• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •

OUTLINE OF FRACTURES CTURES FRACTURES

FRA classification of fractures- caused by sudden injury, fatigue or stress fracture, pathological frac­ tures Closed fracture, open fracture with & without wound Pattern of fracture- transverse, oblique, spiral, comminuted, impacted, compressed, greenstick­ occurs below 10 Repair phases- stage of hematoma> stage of proliferation> stage of calus> stage of consolidation> stageof remodeling Rate of union is high in children & slow as get older Sites of stress fracture -metatarsal, tibia & fibula Common causes of pathological fracture - cancer, bone cyst, paget’s disease Clinical features of fracture- deformity, swelling, visible bruises, local tenderness, impairment of function, abnormal motility. Treatment of fracture- reduction, immobilization, rehabilitation Reduction- manipulative, mechanical reduction, operative reduction Internal fixation- plates & screws, bone graph, compression screw plate, circumferential wires & bands Open fracture- contaminated & non contaminated Complications of fractures- infection, mom union, mal union, a vascular necrosis, shortening Nerve injury- neuropraxia, axonotmesis, neurotmesis post traumatic ossification= myositis ossificants Post traumatic osteodistrophy = reflux sympathetic dystrophy syndrome Growth occurres away from the elbow & towards the knee Fracture of capitulum of humerrus may lead to non union even in children Avulsion injury does not cause premature union of epiphysis Dislocation can’t occur without ligament injury Strain - incomplete rapture of ligament Sprain- acute ligament injury In extension subluxations of spine, anterior longitudinal ligament is ruptured Automatic emptying of urinary bladder when full after3 months of cord injury- automatic bladder Commonest fracture - collie’s fracture In shoulder dislocations- anterior dislocation is common Rotator cuff include- supra spinous, infra spinous, sub scapularis Immobilization is not needed if fracture of humerous is impacted Volkmann’s ischemic contracture occurs if supracondylar fracture block brachial artery Montegia fracture- fracture of upper end of ulna with radial head dislocation Galeazzy fracture- fracture of radial shaft with inferior radio ulnar dislocation Collies fracture- fracture of lower end of radius -fracture occurres 2 cm below the articular surfaces lower end displaced backwards reverse to colli - Smith fracture Scaphoid fracture is most complicated fracture in it, proximal part is prone to a vascular necrosis Rapture of urethra in hip fracture is on the membranous part Pott’s fracture- fracture of bones relates to ankle Ankle sprain - injury to medial & lateral ligament of ankle