Bone Fractures

Bone Fractures

1. INCOMPLETE (predominantly in children- bones are more bendable)

   • bowing- acute plastic bowing (rickets)
   • torus- buckling of cortex
   • greenstick- fractured bone on one side with other side intact

2. COMPLETE

   • simple
   • comminuted- fragmented pieces of bone
   • open- bone protrudes through skin

3. SPECIAL TYPES

   • FATIGUE "march"- constant stress (e.g. jogging)
   • INSUFFICIENCY- abnormal bone and normal stress
   • pathologic- has lytic area (loss of tissue)

4. DIRECTION AND OTHER FEATURES

   • • IMPACTED fracture- bone breaks into multiple fragments which are driven into each other
     • DEPRESSION fracture- fragment is depressed below the normal surface

5. PROCESS OF HEALING

   • Fracture causes bleeding > elevates the periosteum. Periosteum is pushed out > procallus formation forms a bridge > callus is formed and reabsorbed
   • PERIOSTEAL REACTION
     • radiological observation with no clinical equivalent– patient may have bone pain and tenderness
     • lifting of periosteum stimulates osteoclasts to form new bone
     • caused by tumour, pus, haemorrhage, increased vascularity or serum
     • Types of periosteal reaction due to bone tumour
       • E: "onion skin", solid periosteal reaction in layers, caused by aggressive tumour (malignant)
       • E-G caused by aggressive tumours

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