Definitions
A fracture is a break in the continuity of a bone. Fractures may be transverse, oblique or spiral in shape. In a greenstick fracture, only one side of the bone is fractured, the other simply bends (usually immature bones where cartilage is incompletely ossified). A comminuted fracture is one in which there are more than two fragments of bone. In a complicated fracture, some other structure is also damaged (e.g. a nerve or blood vessel). In a compound fracture, there is a break in the overlying skin (or nearby viscera) with potential contamination of the bone / fragments. A pathological fracture is one through a bone weakened by disease, e.g. a metastasis, osteopenia/osteoporosis.
Key Points
- Always consider multiple injury in patients presenting with fractures.
- Remember there may significant blood loss in long bone fractures.
- Compound fractures are a surgical emergency and require appropriate measures to prevent infection, including tetanus prevention.
- Always image the joints above and below a long bone fracture.
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