شكستگي Fracture

شكستگي به اشکال متفاوتی طبقبه بندی میشود چنان : شكستگي كامل ؛ شكستگي ناكامل ؛ شكستگي چندقطعه اي ؛ شكستگي باز ؛ شكستگي بسته ؛ شكستگي ناشي از فشرده شدن ؛ شكستگي همراه با درهم فرو رفتن قطعات حاصل از شكستگي ؛ شكستگي به صورت كنده شدن يك تكه از استخوان ؛ شكستگي پاتولوژيك ؛ شكستگي استرسي و غیره . در این بحث صرفا انواع شکستگی با تصاویر مرتبط به زبان انگلیسی شرح داده خواهد شد . جهت عنوان عکس ، موس را روی تصویر ببرید . برای بزرگنمایی روی تصویر کلیک کنید :

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Avulsion– Bony prominence often serve as attachment for muscle, ligaments and tendons. When these prominences are broken off the main bone by the pull or the passive resistance of a strong ligament, the fracture is known as an avulsion or chip fracture.

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Bennett’s fracture is a fracture of the base of the 1st metacarpal with involvement of the first metacarpocarpal joint.

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Blow-out fracture is a fracture of the orbital floor caused by a sudden increase of intraorbital pressure due to a traumatic blow. The orbital contents are forced into the maxillary sinus which results in a fluid (blood) level in the sinus.


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Boxer’s – a fracture of the neck of the fifth metacarpal resulting from a direct blow with a clenched fist against something. There is dorsal angulation at the fracture site with the head of the metacarpal being displaced volarly.


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Colles – a fracture of the distal radius, within 2.5 cm of the articular surface. There is a dorsal and upward displacement of the distal fragment. An avulsion fracture of the ulnar styloid process, displacement of the head of the ulna and rupture of the triangular fibrocartilage joint disc are also associated with this fracture, (can be refer to as an upside down ‹dinner fork deformity›)


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Comminuted – a fracture in which the bone is broken into more than two fragments. It may be splintered or crushed.


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Compound – exists when the fracture site communicates with the outside environment. It is also known as an open fracture. This type of fracture may predispose osteomyelitis.

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Compression – commonly involves vertebrae. Forceful flexion of the vertebral column drives the superior and inferior surfaces of the vertebral body toward each other and produces a wedge-shaped vertebra. May also be seen in the calcaneus resulting from a fall from a height and landing on the heels.

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Contrecoup – (contralateral) a fracture located on the opposite side of the body to the impact, ie a blow to the right side of the mandible fractures the left side.


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Depressed – occurs when the hard surface of the one bone is driven into the softer surface of the another. Commonly seen in the skull and tibial plateau.

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Incomplete -often occurs in infants and children.


*Greenstick – an incomplete angulated fracture producing a bowing of the bone.

*Torus type or buckle produces a outward elevation of the bone

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Impacted – occurs when one fragment of bone is forcibly driven or telescoped into the adjacent fragment. It usually occurs in areas of cancellous bone for example in the shoulder where the proximal shaft of the humerus is driven into the humeral head.

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Intertrochanteric -fracture through the greater and lesser trochanter of the femur

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Linear (longitudinal, fissure) fracture is a lengthwise break in a bone.


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Malleolar – is a partial dislocation of the ankle with fracture of the fibula within 5 -7.5
cm above the lateral malleolus and rupture medial ligaments of the ankle.

  

Bi – malleolar – involving an avulsion fracture of the medial malleolus as well as the
lateral  malleolus (AKA as Pott’s when dislocation of the joint occurs).

 

Tri – malleolar – involving the posterior malleolus (tibial promontory) as well as medial
and lateral malleolus. It is often associated with dislocation.

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Monteggia– is a fracture of the proximal third of the ulna accompanied by anterior dislocation of the radial head. The injury occurs by the transmission of the force following a fall on the outstretched hand through the hand and forearm when the elbow is partial flexed.

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Oblique – the fracture line runs on the diagonal (45 °) to the long axis of the bone.

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Pathological– is a fracture that occur in a bone which is weakened by a disease process. Usually classified according to the underlying cause:
1.   local changes – secondary to infection, tumours, disease
2.   generalized skeletal changes – secondary to osteoporosis, scurvy, osteomalacia, Paget’s, hyperparathyroidism etc.

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Salter- Harris (epiphyseal) type fractures are five distinct variations in fractures through the epiphyseal plate. Bleeding into the growth plate results in slow or stoppage of growth of the bone.

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Smith’s fracture is similar to a Colles’s fracture except the distal fragment is displaced anteriorly.

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Spiral – caused by a twisting force. The fracture line runs obliquely and twists around the long axis of the bone. It usually involves a long section of the shaft.

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Stress ( fatique) – fracture occurs due to repetitive stress on bones. Examples are:

– Shin splints – minute fractures of the tibia from jogging.

March– fractures of the metatarsals usually at the neck of the 2nd, 3rd, 4th metatarsal. It is commonly seen in military personnel subject to vigorous hiking and marching.
It can also occur in the shaft and neck of the femur, ischial and pubic ramus There may be normal appearance of the radiographs at the onset of symptoms, but 10 -20 days later   a cortical defect or periosteal reaction will be evidence of a healing fracture.

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Supracondylar fracture describes the location of a fracture in the supracondylar region of the humerus. This is a common injury seen in children who have fallen on their elbow from a height.

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Transverse – a fracture which occurs at right angles to the long axis of the bone caused by a direct blow or due to pathology.

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Tripod fracture occurs when the zygoma is fractured at all three sutures: frontal, temporal, and maxilla.

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References
http://en.wikipedia.org/wiki/Colles’_fracture
http://www.eatonhand.com/hw/hw020.htm
http://www.medterms.com/script/main/art.asp?articlekey=8079
http://www.vlib.us/medical/xray/xray6.htm
http://en.wikipedia.org/wiki/Bone_fracture
http://emedicine.medscape.com/article/309615-overview
http://en.wikipedia.org/wiki/Compression_fracture
http://en.wikipedia.org/wiki/Coup_contrecoup_injury
http://en.wikipedia.org/wiki/Skull_fracture
http://en.wikipedia.org/wiki/Greenstick_fracture
http://www.ucd.ie/vetanat/radiology2001/skeletalabnormalities/fractures.html
http://www.wheelessonline.com/ortho/intertrochanteric_fractures
http://www.uchospitals.edu/online-library/content=P08957
http://en.wikipedia.org/wiki/Skull_fracture
http://www.eorthopod.com/content/adult-ankle-fractures-types
http://sdfghj.wordpress.com/2008/01/14/eeee/?preview=true&preview_id=95&preview_nonce=24bd246db6
http://en.wikipedia.org/wiki/Salter-Harris_fractures
http://www.radiologyassistant.nl/en/476a23436683b
http://www.mikety.net/Answers/Fx-mt.html
http://www.joint-pain-expert.net/supracondylar-fracture.html
http://www.infolizer.com/?title=transverse+fracture
http://www.rrc.mb.ca/

Posted on سپتامبر 11, 2010, in English, کل مطالب. Bookmark the permalink. 2 دیدگاه.

  1. سلام دوباره دكتر. من اين تيرماه كه بياد 2ساله كه ساقم پلاتينه. حتما بايد درش بيارم؟ اشكالي نداره بمونه و درش نيارم؟

  2. دكتر سلام. اومدم اينجا سوالم و بپرسم كه كسي نخونه. دكتر من مدتيه خون بالا ميارم تو قفسه سينم هم درد شديدي دارم و نفسم به سختي مياد بالا موقع درد. رفتم پيش دكتر ولي مشخص نشد مشكلم چيه فقط گفتند كه اگه خون بالا آوردي حتما بيا بيمارستان و خون وصل كن. خيلي ميترسم دكتر معده هم مشكلي نداره

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