Lower limb fractures types
Fractures Of The Femoral Neck (Intra-Capsular) Gardens Classification: grade1: incomplete impacted fracture of the femoral neck. grade 2: complete undisplaced fracture. grade 3: complete fracture with moderate displacement. grade 4: severely displaced fracture. 1+2 – AO screws hemiarthroplasty Clinically the patient complains of pain in the hip and the limb may be shortened and externally rotated.
Femur – intertrochanteric (extracapsular) Less commonly associated with AVN Mx – dynamic hip screw Jensons
Femoral Shaft fractures Spiral – twisting w/ anchored foot Transverse/oblique – direct trauma Communited/segmental
Supracondylar fractures Transverse or communited
Tibial plateau Often from MVA, varus or valgus force Type 1: Wedge fracture of lateral tibial plateau. Lag screws alone suffice for fixation Type 2: lateral tibial wedge fracture with a associated depression. Fixation is with a buttress plate and bone grafting. Type 3: Depression of lateral.tibial plateau but no associated wedge fracture Type 4: Medial tibial plateau fracture Type 5: bicondylar fracture of both plateau. Type 6: The hallmark of this fracture is the separation of the metaphysis and the diaphysis
Patella fractures Direct/indirect trauma to knee Most commonly transverse #, rarely vertical Displaced fracture of patella treated with circalage wire and screws
tibfib Fairly common cos tib is superficial, most common open fracture of longbone. Ring principle Most often spiral fractures from rotational force Weber Classification Weber A Fibula Fracture below syndesmosisFracture Weber B Fibula Fracture at syndesmosis, may tear ligamentFracture Weber C Fibula Fracture, above syndesmosis, ligament tornFracture Unstable
Ankle The ankle is usually injured by indirect forces with the foot either being externally rotated, inverted, everted or less commonly internally rotated on the tibia. CLASSIFICATION First degree: fracture of one malleolus, no talar shift with a stable ankle mortice. Second degree: bimalleolar fracture or a fracture of one malleolus with ligament tear leading to instability of the ankle. Third degree: trimalleolar fracture with instability in the mediolateral and anteroposterior direction. Fourth degree: supra-syndesmotic fracture of the fibula, possible tearing of the inferior tib- fibular ligament and diastasis. Fifth degree: vertical impaction fracture of the distal articular surface of the tibia. bimalleolar