Types of Fracture Short Essays

Fractures General Principles Short Essays

Question 1. Compound fracture


Compound fracture

  • Compound fracture or open fracture involves wounds that communicate with the exterior and gets contaminated

Compound Fracture Classification:

  • Type 1
    • The wound is smaller than 1 cm
    • It is clean wound
  • Type 2
    • The wound is longer than 1 cm
    • It is clean and without any soft tissue damage
  • Type 3
    • The wound is longer than 1 cm with extensive soft tissue damage

Compound Fracture Management:

  • Aims
    • To prevent infection
    • To allow tire fracture to heal
    • To restore function
  • Treatment
    • Control of hemorrhage
    • Antibiotic administration
      • Cefazolin or clindamycin is preferred for type 1 and type 2
      • Metronidazole is preferred for type 3
    • Tetanus vaccination
    • Irrigation and debridement of the wound
    • Incision and drainage in case of type 3

Question 2. Pathological fractures


Pathological fractures

  • Pathological fracture is one that occurs due to underlying diseases like
  1. Tumors:
    • Giant cell tumour
    • Bone cysts
  2. Infections:
    • Acute osteomyelitis
  3. Metabolic bone diseases
    1. Hyperparathyroidism
    2. Osteoporosis
    3. Paget’s disease

Pathological fractures Common Sites Involved:

  • Vertebral fractures
  • Fractures of the neck of femur
  • Colles fracture of the wrist

Pathological fractures Diagnosis:

  • Laboratory investigation
    • To rule out the systemic diseases present
    • ESR estimation
    • Total blood count
  • A comminuted bone scan is done
  • Biopsy

Read And Learn More: General Surgery Question and Answers

Question 3. Fracture healing


Stages of Fracture Healing:

  • Stage of inflammation
    • Occurs soon after the fracture
    • Trauma to the blood vessels of the periosteum, endosteum, bone marrow, and Haversian system occurs
    • As a result hematoma formation occurs
    • This causes hypoxia and necrosis of the fragment ends
    • There is acute inflammatory reaction with edema at the site
    • Pleuripotent cells produce osteoblast, fibroblast, and chondroblasts
    • Granulation tissue is formed
    • Hematoma gets organized
  • Soft callus formation
    • There is formation of subperiosteal fibrous tissue with fibrocartilagenous and cartilagenous components
    • This is called callus
    • It is soft at this stage
  • Hard callus formation
    • The endosteal and periosteal blood supply improves
    • The callus gets converted into woven bone
    • This immature bone is called hard callus
  • Stage of remodeling
    • There is a continuous process of deposition and resorption of bone
    • The immature bone gets converted into mature lamellar bone

Question 4. Nonunion



Lack of bony fusion of fractured ends

Nonunion Etiology:

  • Inadequate fixation
  • Infection of the fracture
  • Lack of adequate blood supply
  • Excessive periosteal stripping
  • Pathological fractures

Nonunion Features:

  • Pain
  • Difficulty in occlusion
  • Difficulty in mastication
  • Abnormality mobility of fractured fragments

Nonunion Management:

  • Expose the site
  • Graft the space
  • Stabilize the fractured ends
  • Fixation
  • Immobilization

Question 5. Dislocation and subluxation


Dislocation and subluxation

  • Dislocation refers to the condition in which the condyle is placed anterior to the articular eminence with collapse of the articular space
  • Subluxation is the partial dislocation

Dislocation and Subluxation Clinical Features

  • Pain
  • Inability to close the mouth
  • Tense masticatory muscles
  • Difficulty in speech
  • Excessive salivation
  • Open bite
  • Protruding chin
  • Deviation of the lower jaw

Dislocation and Subluxation Management:

  • Reassure the patient
  • Sedative drugs
  • Pressure and massage the area
  • Manipulation
  • The operator grasp the patient’s mandible
  • Thumb is placed over occlusal surfaces of lower molars
  • Fingertips are placed below the chin
  • Downward pressure is placed over posteriors
  • This overcomes spasm of muscles
  • Backward pressure is applied which pushes entire mandible posteriorly
  • Immobilization is done

Question 6. General management of patient with head injury


General management of patient with head injury

  • Management of the head injury depends on Glasgow Coma Scale
    • Less than 8 score- indicate severe injury
    • Score 9-12- moderate injury
    • Score 13-15- mild injury
  • Measures includes
    • Examination of the wound
    • Continued ventilation
    • Intensive care unit management of intracranial pressure
    • Oxygenation
    • Frequent neurological examination
    • CT scan

Fractures General Principles General Management Of Patient With Head Injury

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