Types of fractures Types of fractures

Shaft – diaphysis Shaft – diaphysis and 2 extremities , and 2 extremities , epiphysisepiphysis

Marrow cavityMarrow cavity

Def : fracture Def : fracture Complete/ Complete/

incomplete break incomplete break – continuity – bone – continuity – bone / cartilage or both, / cartilage or both, with or without with or without displacement of displacement of fracture fragmentsfracture fragments

Assoc. soft tissue Assoc. soft tissue damagedamage

Type of Fracture: Type of Fracture: 1.1. Cause, mild/ Cause, mild/

severesevere2.2. Bone involved: Bone involved:

Young / old / Young / old / cortical / cortical / cancellouscancellous

3.3. Site of fractureSite of fracture4.4. Temperament of Temperament of

animalanimal

Etiology: Etiology: • Extrinsic – trauma Extrinsic – trauma

and forces – act on and forces – act on bonebone

a.a. Direct trauma: Direct trauma: Automobile Automobile accident (80 %)accident (80 %)

Fall from a Fall from a heightheight

Usually comminuted/ Usually comminuted/ multiple typemultiple type

b.b. Indirect : arises during Indirect : arises during running , jumping or running , jumping or falling of an animalfalling of an animal

Forces like Forces like bending , torsional , bending , torsional , compressive and shearing compressive and shearing are transmitted – weak are transmitted – weak link within the bonelink within the bone

Bending forcesBending forces

When it overcomes – When it overcomes – elastic limit of a elastic limit of a bone- cortex bone- cortex opposite to force – opposite to force – breaks – additional breaks – additional force- complete force- complete fracturefracture

Oblique or Oblique or transverse fracturestransverse fractures

Steps into a hole Steps into a hole while runningwhile running

Torsional forceTorsional force

Bone is twisted Bone is twisted along its ling along its ling axis.axis.

Result – one end Result – one end is fixed and other is fixed and other is forced to is forced to rotaterotate

Long / short Long / short spiral fracturespiral fracture

Compressive forces Compressive forces One end is fixed – other is forced One end is fixed – other is forced

towards fixed end – compacted / towards fixed end – compacted / compression fracturecompression fracture

ShearingShearing

Force transmitted Force transmitted along long axis – along long axis – transferred to a transferred to a portion of the same portion of the same bone – peripheral to bone – peripheral to the axis the axis

Fracture line – Fracture line – parallel to direction parallel to direction of applied forceof applied force

Eg: fracture of bony Eg: fracture of bony prominencesprominences

Intrinsic causesIntrinsic causes Cause Inside bodyCause Inside body Related to violent m. Related to violent m.

contraction/ local or contraction/ local or systemic diseasessystemic diseases

a.a. Muscular contraction: Muscular contraction: Skeletal m. – violently – chip Skeletal m. – violently – chip off – bone – attachment off – bone – attachment insertion/ origin)insertion/ origin)

Avulsion fracturesAvulsion fracturesImmature animals – commonImmature animals – commonAcromion , greater trochanter, Acromion , greater trochanter,

tibial tuberosity, calcaneal of tibial tuberosity, calcaneal of fibular tarsalfibular tarsal

B. Pathological: B. Pathological: local / systemic dis. – local / systemic dis. – bones – abnormal/ bones – abnormal/ weak – fracture with weak – fracture with wt.wt.

Bone tumours, cysts, Bone tumours, cysts, osteoporosis, bone osteoporosis, bone infections, rickets , infections, rickets , osteoporosis by osteoporosis by prolonged fixationsprolonged fixations

ClassificationClassification

1.1. Basis of comminucation of the site to Basis of comminucation of the site to the environment: Simple (closed)the environment: Simple (closed)

Compound (open)Compound (open)

Simple: Simple: no wound at surfaceno wound at surface

no communicationno communication

Compound: Compound: open woundopen wound

communicationcommunication

prone to infectionprone to infection

2. Extent of fracture: 2. Extent of fracture: completecomplete IncompleteIncomplete

Incomplete: Incomplete: 1. 1. green stickgreen stick – cortex – cortex

opp. To bending opp. To bending breaks and under the breaks and under the force remains intactforce remains intact

Immature animals – Immature animals – elastic nature of boneelastic nature of bone

2. Fissure fracture2. Fissure fracture; ; Direct trauma – Direct trauma – incomplete fractureincomplete fracture

3. Depression 3. Depression fracturefracture; A small ; A small portion of cortex – portion of cortex – depressed into its depressed into its parent bone – parent bone – Maxilla and frontal Maxilla and frontal bonesbones

Complete fracturesComplete fractures

Complete loss of Complete loss of bone continuity bone continuity and bone – div. – and bone – div. – 2 or more 2 or more fragmentsfragments

On the basis of On the basis of direction of the direction of the fracture lines: fracture lines:

1.1. Transverse- Transverse- result of bending result of bending forceforce

2.Oblique – Bending + 2.Oblique – Bending + axial compression axial compression – diagonal to long – diagonal to long axisaxis

3. Spiral : Frac. Line 3. Spiral : Frac. Line spirals the long spirals the long axis of axis of bone(torsion, bone(torsion, twisting/ rotational twisting/ rotational forces)forces)

4.4. Comminuted: 2 or Comminuted: 2 or more fracture lines more fracture lines interconnect each interconnect each other at one point.other at one point.(butterfly fracture)(butterfly fracture)

5.5. Multiple fracture: 2 Multiple fracture: 2 or more – frac. Lines or more – frac. Lines – donot interconnect – donot interconnect – div. the bone into 3 – div. the bone into 3 or more fracture or more fracture fragments. – severe fragments. – severe soft tissue injuries- soft tissue injuries- healing time is morehealing time is more

6.6. Impacted Impacted fracture: cortical fracture: cortical end is impacted end is impacted into cancellous – into cancellous – usually at usually at junction of junction of diaphysis and diaphysis and metaphysis of a metaphysis of a long bonelong bone

7. Compression 7. Compression fracture: fracture: Cancellous bone Cancellous bone collapses – collapses – compresses upon compresses upon itself- eg. Frac. itself- eg. Frac. Of vertebral Of vertebral bodies – spine bodies – spine traumatrauma

8.8. Avulsion fracture: Avulsion fracture: Part of the bone Part of the bone is torn awayis torn away

Basis of anatomical Basis of anatomical locationlocation1.1. Diaphyseal Diaphyseal

fracture: 1/3fracture: 1/3rdrd, , 2/32/3rdrd or distal 3 or distal 3rdrd

2.2. Metaphyseal Metaphyseal fracture: Distal / fracture: Distal / proximalproximal

3.3. Epiphyseal: Epiphyseal: Distal / Distal / proximalproximal

4. Condylar : frac. 4. Condylar : frac. Lines pass Lines pass through condyles through condyles or between or between condylescondyles

Eg; distal end of Eg; distal end of humerus / femurhumerus / femur

Further classified as Further classified as medial/ medial/ lateral /.interconlateral /.intercondylar/ dylar/ supracondylar supracondylar

5. Articular: frac. Of 5. Articular: frac. Of subchondral bonesubchondral bone

6. fracture dislocation: 6. fracture dislocation: results into a joint results into a joint instability – luxation of instability – luxation of joint eg: Montegia joint eg: Montegia fracture of olecranon fracture of olecranon process and process and dislocation of elbow dislocation of elbow joint. joint.