Fractures (main): Difference between revisions
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==Background==
==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>==
*[[Fracture (Description)]]
[[File:Types of fracture.jpg|thumb|Types of fractures]]
*[[Salter-Harris 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'''
**Intra-articular vs. extra-articular
**Portion of long-bone (proximal, middle, distal)
**Anatomic site (ex. [[supracondylar]], [[Intertrochanteric femur fracture|intertrochanteric]], [[Subtrochanteric femur fracture|subtrochanteric]], [[Femoral neck fracture|femoral neck]])
*'''Direction''' (orientation of fracture line relative to long-axis)
**Transverse
**Oblique
**Spiral
**Impacted
**Torus / [[Greenstick Fracture|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
***Valgus angulation is lateral
***Varus angulation is medial
**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)
 
*'''[[Salter Harris]]'''
 
==Anatomic Terms==
*'''Diaphysis''' - shaft
*'''Metaphysis''' - widened ends of the bones adjacent to the physis
*'''Physis''' - radiolucent growth plate between metaphysis and epiphysis
*'''Epiphysis''' - secondary ossification center at the end of the bones
*'''Apophysis''' - secondary ossification center at site of tendon or ligament attachment


==Head==
==Head and Neck==
*[[Head Trauma]]
{{Maxillofacial trauma DDX}}


==Neck==
{{Cervical spine injuries}}
*[[C-Spine (Canadian Rule)]]
*[[C-Spine (NEXUS)]]
*[[Cervical Spine Injuries]]


== Upper Extremity ==
==Upper Extremity==
===Proximal Arm===
{{Proximal arm fracture DDX}}
*[[Shoulder Fracture]]
*[[Humerus Fracture]]
*[[Humerus Fracture (Peds)]]
*[[Supracondylar Fracture]]


===Elbow===
===Elbow===
*[[Elbow Fracture (Adult)]]
*Adult
**[[Radial head fracture]]
**[[Radial head fracture]]
**[[Olecranon fracture]]
**[[Olecranon fracture]]
**[[Elbow dislocation]]
**[[Elbow dislocation]]
**[[Capitellum fracture]]
*Pediatric
*Pediatric
**[[Nursemaid's elbow]]
**[[Nursemaid's elbow]]
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**[[Radial head fracture (peds)]]
**[[Radial head fracture (peds)]]


===Distal Arm===
{{Forarm fracture DDX}}
*[[Forearm Fracture]]
*[[Wrist Fracture]]


===Hand===
{{Carpal fractures}}
*[[Hand and Finger Fractures]]
 
{{Hand and finger fractures DDX}}


==Torso==
==Torso==
===Chest===
===Chest===
*[[Clavicle Fracture]]
*[[Clavicle fracture]]
*[[Clavicle Fracture (peds)]]
**[[Clavicle fracture (peds)]]
*[[Scapula Fracture]]
*[[Scapula fracture]]
*[[Rib fracture]]
*[[Sternum fracture]]


===Abdomen===
===Abdomen===
*[[Pelvic Fractures]]
*[[Pelvic fractures]]
 
===Spine===
*[[Thoracic and lumbar spine injuries]]


==Lower Extremity==
==Lower Extremity==
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{{Foot and toe fractures DDX}}
{{Foot and toe fractures DDX}}
==Other==
*[[Salter-Harris fractures]]
==Management==
{{General Fracture Management}}


==See Also==
==See Also==
*[[Fracture management overview]]
*[[Splinting]]
*[[Splinting]]
*[[Diagnoses by Body Part (Main)]]
*[[Diagnoses by Body Part (Main)]]
*[[Fractures and dislocations (peds)]]
*[[Fractures and dislocations (peds)]]
*[[Open fracture]]
*[[Joint dislocations (main)]]
==References==
<references/>


[[Category:Ortho]]
[[Category:Orthopedics]]

Revision as of 02:54, 18 September 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
      • Valgus angulation is lateral
      • Varus angulation is medial
    • 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)

Anatomic Terms

  • Diaphysis - shaft
  • Metaphysis - widened ends of the bones adjacent to the physis
  • Physis - radiolucent growth plate between metaphysis and epiphysis
  • Epiphysis - secondary ossification center at the end of the bones
  • Apophysis - secondary ossification center at site of tendon or ligament attachment

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

Management

General Fracture Management

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.
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