General

DEFINITION

Oxford Dictionary Definition – The cracking or breaking of a hard object or material.

A bone is fractured when there is a break in the continuity of the bone cortex. Similar terms used to describe a fracture include broken, crack, greenstick or buckle; all are used to refer to the same thing – a broken bone. The break is often described by its location (i.e. bone) and its direction (horizontal, oblique, transverse).

HOW IT HAPPENS?

Fractures can happen in a variety of ways. Most fractures are due to trauma, while others are due to pathological conditions or overuse. Trauma can vary from high-energy injuries such as motor vehicle accidents to low energy injuries such as simple falls.

TYPES OF FRACTURE

• Open or Compound Fracture – The skin overlying the fracture is also broken.
• Comminuted Fracture – The bone is broken into multiple pieces.
• Avulsion Fracture – A muscle or ligament pulls the bone away, fracturing it.
• Fracture Dislocation – When a fractured bone is associated with a dislocation of a joint.
• Pathological Fracture – A fracture through bone weakened by an underlying condition – e.g. cancer, osteoporosis.
• Stress Fracture – A fracture due to overuse repetitive stresses and strains.

INVESTIGATION AND TREATMENT

The human body heals fractures by forming a blood clot that calcifies, connecting the broken pieces of bone. For a good recovery, the bones must be held in the correct position and protected while healing occurs. This may be simply by a plaster, or if the fracture is displaced, surgery may be needed to put the bone back into the correct position for adequate healing to occur. Fractures that do not heal are called non-unions. Fractures that heal in the wrong position are called mal-unions. Non-unions and mal-unions may require further surgery to be corrected (see limb reconstruction).

Note: These notes have been prepared by orthopaedic surgeons. They are general overviews and information aimed for use by their specific patients and reflects their views, opinions and recommendations. This does not constitute medical advice. The contents are provided for information and education purposes only and not for the purpose of rendering medical advice. Please seek the advice of your specific surgeon or other healthcare provider with any questions regarding medical conditions and treatment.

Limb reconstruction surgery is the field of trauma and orthopaedic surgery that deals with the management of deformities of upper and lower limbs, reconstruction of limb defects and limb equalization techniques. The aim of limb reconstruction surgery is to achieve maximum function form a deformed limb.

A range of modern surgical techniques are used to perform limb econstruction surgery, including:

• Conventional plate fixation
• Locking plate fixation
• Intramedullary Nailing
• Circular fine wire external fixators
• Bone Transport and limb lengthening
• Angular and/or rotational correction
• Joint Arthrodesis or reconstruction

The techniques used are customized for each individual case and often involve a combination of above techniques.

Common deformities treated include:

• Non-unions: Fractures that have failed to heal.
• Mal-unions: Fractures that have healed in the wrong position.
• Post-traumatic arthritis: Arthritis of a joint following a fracture or trauma.
• Bone loss: Fractures that have lost bone at the time of accident or subsequent surgery.
• Bone infection (Osteomyelitis): infected bone commonly associated near a site of previous injury or surgery.

Note: These notes have been prepared by orthopaedic surgeons. They are general overviews and information aimed for use by their specific patients and reflects their views, opinions and recommendations. This does not constitute medical advice. The contents are provided for information and education purposes only and not for the purpose of rendering medical advice. Please seek the advice of your specific surgeon or other healthcare provider with any questions regarding medical conditions and treatment.