Sixty five years old lady presented with history of injury three months back operated at a distant place. She gave a history of fracture in femur which had been fixed.
Her latest xray showed comminuted fracture of distal femur fixed by distal femoral plate.
The fracture had still not united. She was advised bone grafting but never followed up.
Comminuted fractures are generally as a result of direct trauma to the bone. Following xray is anteroposterior view of the forearm and is revealing fracture ulna. A comminuted fragment is seen in the ulnar fracture.
The patient was a young male and was managed with open reduction and closed reduction
Following xray is of 67 years old man who fell in bathroom. He presented in the out patient department three days after the injury with complaint of pain and swelling in the upper part of the arm. There was substantial bruising on the arm and swelling was noted.
The xray revealed comminuted fracture of upper end of humerus.
The patient was advised closed reduction and internal fixation using an interlock nail but patient refused for surgery.
Open fractures occur when the covering skin layer is breached by external force or the fracture fragment injuring from within.
Open fractures are very common occurrence in leg bones because the soft tissue envelopes are very thin around the bones especially tibia in its antero medial aspect.
A 20 year old young male was hit by a motorbike while he was attempting to cross the road. He presented to casualty with large wound over the middle third circumference of the leg. [Read more...]
The xray in image shows a comminuted fracture of upper end of tibia. The xray in present picture is anteroposterior view.
These fractures are high velocity injuries and an extension to knee joint is very common.
Because of their configuration these kinds of fractures often require surgical treatment.
A cause for concern in these patients is compartment syndrome that might develop due to continued bleed in fracture.
Term fracture,a break in the continuity of a bone, depicts all types of disruptions, from microscopic to severely comminuted injuries. Fracture description should be concise and accurate facts must be communicated to the physician regarding the mechanism of injury, the type of fracture present, and associated soft tissue injuries. A comprehensive detail of system for describing fractures using orthopaedic terminology is described below.
For a physician classification of fractures is of utmost importance. Not only it suggests the severity and mechanics of injury that occurred, but also helps to formulate most suitable treatment.There are many types of classifications which are available to physicians. These classifications vary with type of bone involved and the region of bone involved.
For this discussion we would stick to the basic and general classification of the fractures of long bones. We have already discussed closed and open fractures. That is one type of classification according to absence or presence of wounds that communicate with fracture.