures

Types of Fractures
green stick
fissured
comminuted
transverse
oblique
spiral
Clinical Application
Fracture Types
Fractures are oIten classiIied according to the position oI the
bone ends aIter the break:
Open (compound) bone ends penetrate the skin.
Closed (simple) bone ends don`t penetrate the skin.
Comminuted bone Iragments into 3 or more pieces.
Common in the elderly (brittle bones).
Greenstick bone breaks incompletely. One side bent,
one side broken. Common in children
whose bone contains more collagen and are
less mineralized.
Spiral ragged break caused by excessive twisting
Iorces. Sports injury/Injury oI abuse.
Impacted one bone Iragment is driven into the
medullary space or spongy bone oI another.
Fractures
Despite its mineral strength,
bone may crack or even break
iI subjected to extreme loads,
sudden impacts, or stresses
Irom unusual directions.
The damage produced constitutes
a Iracture.
The proper healing oI a
Iracture depends on whether or
not, the blood supply and
cellular components oI the
periosteum and endosteum
survive.
ompIete Fructure
{Rudius}
ompound Fructure
CompIefe frocfure in which
bone breoks fhrough skin
ompound F,
fibio/fibuIo)
http://www.vh.org/adult/provider/radiology/icmrad/skeletal/Parts/Compound.html
What kind of fracture is this?
Its kind of tough to tell, but
this is a fracture.
X-radiograph of a
broken humerus
ShouIder Spica - A cast of fiber glass or
plaster that includes the entire torso and an
entire arm. Used to treat fractures of the
humerus or extreme fractures of the
shoulder bones.
Spica Origin L, an ear, as of corn. A
kind of bandage passing, by successive
turns and crosses, from an extremity to
the trunk; so called from its resemblance
to a spike of a barley.
reenstick F,
http://www.vh.org/adult/provider/radiology/icmrad/skeletal/01Trauma.html
http://www.hawaii.edu/medicine/pediatrics/pemxray/v1c16.html
uIeuzzi f, uIeuzzi f,
Fx. distal 3rd
oI radius
Dislocation
distal ulna
http://www.uphs.upenn.edu/ortho/oj/2002/html/oj15sp02p43.html
yearold girl fell onto
outstretched hand
sustained Gartland
Type II supracondylar
humerus Ix.
oIIes' Fructure
broken wrisf)
one Remodeling
Bone is a
dynamic tissue.
What does that
mean?
WolII`s law
holds that bone
will grow or
remodel in
response to the
Iorces or
demands placed
on it. Examine
this with the
bone on the left.
ruy of
oIIes' fructure
-Iique Fructure
uIunion resuIting in fusion of
rudius/uInu
one coIIus & frogmenfs coused bones fo ossify ond
fuse, prevenfs pronofion & supinofion.
http://www.vh.org/adult/provider/radiology/icmrad/skeletal/01Trauma.html
omminuted Fructure
of Lower Leg
yeoroId mon wos
sfruck by o forkIiff)
omminuted f,
{distuI humerus}
unterior view
omminuted f,
humerusIuteruI view
Step 3:
A. Bone trabeculae
increase in number
and convert the
Iibrocartilaginous
callus into a bony
callus oI spongy
bone. Typically
takes about 6-8
weeks Ior this to
occur.
Fracture
Repair
Step 4:
A. During the next several months, the bony callus is continually
remodeled.
B. Osteoclasts work to remove the temporary supportive structures
while osteoblasts rebuild the compact bone and reconstruct the
bone so it returns to its original shape/structure.
ncompIete
LongitudinuI Fructure
isfoI PhoIonx of Leff
Thumb)
$piruI Fructure
PofhoIogicoI Frocfure
of femur secondory
fo rickefs
yeor oId boy)
!uthoIogic f, us resuIt
of -one tumor thut
weukened the urm,
tumor
F,
F,
http://www.hawaii.edu/medicine/pediatrics/pemxray/v6c01.html
!uthoIogic f,
from tumor which
compromised
-one's strength,
http://www.vh.org/adult/provider/radiology/icmrad/skeletal/01Trauma.html
$tress F,
#esuIf of overuse
or sfress on bone.
0rowfh pIofes
F,
http://www.vh.org/adult/provider/radiology/icmrad/skeletal/01Trauma.html
isIocution
of eI-ow
humerus
http://www.vh.org/adult/provider/radiology/icmrad/skeletal/01Trauma.html
isIocution of EI-ow
Joint
vuIsionhip
peIvis of yeor
oId high schooI
sprinfer)
ony frogmenf puIIed from
peIvis of poinf of growfh
pIofe ond muscIe offochmenf.
http://www.vh.org/adult/provider/radiology/icmrad/skeletal/01Trauma.html
ompression f, ompression f,
L1 verte-ruI -ody L1 verte-ruI -ody
http://www.emedicine.com/radio/topic817.htm
horucic F,
http://www.vh.org/adult/provider/radiology/icmrad/skeletal/01Trauma.html
epressed f,
Fracture
Repair
Step 1:
A. Immediately aIter
the Iracture,
extensive
bleeding occurs.
Over a period oI
several hours, a
large blood clot,
or Iracture
hematoma,
develops.
B. Bone cells at the
site become
deprived oI
nutrients and die.
The site becomes
swollen, painIul,
and inIlamed.
Step 2:
A. Granulation tissue is Iormed as the hematoma is
inIiltrated by capillaries and macrophages, which begin
to clean up the debris.
B. Some Iibroblasts produce collagen Iibers that span the
break , while others diIIerentiate into chondroblasts and
begin secreting cartilage matrix.
C. Osteoblasts begin Iorming spongy bone.
D. This entire structure is known as a Iibrocartilaginous
callus and it splints the broken bone.