Fractures (main)

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Describing Fractures[1]

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

Cervical Spine Fractures and Dislocations

Upper Extremity

Humerus Fractures

Humeral anatomy


Forearm Fractures

Carpal fractures

Hand and Finger Fractures





Lower Extremity

Proximal Leg

Distal Leg Fractures

Foot and Toe Fractures





See Also


  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.