1. the breaking of a part, especially a bone.
a break in continuity of bone; it may be caused by trauma, twisting due to muscle spasm or indirect loss of leverage, or by disease that results in osteopenia
. See illustration.
Types of fractures.
. Immediate first aid consists of splinting
the bone with no attempt to reduce the fracture; it should be splinted “as it lies,” which means supporting it in such a way that the injured part will remain steady and will resist jarring if the victim is moved. Later it will be treated by reduction
, which means that the broken ends are pulled into alignment and the continuity of the bone is established so that healing can take place. Fracture healing is truly a process of regeneration. Fractures heal with normal bone, not with scar tissue. Closed reduction is performed by manual manipulation of the fractured bone so that the fragments are brought into proper alignment; no surgical incision is made. Open fractures are highly contaminated and must be débrided and copiously irrigated in the operating room. A fracture may also require internal fixation with pins, nails, metal plates, or screws to stabilize the alignment. Once closed reduction is accomplished, the bone is immobilized by application of a cast
or by an apparatus exerting traction
on the distal end of the bone.
avulsion fracture separation of a small fragment of bone cortex at the site of attachment of a ligament or tendon.
Barton's fracture fracture of the distal end of the radius into the wrist joint.
Bennett's fracture fracture of the base of the first metacarpal bone, running into the carpometacarpal joint, complicated by subluxation.
blow-out fracture fracture of the orbital floor caused by a sudden increase of intraorbital pressure due to traumatic force; the orbital contents herniate into the maxillary sinus so that the inferior rectus or inferior oblique muscle may become incarcerated in the fracture site, producing diplopia on looking up.
Colles' fracture fracture of the lower end of the radius, the distal fragment being displaced backward.
comminuted fracture one in which the bone is splintered or crushed, with three or more fragments. See illustration.
complete fracture one involving the entire cross section of the bone.
compression fracture one produced by compression.
depressed fracture (depressed skull fracture) fracture of the skull in which a fragment is depressed.
direct fracture one at the site of injury.
dislocation fracture fracture of a bone near an articulation with concomitant dislocation of that joint.
double fracture fracture of a bone in two places.
Duverney's fracture fracture of the ilium just below the anterior inferior spine.
fissure fracture a crack extending from a surface into, but not through, a long bone.
greenstick fracture one in which one side of a bone is broken and the other is bent, most commonly seen in children. See illustration.
impacted fracture fracture in which one fragment is firmly driven into the other.
incomplete fracture one that does not involve the complete cross section of the bone.
indirect fracture one distant from the site of injury.
intrauterine fracture fracture of a fetal bone incurred in utero.
Jefferson's fracture fracture of the atlas (first cervical vertebra).
lead pipe fracture one in which the bone cortex is slightly compressed and bulged on one side with a slight crack on the other side of the bone.
Le Fort fracture bilateral horizontal fracture of the maxilla. Le Fort fractures are classified as follows: Le Fort I fracture, a horizontal segmented fracture of the alveolar process of the maxilla, in which the teeth are usually contained in the detached portion of the bone. Le Fort II fracture, unilateral or bilateral fracture of the maxilla, in which the body of the maxilla is separated from the facial skeleton and the separated portion is pyramidal in shape; the fracture may extend through the body of the maxilla down the midline of the hard palate, through the floor of the orbit, and into the nasal cavity. Le Fort III fracture, a fracture in which the entire maxilla and one or more facial bones are completely separated from the craniofacial skeleton; such fractures are almost always accompanied by multiple fractures of the facial bones.
longitudinal fracture one extending along the length of the bone. See illustration.
Monteggia's fracture one in the proximal half of the shaft of the ulna, with dislocation of the head of the radius.
oblique fracture one in which the break extends in an oblique direction. See illustration.
one in which a wound through the adjacent or overlying soft tissue communicates with the outside of the body; this must be considered a surgical emergency. The compounding may come from within (by a bone protruding through the skin) or from without (e.g., by a bullet wound communicating with the bone). See illustration. Called also compound fracture
one due to weakening of the bone structure by pathologic processes such as neoplasia or osteomalacia; see illustration. Called also spontaneous fracture
pertrochanteric fracture fracture of the femur passing through the greater trochanter.
ping-pong fracture an indented fracture of the skull, resembling the indentation that can be produced with the finger in a ping-pong ball; when elevated it resumes and retains its normal position.
Pott's fracture fracture of lower part of the fibula with serious injury of the lower tibial articulation.
Smith's fracture reversed Colles' fracture.
spiral fracture one in which the bone has been twisted and the fracture line resembles a spiral. See illustration.
sprain fracture the separation of a tendon from its insertion, taking with it a piece of bone.
stellate fracture one with a central point of injury, from which radiate numerous fissures.
Stieda's fracture a fracture of the internal condyle of the femur.
transcervical fracture one through the neck of the femur.
transverse fracture one at right angles to the axis of the bone. See illustration.
trophic fracture one due to a nutritional (trophic) disturbance.