Fractures (main): Difference between revisions
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[[File:Fracture Naming Construct.png|thumb|Fracture naming construct]] | [[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. | A systematic approach for the description of fractures should be used to aid in clear communication with radiologists and consulting specialists. | ||
*Laterality | *'''Laterality''' | ||
*[[Open fracture|Open]] vs. Closed | *'''[[Open fracture|Open]] vs. Closed''' | ||
*Affected Bone | *'''Affected Bone''' | ||
*Location | *'''Location''' | ||
**Intra-articular vs. extra-articular | **Intra-articular vs. extra-articular | ||
**Portion of long-bone (proximal, middle, distal) | **Portion of long-bone (proximal, middle, distal) | ||
**Anatomic site (ex. [[supracondylar]], [[Intertrochanteric femur fracture|intertrochanteric]], [[Subtrochanteric femur fracture|subtrochanteric]], [[Femoral neck fracture|femoral neck]]) | **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) | *'''Direction''' (orientation of fracture line relative to long-axis) | ||
**Transverse | **Transverse | ||
**Oblique | **Oblique | ||
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**Impacted | **Impacted | ||
**Torus / [[Greenstick Fracture|Greenstick]] (Peds) | **Torus / [[Greenstick Fracture|Greenstick]] (Peds) | ||
*Alignment | *'''Alignment''' | ||
**Displacement (distal relative to proximal fragment) | **Displacement (distal relative to proximal fragment) | ||
***State in terms of direct measurement (e.g. 4mm) or %width of bones (50% displacement) | ***State in terms of direct measurement (e.g. 4mm) or %width of bones (50% displacement) | ||
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***Deviation from longitudinal axis, described in degrees and direction | ***Deviation from longitudinal axis, described in degrees and direction | ||
***Direction of apex of angle formed from redrawn longitudinal axes of fracture fragments | ***Direction of apex of angle formed from redrawn longitudinal axes of fracture fragments | ||
***Valgus angulation is lateral | |||
***Varus angulation is medial | |||
**Rotation | **Rotation | ||
***Twisting around longitudinal axis (distal relative to proximal fragment) | ***Twisting around longitudinal axis (distal relative to proximal fragment) | ||
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***Pathologic: Caused by trivial trauma or biomechanically routine force, suggestive of abnormal bone. | ***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 | ***Fracture-Dislocation: Be careful not to describe these injuries as fractures with displacement | ||
*Fragmentation | *'''Fragmentation''' | ||
**Segmental (>2 fragments, with one segment not connected to either end) | **Segmental (>2 fragments, with one segment not connected to either end) | ||
**Comminuted (>3 fragments) | **Comminuted (>3 fragments) | ||
*[[Salter Harris]] | *'''[[Salter Harris]]''' | ||
==Anatomic Terms== | ==Anatomic Terms== | ||
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*[[Scapula fracture]] | *[[Scapula fracture]] | ||
*[[Rib fracture]] | *[[Rib fracture]] | ||
**[[Flail chest]] | |||
*[[Sternum fracture]] | *[[Sternum fracture]] | ||
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==Other== | ==Other== | ||
*[[Salter-Harris fractures]] | *[[Salter-Harris fractures]] | ||
==Management== | |||
{{General Fracture Management}} | |||
==See Also== | ==See Also== | ||
Latest revision as of 18:00, 13 June 2020
Describing Fractures[1]
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
- Intra-articular vs. extra-articular
- Portion of long-bone (proximal, middle, distal)
- Anatomic site (ex. supracondylar, intertrochanteric, subtrochanteric, femoral neck)
- 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
- Displacement (distal relative to proximal fragment)
- 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
- Ears
- Nose
- Oral
- Other face
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Related
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Upper Extremity
Humerus Fracture Types
Elbow
- Adult
- Pediatric
Forearm Fracture Types
- Distal radius fractures
- Radia ulna fracture
- Isolated radius fracture (proximal)
- Isolated ulna fracture (i.e. nightstick)
- Monteggia fracture-dislocation
- Galeazzi fracture-dislocation
- Forearm fracture (peds)
Carpal fractures
- Scaphoid fracture
- Lunate fracture
- Triquetrum fracture
- Pisiform fracture
- Trapezium fracture
- Trapezoid fracture
- Capitate fracture
- Hamate fracture
Hand and Finger Fracture Types
Torso
Chest
Abdomen
Spine
Lower Extremity
Proximal Leg
Distal Leg Fracture Types
- Tibial plateau fracture
- Tibial shaft fracture
- Pilon fracture
- Maisonneuve fracture
- Tibia fracture (peds)
- Ankle fracture
- Foot and toe fractures
Foot and Toe Fracture Types
Hindfoot
Midfoot
Forefoot
Other
Management
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
See Also
- Fracture management overview
- Splinting
- Diagnoses by Body Part (Main)
- Fractures and dislocations (peds)
- Open fracture
- Joint dislocations (main)
References
- ↑ 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.