Definition and

Classification of fractures
V.ARUNKUMAR
2017 BATCH
 DEFINITION

A fracture is a break in the continuity of a bone

CLASSIFICATION OF FRACTURE:
ON THE BASIS OF AETIOLOGY
• Traumatic fracture
eg: fractures caused by a fall, road traffic accident,
fight

• Pathological fracture
underlying disease – abnormal bone

• Stress Fracture
ON THE BASIS OF DISPLACEMENTS

• Undisplaced fracture
• Displaced fracture

Fig-1.1 Displacements in fractures

ON THE BASIS OF RELATIONSHIP
WITH EXTERNAL ENVIRONMENT

• Closed fracture
• Open fracture
ON THE BASIS OF COMPLEXITY OF TREATMENT

• Simple fracture
eg. transverse fracture of humerus

• Complex fracture
eg. communited fracture of tibia
ON THE BASIS OF QUANTUM OF FORCE CAUSING
FRACTURE
• High-velocity injury
severe trauma force
extensive damage and slow to heal

• Low-velocity injury
mild trauma force
heal predictably
ON THE BASIS OF PATTERN

• Transverse fracture
• Oblique fracture
• Spiral fracture
• Comminuted fracture
• Segmental fracture
PATHOLOGICAL FRACTURES

A fracture is termed pathological

when it occurs in a bone made weak
by some disease.

Often, the bone breaks as a result of

a trivial trauma or even
spontaneously.

(a) X-ray of the hip showing destruction of the bone,

(b) which lead to a pathological fracture through the weak
portion
PATHOLOGICAL FRACTURES : Pathology in the bone
Localised Diseases: Generalised Diseases
Inflammatory Hereditary
• Pyogenic osteomyelitis • Osteogenesis imperfecta
• Tubercular osteomyelitis • Dyschondroplasia (Ollier's disease)
Neoplastic • Osteopetrosis
• Benign tumours Acquired
– Giant cell tumour, Enchondroma • Osteoporosis
• Malignant tumours • Osteomalacia
– Primary • Rickets
Osteosarcoma, Ewing's tumour • Scurvy
– Secondary • Disseminated malignancy in bones
In males: lung, prostate, kidney – Multiple myeloma
In females: breast, lung, genitals – Diffuse metastatic carcinoma
Miscellaneous • Miscellaneous
• Simple bone cyst – Paget's disease
• Aneurysmal bone cyst – Polyostotic fibrous dysplasia
• Monostotic fibrous dysplasia
• Eosinophilic granuloma
• Bone atrophy secondary to polio etc.
Causes of pathological fractures at
different ages
Age Causes
• At birth Osteogenesis imperfecta
• 0-5 years Osteogenesis imperfecta
Osteomyelitis
• 5-20 years Osteomyelitis
Simple bone cyst
Primary bone malignancy
• 20-50 years Cystic lesions of the bone
Malignancy
Osteomalacia
Giant cell tumour
• After 50 yrs Osteoporosis
Multiple myeloma
Secondaries in the bone
Clinical presentation:
Before the fracture, there is pain

Do the X- ray -- lesion is found.

Treatment: internal fixation

Stress Fracture
Occurs in normal bone due to repeated abnormal loading of bone

Seen in dancers, athelets, military recruits.

Commonly seen in lower limb bones (point tenderness)

MC bone affected in the body : TIBIA

MC bone affected in the foot : METATARSAL (2nd >3rd )

X-Ray is normal : the features take 2-3 weeks to appear in X ray.

IOC: MRI
Jone's fracture: fracture of the base of the March fracture: Fatigue fracture of the
5th metatarsal. – zone 2 shaft of 2nd or 3rd metatarsal.

Water shed area (high chance of non union)

THANK YOU