fractures

DR.UJJWAL SINHA
DEPARTMENT OF ORTHOPAEDICS
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AXIAL SKELETON - 80
APPENDICULAR SKELETON - 126
FUNCTION
PROTECTIVE
SUPPORT OF BODY
HAEMOPOESIS
LOCOMOTIVE
MINERAL STORAGE
COMPOSITION :
MATRIX - TYPE 1 COLLEGEN IN
MUCOPOLYSACHRIDE GROUND SUBSTANCE
- OSTEOID
MINERAL - Ca , Phosphate , IN THE FORM OF
HYRDOXY APPATITE
BONE CELL - OSTEOCYTE
OSTEOBLAST
OSTEOCLAST
HARVESIAN SYSTEM - LAMELLI CONNECTED
WITH CANALICULI
ANATOMY :
MEDULLA - STORAGE
- MARROW
CORTEX
- STRENGTH
- REMODELING
- ATTACHMENTS
EPIPHYSIS
GROWTH PLATE
METAPHYSIS
DIAPHYSIS
TYPES:
LONG BONES
SHORT BONES
FLAT BONES
IRREGULAR BONES
SESAMOID BONES
HISTORY
Egyptians
Hippocrates
Al-Zabra
Chinese
Arabians
Mathysen
H.O.Thomas
Splintage; 460 B C
Casting
Willon Board
Immobilization
POP in 1876
Rest, Rest & Rest
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Robert Jones
Orthopaedics
Sarmiento
Kuntscher
AO Group
Illizarov
Dr.M.G.Kini
Father of
FCB
IM Nailing
1958,Muller,
Primary intention
DEFINITION
Break in surface of bone(Cortex or Articular
surface)
FORCE REQUIRED
-Sudden & Severe
-Repetitive
-Trivial(Pathological)
Direct
Indirect
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Definite history
Pain
Swelling
Tenderness
Deformity
Crepitus
Inability to use the involved limb
Loss of transmitted movements
I
TYPES
1.Simple
2.Compound
II
1.Complete
Displaced
-Shift, Tilt,
Rotation
Un Displaced
2.Incomplete
III 1.Linear
Transverse
Oblique
Spiral
- Butter Fly
2.Comminuted
3.Segmental
4.Bone Loss
<50%
>50%
IV. ATYPICAL FRACTURES
1)
2)
3)
4)
5)
6)
Green stick
Impacted
Stress
Pathological
Hairline
Torus
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Each long bone is numbered.
First digit
Bone
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Second digit
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Third letter
AO/ASIF
Segment
1–4
Type A – C
Proximal & distal
A - C
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Usually caused by directly applied force to
fracture site
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Caused by violence transmitted through limb
from a distance (twisting movements)
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Occurs in children: bones soft and bend
without fracturing completely
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Fracture in cancellous bone: result of
compression (osteoporosis)
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Two or more bone pieces - high energy
trauma
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Bone fragments are impacted into each other.
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Abnormal stress on normal bone (fatigue
fracture) or normal stress on abnormal bone
(insufficiency fracture).
Fig.
61-9
OPEN FRACTURES
: EMERGENCY
GUSTILLO ANDERSON:
I
Less than 1cm
II
1-10 cm ; No devitalization
III > 10cm ; Devitalized, Contaminated
III a. Extensive, but soft tissue coverage
present
III b. Bone exposed, periosteum
III c. NeuroVascular injury