Lecture Notes: Common Fracture Description Terms

Introduction

• Presenter: Dr. Lee Manini
  • Chief of Sports & Exercise Medicine, UMass Chan Medical School
  • Director, UMass Primary Care Sports and Exercise Medicine Fellowship
• Purpose: Discuss common fracture description terms
• Disclosure: No conflicts of interest

Objectives

• Introduce common fracture terminology
• Overview of different fracture types

Key Points in Describing Fractures

1. Bone Involvement: Identify the specific bone affected.
   • Location: Midshaft, distal, proximal
2. Fracture Type: Identify the fracture pattern.
3. Fracture Alignment: Assess and describe the alignment accurately.

Terms and Types of Fractures

Displacement

• Definition: Relationship between distal and proximal fragment
• Measurement: Millimeters or percentage
• Non-displaced: No displacement
• Minimally displaced: ≤ 3 mm

Angulation

• Definition: Relation of two fractures in frontal or sagittal planes
• Assessment: Requires two 90-degree apart views (AP and lateral)
• Acceptability: Evaluates if angulation is acceptable or surgical intervention needed

Apposition

• Definition: Type of displacement relating to bone ends
• Examples:
  • End-to-end
  • 50% apposition
  • Bayonet (0% overlap)
  • No apposition
• Example: Midshaft tibia fracture with minimally displaced apposition

Comminuted Fractures

• Definition: Fractures with multiple fragments
• Simple Fracture: Two parts
• Example: Comminuted fracture of the femur
• Segmental Fracture: Fracture with three distinct fragments

Avulsion Fractures

• Definition: Tendon/ligament pulls a bone piece away
• Common Sites: Hip, elbow, ankle

Intraarticular Fractures

• Definition: Fracture extends into joint space
• Implications: Increases risk of osteoarthritis, cartilage damage

Transverse Fractures

• Definition: Perpendicular to bone's long axis
• Types:
  • Transverse
  • Short Oblique
  • Long Oblique

Spiral Fractures

• Definition: Caused by extreme twisting forces
• Distinction: Not the same as long oblique fractures

Compression Fractures

• Common Locations: Cancellous bones; vertebrae
• Related Conditions: Osteoporosis increases risk

Impaction Fractures

• Definition: Direct force compressing along bone's length
• Common in: High trauma situations

Pathologic Fractures

• Definition: Occurs at weakened bone sites
• Common Causes: Tumors, osteoporosis

Summary

• Reviewed fracture description terminology:
  • Displaced, Angulation, Apposition
  • Simple vs. Comminuted, Segmental
  • Avulsion, Intraarticular
  • Transverse, Oblique (short and long), Spiral
  • Compression, Impaction, Pathologic

Closing

• Thank you for your attention.