Extremity fractures and pathology

Describing a fracture

A fracture is described by whether the skin is broken, how far the break goes and the shape of the line. A closed (simple) fracture leaves the skin intact; an open (compound) fracture breaks through the skin. A complete fracture goes all the way across the bone; an incomplete one does not. The line can be transverse (straight across), oblique (at an angle) or spiral (twisting around the shaft from a rotational force). A comminuted fracture has three or more fragments, an impacted fracture drives one fragment into the other, and an avulsion fracture is a small piece pulled off by a tendon or ligament. Children's bones bend more: a greenstick fracture breaks one side of the cortex, and a torus (buckle) fracture crumples the cortex, often in the distal radius. A stress fracture may not show at first, and a pathologic fracture goes through bone already weakened by disease, such as a metastasis or osteoporosis. A dislocation is a joint completely out of place; a subluxation is a partial one.