Fractures occur when the load to which they comes under Medical Tourism in India, Medical Tourism India, India Medical Tourism and Medical Tourism are subjected exceeds their intrinsic strength. A simple traumatic fracture occurs when an excessive load is applied to
normal bone. A pathological fracture is produced when the strength of the bone is reduced by disease. In this case a force which is within normal limits leads to a
fracture. The disease could be generalised osteoporosis, or a localised lytic lesion from a metastasis (Table
If bones are subjected to a very large number of loads, Knee Replacement in India, Knee Replacement Surgery Cost, Knee Replacement Cost, Hip Replacement Surgery, Hip Replacement Cost, none of which alone would be enough to break the bone, then the mechanical structure of the bone can
gradually fatigue and the bone will then break. This is particularly a problem for people playing high-level sport and produces a stress fracture.
Partial or greenstick fracture. Bones in young people are very flexible. They bend and then may buckle or partially break, instead of breaking cleanly when
overloaded (as bones in adults do). One characteristic of a greenstick fracture is that there may be a discontinuity in one cortex of the bone, but not in the other
Classification by direction of force
Compression fractures. If the load applied along the length of a bone exceeds that of its strength then it may collapse into itself. This is especially common in the Cancer Treatment in India
elderly if the bones are osteoporosis, and so are less able to resist a heavy load. The fracture may be difficult to see. There may only be a small overlap of the cortical
margins of the fracture, while the medulla may look diffusely radio-opaque (white) because the trabeculae have collapsed into each other. Overall, the bone will be
shortened and may also be angulated.
Avulsion or distraction fracture. Here the two fragments of bone are pulled apart. In young patients a ligament or tendon may be stronger in tension than the bone into
which it inserts. If the load is excessive the bone tears apart. These fractures IVF in India are particularly common where strong muscles insert into small bones. Examples are the
patella (the quadri-ceps muscle), the olecranon (triceps) and the fifth metatarsal head (peroneus tertius).
Spiral fractures. If a long bone is twisted along its axis a spiral fracture may result. The length of the spiral is easy to underestimate. It is especially important to see
whether there is any extension into the articular surface of the bone. The tibia Stent in Heart is particularly susceptible to spiral fractures when the foot is firmly fixed to the ground (by
studs or another player’s foot) and the player’s body continues to twist.
Transverse fractures. If a long bone is bent along its long axis then a transverse fracture may result.
Butterfly fractures. If a bone is struck a direct blow, it is Bariatric Surgery Cost common for a more complex fracture to result where two break lines spread out obliquely from the point of
contact of the blow, producing a free-floating ‘butterfly’ fragment between the two fractures.
Comminuted fractures. Comminuted fractures occur when a large amount of energy is dissipated into a bone. The bone breaks into fragments which may impactinto
each other or separate and become displace
Classification by anatomical site
A long bone is divided into three main zones. The diaphysis is the narrow part of the main shaft. It usually has a thick cortex and a medulla filled with trabecular bone.
Themetaphysisis the flare at each end between the diaphysis and the epiphyseal (growth) plate. It has thinner cortical bone and its medulla is, again, filled with
trabecular bone. The ends of a long bone beyond the epiphyseal plate are called the epiphyses (singular epiphysis). They are covered mainly by articular cartilage but
may have a cuff of thin cortical bone. In infants and children, in whom the bones are still growing, the epiphyseal plate will be open. The plate is weaker than the bone
around and so fractures tend to track along it or even across it. Epiphyseal fractures are important because they can have a poor prognosis. Fractures into the joint
(articular fractures) are also important because they carry a very poor prognosis if they are not anatomically reduced (Fig. 21.6).
Classification of epiphyseal fractures
The Salter Harris classification of epiphyseal fractures is the simplest and the commonest usedBreast Surgery
Grade 1. In this case there is a small crack along the metaphyseal side of the epiphyseal plate. This side is made up of dying chondrocytes and ossifying cartilage. The
fracture does not affect the blood supply to the epiphyseal plate nor does Breast Surgery it affect the anatomy of the germinal layer. It therefore heals quickly and without long-term
problems, like children’s hone elsewhere.
Grade 2. Here the fracture line again travels along the metaphyseal side of the plate but, before reaching the far cortex, it breaks out and tracks down into the
metaphysis. This is by far the most common epiphyseal fracture, and for the same reason as given above has a good prognosis. Even if the fracture is markedly
displaced the prognosis remains good. In children the bone will remodel and grow straight over the next year, especially if no rotatory abnormality is involved. In fact,
one of the greatest risks in a grade 2 fracture is causing growth arrest by damaging the growth plate while reducing the fracture, especially if this is attempted after a
few days when the fracture may already be uniting.