Fractures (main): Difference between revisions

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==Describing Fractures==
==Describing Fractures<ref>Wolfson, A. B., Cloutier, R. L., Hendey, G. W., Ling, L., & Schaider, J. (n.d.). Approach to Musculoskeletal Injuries. In Harwood-Nuss' clinical practice of emergency medicine (6th ed.). LWW.</ref>==
*Open versus Closed
[[File:Types of fracture.jpg|thumb|Types of fractures]]
[[File:Fracture Naming Construct.png|thumb|Fracture naming construct]]
A systematic approach for the description of fractures should be used to aid in clear communication with radiologists and consulting specialists.
*Laterality
*[[Open fracture|Open]] vs. Closed
*Affected Bone
*Location
*Location
**Intra-articular versus articular
**Intra-articular vs. extra-articular
**Mid-shaft, proximal 1/3, or distal 1/3
**Portion of long-bone (proximal, middle, distal)
**Supracondylar
**Anatomic site (ex. [[supracondylar]], [[Intertrochanteric femur fracture|intertrochanteric]], [[Subtrochanteric femur fracture|subtrochanteric]], [[Femoral neck fracture|femoral neck]])
**Intertrochanteric, subtrochanteric, femoral neck, or subcapital
*Direction (orientation of fracture line relative to long-axis)
*Orientation of the fracture line
**Transverse
**Transverse
**Oblique
**Oblique
**Spiral
**Spiral
**Comminuted
**Impacted
**Segmental
**Torus / [[Greenstick Fracture|Greenstick]] (Peds)
**Torus / Greenstick (Peds)
*Alignment
*Displacement
**Displacement (distal relative to proximal fragment)
**Extent to which fracture fragments are offset from each other
***State in terms of direct measurement (e.g. 4mm) or %width of bones (50% displacement)
***State in terms of direct measurement (e.g. 4mm) or %width of bones (50% displacement)
**Direction of displacement is based on position of distal fragment relative to proximal
**Angulation
*Separation
***Deviation from longitudinal axis, described in degrees and direction
**Distance the two fragments have been pulled apart (but not offset from each other)
***Direction of apex of angle formed from redrawn longitudinal axes of fracture fragments
*Shortening
**Rotation
**Amount by which a bone's length has been reduced (expressed in mm or cm)
***Twisting around longitudinal axis (distal relative to proximal fragment)
**May occur by impaction or by overriding
***Described as medial or lateral rotation (towards or away from midline respectively)
*Angulation
**Separation
**Described in terms of degree and direction
***Distance two fragments have been pulled apart (but not offset from each other)
***Degree
**Shortening
****Calculate amount of "unbending" needed to make fx fragments parallel
***Amount by which a bone's length has been reduced (expressed in mm or cm)
***Direction
***May occur by impaction or by overriding
****Described by direction of the apex of the angle formed by the two fragments OR
**Other
****Described by direction the terminal fragment is deviated
***Incomplete: Only one side of cortex disrupted
****Examples: anterior or posterior, lateral or medial, radial or ulnar, dorsal or volar
***Stress: Caused by repetitive low-force trauma/impact
*Rotational Deformity
***Pathologic: Caused by trivial trauma or biomechanically routine force, suggestive of abnormal bone.
**Usually apparent on physical exam, not on radiographs
***Fracture-Dislocation: Be careful not to describe these injuries as fractures with displacement
*Fracture-Dislocation
*Fragmentation
**Be careful not to describe these injuries as fractures with displacement
**Segmental (>2 fragments, with one segment not connected to either end)
**Comminuted (>3 fragments)
 
*[[Salter Harris]]
*[[Salter Harris]]


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{{Cervical spine injuries}}
{{Cervical spine injuries}}


== Upper Extremity ==
==Upper Extremity==
{{Proximal arm fracture DDX}}
{{Proximal arm fracture DDX}}


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**[[Olecranon fracture]]
**[[Olecranon fracture]]
**[[Elbow dislocation]]
**[[Elbow dislocation]]
**[[Capitellum fracture]]
*Pediatric
*Pediatric
**[[Nursemaid's elbow]]
**[[Nursemaid's elbow]]
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==See Also==
==See Also==
*[[Fracture management overview]]
*[[Splinting]]
*[[Splinting]]
*[[Diagnoses by Body Part (Main)]]
*[[Diagnoses by Body Part (Main)]]
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*[[Joint dislocations (main)]]
*[[Joint dislocations (main)]]


[[Category:Ortho]]
==References==
<references/>
 
[[Category:Orthopedics]]

Revision as of 01:13, 14 August 2019

Describing Fractures[1]

Types of fractures
Fracture naming construct

A systematic approach for the description of fractures should be used to aid in clear communication with radiologists and consulting specialists.

  • Laterality
  • Open vs. Closed
  • Affected Bone
  • Location
  • Direction (orientation of fracture line relative to long-axis)
    • Transverse
    • Oblique
    • Spiral
    • Impacted
    • Torus / Greenstick (Peds)
  • Alignment
    • Displacement (distal relative to proximal fragment)
      • State in terms of direct measurement (e.g. 4mm) or %width of bones (50% displacement)
    • Angulation
      • Deviation from longitudinal axis, described in degrees and direction
      • Direction of apex of angle formed from redrawn longitudinal axes of fracture fragments
    • Rotation
      • Twisting around longitudinal axis (distal relative to proximal fragment)
      • Described as medial or lateral rotation (towards or away from midline respectively)
    • Separation
      • Distance two fragments have been pulled apart (but not offset from each other)
    • Shortening
      • Amount by which a bone's length has been reduced (expressed in mm or cm)
      • May occur by impaction or by overriding
    • Other
      • Incomplete: Only one side of cortex disrupted
      • Stress: Caused by repetitive low-force trauma/impact
      • Pathologic: Caused by trivial trauma or biomechanically routine force, suggestive of abnormal bone.
      • Fracture-Dislocation: Be careful not to describe these injuries as fractures with displacement
  • Fragmentation
    • Segmental (>2 fragments, with one segment not connected to either end)
    • Comminuted (>3 fragments)

Head and Neck

Maxillofacial Trauma

Vertebral fractures and dislocations types

Vertebral anatomy.
Numbering order of vertebrae.

Upper Extremity

Humerus Fracture Types

Humeral anatomy

Elbow

Forearm Fracture Types

Carpal fractures

AP view

Hand and Finger Fracture Types

Torso

Chest

Abdomen

Spine

Lower Extremity

Proximal Leg

Distal Leg Fracture Types

Foot and Toe Fracture Types

Hindfoot

Midfoot

Forefoot

Other

See Also

References

  1. Wolfson, A. B., Cloutier, R. L., Hendey, G. W., Ling, L., & Schaider, J. (n.d.). Approach to Musculoskeletal Injuries. In Harwood-Nuss' clinical practice of emergency medicine (6th ed.). LWW.