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A fracture is a complete or incomplete break in a bone resulting from the application of excessive force. An injury may be classified as a fracture-dislocation when a fracture involves the bony structures of any joint with associated dislocation of the same joint.
Fractures usually result from traumatic injury to a bone, causing the continuity of bone tissues or bony cartilage to be disrupted or broken. Fracture classifications include simple, compound, incomplete, and complete. Simple fractures (more recently termed closed fractures) are not obvious on the surface, as the skin has not been broken and remains intact. Compound fractures (now commonly referred to as open fractures) break the skin, exposing bone and causing additional soft tissue injury and possible infection. Single and multiple fractures refer to the number of breaks in the same bone. Fractures are termed complete if the break is completely through the bone, and described as incomplete or "greenstick" if the fracture occurs partly across a bone shaft. This latter type of fracture is often the result of bending or crushing forces applied to a bone.
Fractures are also named by the specific portion of the bone involved and the nature of the break. Identification of a fracture line can further classify fractures. Types include linear, oblique, transverse, longitudinal, and spiral fractures. Fractures can be further subdivided by the positions of bony fragments and are described as comminuted, non-displaced, impacted, overriding, angulated, displaced, avulsed, and segmental.
Linear fractures have a break that runs parallel to the bone's main axis or in the direction of the bone's shaft. For example, a linear fracture of the arm bone could
extend the entire length of the bone. Oblique and transverse fractures differ in that an oblique fracture crosses a bone at approximately a 45° angle to the bone's axis. In contrast, a transverse fracture crosses a bone's axis at a 90° angle. A longitudinal fracture is similar to a linear fracture. Its fracture line extends along the shaft but is more irregular in shape and does not run parallel to the bone's axis. Spiral fractures are described as crossing a bone at an oblique angle, creating a spiral pattern. This type of break usually occurs in the long bones of the body such as the upper arm bone (humerus) or the thigh bone (femur).
Author Info: L. Fleming Fallon, Jr., MD, PhD, DrPH, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002
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