Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Trauma: adult trauma
- Trauma: paediatric trauma
- Trauma: trauma scoring systems
- Trauma: traumatic brain injury
- Trauma: thoracic trauma
- Trauma: abdominal trauma
- Burns
- Acute abdomen
- Acute pancreatitis
- Acute appendicitis
- Acute cholecystitis
- Large-bowel obstruction
- Small-bowel obstruction
- Perforated gastro-duodenal ulcer
- Volvulus
- Gastrointestinal bleeding
- Mesenteric ischaemia
- Acute limb ischaemia
- Leaking abdominal aortic aneurysm
- Epistaxis
- Inhaled foreign body (FB)
- Urinary retention
- Gross haematuria
- Renal colic
- Testicular pain
- Priapism
- Paraphimosis
- Necrotizing fasciitis
- Principles of fracture classfication and management
- Compartment syndrome
- Acute abdominal pain in pregnancy
- Paediatric surgical emergencies
- Acute hand injuries
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Principles of fracture classfication and management
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- List of contributors
- Foreword by Professor Lord Ara Darzi KBE
- Preface
- Section 1 Perioperative care
- Section 2 Surgical emergencies
- Trauma: adult trauma
- Trauma: paediatric trauma
- Trauma: trauma scoring systems
- Trauma: traumatic brain injury
- Trauma: thoracic trauma
- Trauma: abdominal trauma
- Burns
- Acute abdomen
- Acute pancreatitis
- Acute appendicitis
- Acute cholecystitis
- Large-bowel obstruction
- Small-bowel obstruction
- Perforated gastro-duodenal ulcer
- Volvulus
- Gastrointestinal bleeding
- Mesenteric ischaemia
- Acute limb ischaemia
- Leaking abdominal aortic aneurysm
- Epistaxis
- Inhaled foreign body (FB)
- Urinary retention
- Gross haematuria
- Renal colic
- Testicular pain
- Priapism
- Paraphimosis
- Necrotizing fasciitis
- Principles of fracture classfication and management
- Compartment syndrome
- Acute abdominal pain in pregnancy
- Paediatric surgical emergencies
- Acute hand injuries
- Section 3 Surgical disease
- Section 4 Surgical oncology
- Section 5 Practical procedures, investigations and operations
- Section 6 Radiology
- Section 7 Clinical examination
- Appendices
- Index
Summary
Introduction
A fracture is defined as a disruption in the integrity of living bone. It involves injury to bone marrow, periosteum, and adjacent soft tissues. Fractures can be classified as closed or open. In closed fractures the enveloping skin and soft tissue are intact but the area may be bruised and swollen. When fractures are classified as open, the integrity of the skin is lost and the fracture haematoma communicates with the external environment. In a complete fracture, the bone is broken completely into two or more fragments. In an incomplete fracture, the bone is divided but with periosteal continuity remaining. In a greenstick fracture, seen most commonly in children, the bone is buckled or bent. Intra-articular fractures are those where the fracture line involves the joint.
Fractures are also described in terms of the fracture patterns, such as transverse, oblique, or spiral. In comminuted fractures there are more than two broken fragments. Compressive forces may result in impacted or crush fractures; avulsion fractures are caused by traction forces, and spiral or oblique fractures are due to rotational forces. Fracture segments are defined by looking for displacement (described as: translation, angulation or tilt, and finally rotation). If a trivial force was needed to produce the injury then a pathological fracture must be ruled out as the bone may be diseased with osteoporosis, Paget's disease or malignancy (primary or secondary).
Fracture healing
Occurs in four different stages (Figure 54):
Haematoma formation
Granulation tissue and soft callus formation
Bony callus
Bone remodelling.
- Type
- Chapter
- Information
- Hospital SurgeryFoundations in Surgical Practice, pp. 312 - 319Publisher: Cambridge University PressPrint publication year: 2009