general. principles of fractures.pptx

general principles of fractures.

1. General principles of fractures

2. Fractures Definition : F racture is a break in the structural continuity of bone . Or Fracture is loss of continuity of bone .

3. Pathology of fractures Traumatic fractures : caused by sudden and excessive force , which may be direct or indirect . Direct fracture: the bone breaks at site of imapact and the surrounding soft tissues are also damaged . Indirect fracture: the the bone breaks at a distance from where the force is applied

4. Pathology of fractures Stress or fatigue fracture : occur in normal bone which is subjected to repeated heavy loading , typically in athletes , dancers or military personnel Pathological fractures : Fractures may occur even with normal stresses if the bone has been weakened by a change in its structure ( e.g . I n osteoporosis , osteogenesis imperfecta or Paget’s disease ) or through a lytic lesion ( e.g . A bone cyst or a metastasis )

5. Mechanism of traumatic fractures Compression : When a force is applied perpendicularly to the long axis of a bone , it can compress the bone , causing it to fracture. Tension : Forces that pull on the bone along its long axis can also cause fractures . Bending : When a bone is bent beyond its elastic limit , it can fracture. Torsion : Twisting or rotating forces can cause fractures , especially in bones with a spiral or oblique shape . Shearing : Forces that act parallel to the surface of a bone can cause shearing fractures

6. Mechanism of stress or fatigue fracture: W hen the intensity of exercise is significantly increased from baseline . The heavy loading creates minute deformations that initiate the normal process of remodelling – a combination of bone resorption and new bone formation in accor - dance with Wolff’s law . When exposure to stress and deformation is repeated and prolonged , bone resorp - tion occurs faster than replacement ( new bone forma - tion ) and leaves the area liable to fracture

7. Classification of fractures : According to extent of fracture : Complete fractur e:The bone is split into two or more fragments . Incomplete fracture: one side of cortex and periosteum split but the another side of cortex and periosteum are continuity . Ex : greenstick fracture in children and fissure in adult

8. Classification of fractures .2. According to shape of fracture :

9. Classification of fractures According to presence of skin wound Closed Fracture : closed fracture, also known as a simple fracture, is a fracture in which the bone is broken but the skin is intact . An open fracture , also known as a compound fracture, is a fracture in which the broken bone breaks through the skin , exposing the bone to the environment .

10. Classification of fractures : According to displacement and deformity : Undisplaced fracture : After fracture the bone fragments remain in normal anatomical position . Displaced fracture : After fracture the bone fragments are present in non - anatomical abnormal position , in one or more planes .

11. Classification of fractures : D isplacement of bone fragments occur due to : F orce of injury E ffect of gravity R eflex spasm of muscles attached to the bone fragments

12. Displacement fractures . After a complete fracture the fragments usually become displaced . Translation ( shift ) – The fragments may be shifted sideways , backward or forward in relation to each other.and . Described in three planes according to the position of distal to the proximal fragments . Flexion or extension Abduction or adduction .
+ Medial or lateral rotation .

13. Classification of fractures . Angulation ( tilt ) – The fragments may be tilted or angulated in relation to each other Rotation ( twist ) – One of the fragments may be twisted around its longitudinal axis ..
• Length – The fragments may be distracted and separated , or they may overlap , due to muscle spasm , causing shortening of the bone

14. Classification of fractures . According to impaction : Non impacted fracture: Impacted fracture : bone fragment is driven into another bone fragment

15. Classification of fractures According to stability after reduction : • Stable fracture is not liable for further displacement .
• Unstable fracture liable for redisplacement . Complicated or uncomplicated fracture.

16. Thanks Prepared by anas alkamali