FRACTURE NOTES.docx - Fractures • • A fracture is a...

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Fractures A fracture is a disruption or break in the continuity of the structure of bone. Although traumatic injuries account for the majority of fractures, some fractures are secondary to a disease process (pathologic fractures from cancer or osteoporosis). CLASSIFICATION Fractures can be classified as open (formerly called compound ) or closed (formerly called simple ) depending on communication or noncommunication with the external environment (Fig. 62-6). In an open fracture the skin is broken, exposing the bone and causing soft tissue injury. In a closed fracture the skin has not been ruptured and remains intact. Fractures can also be classified as complete or incomplete. A fracture is termed complete if the break is goes through the bone and incomplete if the fracture occurs partly across a bone shaft but the bone is still intact. An incomplete fracture is often the result of bending or crushing forces applied to a bone. Fractures are also described and classified according to the direction of the fracture line. A, Transverse fracture is a fracture in which the line of the fracture extends across the bone shaft at a right angle to the longitudinal axis. B, Spiral fracture is a fracture in which the line of the fracture extends in a spiral direction along the shaft of the bone. C, Greenstick fracture is an incomplete fracture with one side splintered and the other side bent. D, Comminuted fracture is a fracture with more than two fragments. The smaller fragments appear to be floating. Types of fractures. E, Oblique fracture is a fracture in which the line of the fracture extends in an oblique direction. F, Pathologic fracture is a spontaneous fracture at the site of a bone disease. G, Stress fracture is a fracture that occurs in normal or abnormal bone that is subject to repeated stress, such as from jogging or running. Finally, fractures can also be classified as displaced or nondisplaced. In a displaced fracture, the two ends of the broken bone are separated from one another and out of their normal positions. Displaced fractures are often comminuted (more than two fragments) or oblique (see Fig. 62-7 in previous slide). In a nondisplaced fracture, the periosteum is intact across the fracture, and the bone fragments are still in alignment. Nondisplaced fractures are usually transverse, spiral, or greenstick. MANIFESTATIONS The clinical manifestations of fracture include immediate localized pain, decreased function, and inability to bear weight on or use the affected part. The patient guards and protects the extremity against movement. Obvious bone deformity may not be present. Immobilize extremity in the position found Unnecessary movement ↑ soft tissue damage May convert closed fracture to open fracture Create further injury to adjacent nerves & blood vessels FACTORS INFLUENCING HEALING
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