A

fracture is any disruption in the normal continuity of a bone.

Mechanical overload of bone

Metabolic bone disease Eg: Osteoporosis

Direct force.Eg: Moving object strikes body Indirect force Eg: Muscle contraction Stress/ Fatigue

 Biologic

conditions- Osteopenia

Neoplasms Post

menopausal estrogen loss & protein malnutrition

High

risk recreation or employment related activity

Fracture Muscles attached to bone are disrupted

Muscle spasm- Pull fracture fragments out of position

Proximal portion of bone remains in place, distal displaced Fracture fragments displaced sideways or overriding Periosteum & blood vessels of fractured bone disrupted

Soft tissue damage

Bleeding from soft tissue & damaged bone ends Hematoma between fracture fragments & beneath periosteum Bone tissue surrounding fracture site dies Intense inflamatory response Vasodilation, edema, pain, loss of function, Infiltration of WBC

 Appearance:

1.Burst fracture - Multiple pieces of bone

2. Comminuted fracture - More than one fracture line, more than 2 bone fragments, Fragments crushed

3.Complete fracture - Break across entire section of bone, dividing into distinct fragments

4. Displaced fracture - Fragments out of normal position at fracture site

5. Incomplete fracture - Fracture occurs through only one cortex of bone, usually nondisplaced

6. Linear fracture - Fracture line is intact; Caused by minormoderate force

7. Longitudinal fracture - Fracture line extends in the directon of bones longitudinal axis

8. Nondisplaced fracture - -Fragments aligned at fracture site

9. Oblique fracture - -Fracture line occurs at 45 degree angle across longitudinal axis of bone

10. Spiral fracture - -Fracture line results from twisting force

11. Stellate fracture - -Fracture line radiate from one central point

12. Transverse fracture - -Fracture line occurs at 90 degree angle to longitudinal axis of bone

Avulsion - Bone fragments are torn away from body of the bone at the site of attachment of ligaments or tendon
1.

2. Compression fracture - Bone cracks as a result of loading forcee applied to its longitudinal axis

3. Greenstick fracture - Incomplete fracture in which one side of the cortex is broken & the other side is flexed but intact

4. Impacted fracture -One fragment driven to another

Anatomic Location 1. Colles fracture -Fracture within last inch of distal radius

2. Potts fracture -Fracture of distal fibula

Deformity

Swelling

Bruising ( Ecchymosis)
Muscle spasm

Pain Tenderness

 Loss

of function Abnormal mobility & Crepitus

Neurovascular

changes

Shock

Medical management Goals: Assessment of injury Reduction and stabilization of fracture Monitoring complications Eventual remobilization & rehabilitation

1.

Thorough initial assessment: Assessment Emergency assistance Stabilize Neurologic assessment Cover with sterile dressing( Open fracture) Antibiotic therapy

2. Fracture Reduction/ Bone setting:

Manipulation of fracture to restore lignment, position and length by bringing fragments

a. b.

Closed reduction Open reduction