Presentation on theme: "Fracture Description & Classification"— Presentation transcript:
1Fracture Description & Classification Regions Emergency Medicine
2Anatomic description of fractures TypeComminutionLocationDisplacement
3Anatomic description - Type Type is the overall fracture patternExamples are:SimpleSpiralsegmental
4Anatomic description - Communition Comminution is the measure of the number of pieces of broken bone that there are.Examples are: non-comminuted or mildly comminuted or severely comminuted
5Anatomic description - Location Location is the anatomic location of the fracture usually described by giving the bone involved and location on the boneExamples are: distal radial shaft, proximal 1/3 humeral shaft, intra-articular distal tibial
6Anatomic description - Displacement Displacement is the amount the pieces of a fracture have moved from their normal locationCan be displaced or non-displacedSubdivided into 3 sub-categories: translation, angulation, and shortening
7Displacement - Translation Translation is sideways motion of the fracture - usually described as a percentage of movement when compared to the diameter of the bone.
8Displacement - Angulation Angulation is the amount of bend at a fracture described in degrees. Described with respect to the apex of the angle or with respect to direction of distal fragment.
9Displacement - Shortening Shortening is the amount a fracture is collapsed expressed in centimeters. Sometimes called bayonette apposition.
17AO Classification 1st number = long bone 2nd number = bone segment Letter = fracture type (A,B,C)Then 3rd & 4th numbers classify fracture group & subgroup
18Salter-Harris Classification Only used for pediatric fractures that involve the growth plate (physis)Five types (I-V)
19Salter-Harris type I fracture Type I fracture is when there is a fracture across the physis with no metaphysial or epiphysial injury
20Salter-Harris type II fracture Type II fracture is when there is a fracture across the physis which extends into the metaphysis
21Salter-Harris type III fracture Type III fracture is when there is a fracture across the physis which extends into the epiphysis
22Salter-Harris type IV fracture Type IV fracture is when there is a fracture through metaphysis, physis, and epiphysis
23Salter-Harris type V fracture Type V fracture is when there is a crush injury to the physis
24Gustillo classification The Gustillo classification is used to classify open fracture - ones in which the skin has been disruptedThree grades that try to quantify the amount of soft tissue damage associated with the fracture
25Open fractures - grade 1wound less than 1 cm w/ minimal soft tissue injurywound bed is cleanbone injury is simple w/ minimal comminutionw/ IM nailing, average time to union is weeks
26Open fractures - grade 2wound is greater than 1 cm w/ moderate soft tissue injurywound bed is moderately contaminatedfracture contains moderate comminutionw/ IM nailing, average time to union is weeks
27Open fractures - grade 3A wound greater than 10 cm w/ crushed tissue and contaminationsoft tissue coverage of bone is usually possiblew/ IM nailing, average time to union is weeks
28Open fractures - grade 3B wound greater than 10 cm w/ crushed tissue and contaminationsoft tissue is inadequate and requires regional or free flapw/ IM nailing, average time to union is weeks
29Open fractures - grade 3C is fracture in which there is a major vascular injury requiring repair for limb salvagefractures can be classified using the MESSin some cases it will be necessary to consider BKA following tibial fracture