1. Fractures
ALI B ALHAILIY

2. Definition Fracture :a break in the continuity of a bone
A fracture is present when there is loss of continuity in the substance of a bone.
The term covers all bony disruptions, ranging
from the situation when a bone is broken into one or many fragments

3. Causes of fracture Fractures are caused by the
application of stresses which
exceed the limits of strength of
a bone.
Violence is the commonest cause
1- direct violence, a
bone may be fractured by being
struck by a moving or falling
object.
2- indirect violence. A
twisting or bending stress is
applied to a bone, and this
results in its fracture at some
distance from the application of
the causal force.

4. Types of fracture 1-Pathological fracture
Sometimes fracture may occur in an abnormal or diseased bone. That will
reduce the strength of the bone then the force required to produce fracture is reduced.
Bone cyst

5. 2-Fatigue fractures (stress fractures) Stresses, repeated
with excessive frequency to a
bone, may result in fracture.
It is hairline in pattern and are often not diagnosed with certainty
until there is callus formation, or increased density at the fracture site.
3-6 weeks after the onset of symptoms
Healed fatigue fracture
through the second
metatarsal bone

6. 3- Open and closed fractures
Closed fracture: (a) the bone is
broken, but there is no external
wound. A fracture not
communicating with the external environment, the overlying skin are intact
Open fracture: A fracture with break in
the overlying skin and soft-tissues,
leading to the fracture.

7. 4- Simple transveres fractures
Transverse fractures run either at right angles to the long axis of a bone (1), or with an obliquity of less than 30°.
5- Multifragmental fractures
There are two fragments or more. 4 5

8. 6- Avulsion fractures :
produced by a sudden muscle contraction,
the muscle pulling off the portion of bone to which it is attached.
Common examples include:
(1) Base of fifth metatarsal.
(2) Tibial tuberosity (quadriceps).
(3) Upper pole of patella (quadriceps).
(4) Lesser trochanter (iliopsoas).

9. 7-Fracture-dislocations
present when a joint has dislocated and there is in addition a fracture of one of the bony components of the joint.
fracture-dislocation of the shoulder, where there is an anterior dislocation with a fracture of the neck of the humerus.
Injuries of this kind may be difficult to reduce and may be
unstable. Stiffness and avascular necrosis
are two common complications

10. Describing the level of a fracture
The anatomical divisions of a long bone include
the epiphysis (E), epiphyseal plate (EP), and diaphysis or shaft (D). Between the latter two is the metaphysis (M).
A fracture may be described as lying within these divisions, or involving a distinct anatomical part, e.g.
A = fracture of the tibial diaphysis;
B = fracture of the femoral neck;
C = fracture of the greater trochanter;
F = supracondylar fracture of the femur.

11. Describing the level of a fracture
For descriptive purposes a bone may be divided into thirds. In this way:
A = fracture of the mid third of the femur;
B = fracture of the femur in the distal third;
C = fracture of the femur at the junction of the
middle and distal thirds.
D = fracture of the distal metaphysis of radial bone

12. X RAY FINDINGS Phalangeal dislocations
Forced hyperextension of the thumb or finger joints is the usual cause for these injuries. Normally the distal segment is displaced posteriorly

13. Bennett’s fracture
It is a fracture of the base of the first metacarpal bone which extends into the carpometacarpal (CMC) joint.[1] This intra-articular fracture is the most common type of fracture of the thumb
A vertical lucent line is seen intersecting the proximal articular surface of the first metacarpal bone

14. Scaphoid Fracture

15. Scaphoid Fracture
Usually fractures through the waist (middle) of the scaphoid bone
Mechanism – fall on dorsiflexed outstretched hand
May not be evident for up to 10 days post trauma
Very well diagnosed clinically – pain and tenderness in anatomical snuff box
Poor healing fracture due to complicated blood supply
Most easily diagnosed via the PA ulnar deviation with angulation projection

16. Scaphoid fractures
How many projections for scaphoid # ?

17. Or… PA
OBL PA PA
DEV
LAT
General setup of 24 x 30 cm cassette for patients who have defined trauma to scaphoid or follow up films or minimal injury

18. Colles’ fracture.

19. Colles’ Fracture
# of the distal end of the radius (3cm from joint) +/- # of the styloid process of the ulnar
Dorsal angulation of the distal fragment – ventral angulation of proximal radius
Most common form of wrist fracture – females, middle aged and older
Caused by fall on outstretched hand (FOOSH)

20. Smith’s Fracture Reverse Colles’ #
Hyperflexion with fall on back of hand
Fracture of the radius with ventral displacement of distal fragment and dorsal angulation of proximal radius

22. Galeazzi’s Fracture # of the mid shaft of the radius
Dislocation of the distal radioulnar joint
Fall on outstretched hand with elbow flexed
High incidence of nonunion and a limitation on pronating or supinating the hand

24. Please read about Salter–Harris fractures ? Types with figures ?

25. Thank You