What do we mean by fractures? A fracture is defined as a break in a skeletal segment (bony or cartilaginous)

The exact point of interruption of the skeletal segment is referred to as the ‘fracture rhyme’, while ‘fracture focus’ is defined as the area immediately surrounding the fracture rhyme.

Classification of fractures

Fractures are based on aetiology, mechanism of injury, number of breaks, skeletal location and extent of damage.

With respect to aetiology, a distinction is made:

• traumatic fractures. When a single effective trauma causes the interruption of a healthy skeletal segment.
• Pathological fractures. When a minor trauma, which would not normally be sufficient to cause the interruption of a bone, acts on a skeletal segment already undermined by an ongoing or previous pathological process (fractures at the site of tumours, osteomyelitis, etc.). They are more correctly defined as fractures in pathological bone.
• Durable or fatigue fractures (stress fractures). When repeated microtraumas act on a healthy bone over time. They are well exemplified by fractures of the metatarsal bones in marathon runners.

Depending on the injury mechanism, we recognise fractures of four types:

• By bending: the trauma causes a change in the normal curvature of the bone until fracture.
• By torsion.
• By compression: they are typical of the spinal cord and the spongy tissue during the trauma is crushed between the diaphysis and the joint cavity.
• By tearing: abrupt traction on the skeleton of a ligament or tendon causes this type of fracture.

Based on the number of breaks, we recognise three types of fracture: unifocal, bifocal, plurifractured.

According to skeletal location: diaphyseal, metaphyseal, epiphyseal.

Based on displacement we recognise two types of fractures:

• compound. When there is no migration of stumps or fragments.
• decomposed. When the stumps or any fragments migrate.
• Exposed fractures occur when the bone comes into contact with the outside (with serious risk of infection through bacterial contamination).

Therapy

Therapy is conservative (plaster cast) in most compound fractures, and surgical in compound and/or exposed fractures.

Fractures usually heal in about 30 days in moderate-sized segments and in 3-6 months in long limb bones.

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