14. Mechanism of fractures Lower limb fracture is a result of a high energy trauma except in elderly people or diseased bones Types of fracture are depend on position of limb during impaction and magnitude of forces applied.
20. Intracapsular types subcapital- just distal to femoral head Transcervicalâ at the middle of femoral neck
21. Extracapsular types Intertrochanteric- passes between two trochanterspertrochanteric âpasses through the two trochanters,one or both of which may be seperated Subtrochanteric -2or3 inches below lesser trochanter
25. this is a complete femoral neck fracture with full displacement: the proximal fragment is free and lies correctly in the acetabulum so that the trabeculae appear normally aligned
26. - Management : - Immobilization with traction until surgery - Surgery: indicated to stabilize the fracture to help healing, - Internal fixation by, angled plate , condylar plate or multiple pins . - Arthroplasty
29. Fracture of Femoral Shaft : - Mechanism : - High energy trauma , falling from height - Management : - Closed reduction ( In children ) - Open reduction internal fixation by plate and screws or interlocking nail .( In adult) - External fixator .
30. Open reduction of a fracture involves making an incision in the skin and putting the fractured bones together and stabilizing with screws or plates or rods. Closed reduction means just that: no incision made, the fracture is manipulated under a type of X-ray machine called fluoroscopy or just by feel and a cast is then usually applied. Open usually leads to quicker healing because the fragments are held together. Closed has the advantage of avoiding an operation but the healing can be slower because the bones are not rigidly held together.
33. splint  a rigid or flexible appliance for fixation of displaced or movable parts Thomas splint A long leg splint that extends from a ring at the hip to beyond the foot, allowing traction to a fractured leg, and is used in emergencies and for transportation.
39. Direct Mechanism- a fall on patella, heavy object falling across the knee Inspection- knee joint is extremely swollen, in slightly flexed position Palpation- effusion in the knee joint is easily determined
40. X ray- shows fracture lines running radialy. There may or may not be any displacement full extension of the knee joint is possible in majority of cases.
41. Treatment 1.When there is crack fracture with no displacement operation is not needed 2. Even slight displacement patellectomy is the treatment of choice, irregular articular surface of patella will damage the femoral articular cartilage and lead to osteoarthritis early in age
43. Indirect Mechanism- when a person slips on leg with the other leg in a semi flexed position Inspection- there is swelling but is less than direct fracture Palpation- one can feel the fracture line and even gap between the segments the patient is unable extend the knee and is also unable to lift the leg
44. Treatment 1.Undisplaced crack fracture by plaster cylinder 2.With separation{in middle} a) internal fixation b) patellectomy
45.
46. Fracture Tibia & Fibula: - Mechanism : -Direct trauma , falling . - Management : - Closed reduction & cast immobilization . - Open reduction internal fixation by plate and screws or inter locking nail .
51. Fractures of the Ankle Classification : - According to mechanism of injury : - Abduction - Adduction - Ext. rotation - Vertical compression Management : Surgical treatment is indicated to restore normal anatomy and function of ankle joint
56. Fractures of calcaneum Mechanism - fall from height degree of displacement also varies according to the violence Types Chip fractures- rare type Split fractures- split in to two fragments Crush fractures- the portion which articulates with talus is completely crushed
57. Functional treatment a crepe bandage is applied, the foot is elevated and active exercises are encouraged from the beginning. Majority of patients return to full activity within 6 months.
59. Mechanism â from direct violence usually at the neck Treatment - mainly functional method Stress fracture{march fracture} â due tolong march or overuse mostly in 2nd metatarsal
61. Pelvis â three bones make up each side of the pelvis. (ilium, ishium,and pubis). They are connected to the sacrum by ligaments.
62. Causes⊠Elderly people with osteoporosis. May fracture pelvis during a fall. These injuries do not usually damage the structural integrity of the pelvic ring, but may fracture an individual bone.
63. Causes⊠High- energy forces â what most fractures involve Crush accident Falls Surgical treatment may need to be done, depending on the direction and degree of the forces Injuries can possibly be life-threatening
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