Fractures and Disorders

• - comminuted fx where bone is broken into 2 fragments on each side of a central fx
• - caused by high energy force

• - fx across the long axis of the bone at
• right angle
• - Mx - direct blow

• - fx is at angle line to long axis
• - less stable than transverse
• - Mx- twisting motion

break only on one side of bone

bone broken in more than 2 pieces

bone is pushed in as often in skull fxs

fx occurs without trauma

additional fx's radiate from a central fx

crack in the surface of the bone that doesn't extend through the bone

doesn't extend all the way through bone

stress fx that occurs when bone that is abnormally thin is put under stress

results from nutritional deficits

spontaneous fx that results from less than ideal osteogenesis

projectile causes hole in bone

one that appears as a thin line in an x-ray as the bone fragments aren't separated

slanted piece of bone is detached from the head of the radius

occurs at the site of injury

occurs due to weakening of bone from disease

doesn't involve a break in the periosteum

fx occurs as result of the bone weakening from an endocrine disorder

involves the surface of the bone but not all the way through

fx of humerus caused by the muscular action involved in throwing heavy object

one that is some distance from location of injury

caused by the weakening on bone due to inflamm.

occurs within joint capsule

involves compression of the cortex on one side of bone and crack on the opposite side of bone

occurs in a bone weakened by malignancy

occurs in a bone weakened by neurological disorder

fx of ulnar shaft caused by blocking of a downward blow of an object

occurs near jt.

occurs due to pressure placed on the bone by a tumor

fragment of bone is removed by a violent action

double fx

comminuted fx where the bones are broken into sharp thin pieces.

fx of bone underneath head

doesn't penetrate skin

break doesn't penetrate periosteum and shape and alignment of bone aren't changed

involving the lower end of shaft of humerus

involving the condyles of the humerus in which the fx line crosses the fossae. Fx extends into the jt. capsule

greenstick fx

fx at neck of femur near trochanters

fx involving one or both of the lower extremities below the knee

fx of ilium

fx of the posterior part of the tibial articular margin and/or the malleoli

fx involving ITB

fx of the external tubercle of talus

fx of the femur at the internal condyle

avulsion of anterior superior, or inferior, spine of the ilium

fx with a dislocation of medial malleolus

body of the vertebrae is crushed all around. Can cause paralysis.

unilateral or bilateral fx of the first cervical vertebrae at the ant. and post. arches. Axial loading injury and is unstable

• - depression fx of skull
• - usually occurs in babies and resolves spontaneously

intracapsular fx where neck of femur joins head of femur

fx of the epicondyles of the distal humerus

fx locate above the condyles and epicondyles

transverse fx across the condyles of the humerus or femur

• - oblique fx of base of metacarpal of thumb
• - Mx - forced abd of thumb
• - extends to CMC and abd pollucus longus shifts the bone laterally
• - usually surgical

• - fx/dislocation of 1st metacarpal at the base of bone
• - comminuted, intra-articular
• - 3 fragments usually involved form a T or Y
• - Mx - forceful abd

• - intra-articular oblique fx of distal radius involving radiocarpal jt.
• - comminuted fx
• - dislocation of radiocarpal jt. and fx line over distal rim of radius
• - unstable fx
• - Mx - fall forward on extended hand

• - just like Barton's except fx runs on volar rim of distal radius
• - usually surgical

• - intra-articular oblique fx of radial styloid process
• - can cause lunate dislocation
• - Mx - forceful ulnar deviation and supination of wrist
• - casting or fixation

• - incomplete fx where cortex of bone is compressed causing a buckle on the compressed side. The other side of bone is undamaged
• - Mx - fall on outstretched arm
• - can be classic or angled
• - non surgical - casting

• - fx of fifth metacarpal
• - Mx - punching object
• - loss of knuckle in fifth metacarpal
• - usually surgical

• - fx of distal metaphysis of radius in which the fx fragment is displaced dorsally
• - may cause ulnar styloid fx
• - Mx- forced dorsiflexion of wrist

• - reverse Colle's fx
• - transverse fx of distal radius
• - volar displacement
• - Mx- fall forward on flexed wrists

• - occurs with mallet finger - extensor injury
• - avulsion fx causing finger to drop
• - Mx- forceful hyperext

• - fx of proximal ulna with dislocated radial head within elbow jt.
• - 2 types - extension and flexion
• - Mx - forces through hand/forearm with elbow bent
• - radius is pulled away from joint by interosseous lig.
• - usually surgical

• - reverse Monteggia fx
• - fx/dislocation of shaft of radius b/w middle and distal thirds and dorsal dislocation of inf. radioulnar jt.
• - Mx - direct blow to dorsal wrist or fall on outstretched arm
• - usually surgical

• - fx of distal phalanx (finger tip)
• - can be open or closed
• - usually causes nail bed damage
• - Mx- blunt trauma or crushing

- fx of navicular with volar dislocation of lunate

fx of distal portion of radius with dislocation of ulnar head and entrapment of styloid process

complete fx through bottom third of radius with greenstick fx at bottom third of ulna

avulsion fx at site of proximal interphalangeal jt.

• - fx/dislocation of ankle
• - fx of fibula about ankle jt and fx of medial malleolus
• - internal lig. rupture
• - foot displaced laterally

- v-shaped fx of the distal tibia which extends to ankle jt

• - spiral fx of proximal third of fibula
• - disruption of distal tibiofib. syndesmosis
• - fx of tibia and deltoid tear also may occur

• - comminuted fx of distal end of tibia
• - oblique fx and extends medially and laterally to tibiofibular jt.
• - impact injury caused by axial loading caused by talus driving into tibial platue

• - avulsion fx of anterial lateral margin of distal end of tibia
• -twisting injury
• - ant. tibiofib pulls away from tibia
• - Salter harris II fx

• - fx of the epiphysis,physis and metaphysis of distal tibia
• - vertical, transverse and coronal
• - Mx- twisting
• - Salter IV fx

• - fx of medial and lateral malleoli of tibia and post. process of tibia
• - surgical and non weight bearing

• - fx of base of fifth
• - dec. blood flow

• - transverse fx of maxillae
• - 3 types
• - Type I - transverse fx through alveolar process of maxilla
• - Type II - bilat/unilat. fx of maxilla
• - Type III - complete separation of maxilla

• - fx of growth plate
• - Types I - epiphysis is separated from metaphysis
• - Type II - partial sep. of epiphysis and physis from metaphysis
• - Type III - distal portion of tibia
• - Type IV - distal protion of humerus
• - Type V - crushing fx of physis

• - Newer classifications of Salter Harris
• - Adds Type VI - epiphysis,physis and metaphysis is removed from site
• - MX - gunshot or heavy machinery

• - fx b/w greater and lesser trochanters of femur
• - fx of cancellouse bone so heals well

• - MX- car impact, twisting or lateral forces to bone
• - 6 types

• - used in describing fx of femoral head
• - 4 types

• - fx of the femoral neck
• - Type I - incomplete fx
• - Type II - complete/nondisplaced
• - Type III - complete w/ partial displacement
• - Type IV - complete fx w/ complete displacement

• - describes ankle fx
• - Type A - fx is below syndesmosis
• - Type B - at jt. level with syndesmosis
• - Type C - above sysndesmosis

• - types of open fx
• - Type I - fx with open wound less than 1cm
• - Type II - open fx with wound greater than 1cm
• - Type III - fx with wound greater than 1cm and extensive soft tissue damage

- injury to the central slip of the ext. mech. of PIP jt.