13.03.01 Orthopaedics - Fractures

Terminology

    • Fracture line

      • Transverse

      • Oblique

      • Spiral (often in legs, from rotational force when walking etc)

    • Bits

      • Comminuted = Smashed up (>2 bits)

      • Segmental = >1 fracture line

      • Avulsion = Bit ripped off

    • Childhood fractures

      • Torus (bulge)

      • Greenstick

    • Distraction

      • Distance between bone ends

    • Displacement

      • Distance of malalignment (measured in % of bone width or mm)

    • Angulation

      • Distal relative to proximal fragment

Epiphyseal plate fusion / End of bone growth

Salter-Harris classification

    • Type II is the most common

    • Type V is the worst and the easiest to miss, but also the rarest

Two key (common) fractures in kids

    • Slipped upper femoral epiphysis (disjointed head)

    • Supracondylar humerus fracture (angle of distal humerous goes back instead of forward)

Wrist fractures

    • Colles

      • Dinner-fork deformity / Posterior displacement

      • Conservative management / Splinting

    • Smith

      • Anterior displacement

      • Requires surgery

Ligaments of the ankle

    • Talus should have equal space all around it

      • If not => Talar shift, from ligament damage (NB this is unstable)

Notes

    • The growth plate is the most fragile/vulnerable bit in kids

    • Divide the length of bones into thirds when reporting position

    • Subluxation is partial dislocation