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Principles of fracture management Saseendar
1. PRINCIPLES OF FRACTURE
MANAGEMENT
Dr Saseendar S, MS Ortho, DNB Ortho, MNAMS,
Dip SICOT(Belgium), FISOC(US), FASM (Sing),
Shoulder, Elbow and Knee Arthroscopy Surgeon,
Chettinad Super Speciality Hospital,
Chettinad Health City, Chennai
2. TOPICS COVERED
Definition
Mechanism of fractures
Fracture types
Complete
Incomplete
Types of displacements
Fracture healing
Stages
Treatment of fractures
Closed fractures
Open fractures
3. DEFINITION
An interruption in the continuity of
the bone which may be a
complete break or an incomplete
break.
12. MECHANISMS OF FRACTURES - INDIRECT
Twisting causes a spiral fracture;
Compression causes a short oblique fracture;
Bending results in fracture with a triangular
'butter-fly‘ fragment;
Tension tends to break the bone transversely
18. GREENSTICK FRACTURES
Bending mechanism
Failure on tension side
Incomplete fracture,
plastic deformation on
compression side
May need to complete
fracture to realign
19. BUCKLE OR TORUS FRACTURE
Compression failure
Stable
Usually at
metaphyseal /
diaphyseal junction
20.
21. CLASSIFICATION OF FRACTURES
Closed fractures
There is no communication between the external
surface of the body and the fracture
22. Open fractures
There is a communication between the fracture and the
skin.
From inside-out
From outside-in
High risk of infection/
neurovascular injury
29. HEALING OF FEATURES
Stage of haematoma
Stage of cellular proliferation
Stage of callus formation
Stage of consolidation
State of remodelling
30.
31.
32.
33.
34. PRINCIPLES OF MANAGEMENT
General condition
Temporary stabilisation
Definitive treatment
Reduce
Hold
Exercise
60. LAWNMOWER INJURIES
probably most common
cause of open fractures
in children
most children are a
rider or bystander
(70%)
high complication rate -
infection, growth
arrest,amputation
> 50% unsatisfactory
results (Loder)
62. PHYSIOTHERAPY DURING
IMMOBILIZATION
Reduce oedema – to prevent the adhesion formation
Assist the maintenance of the circulation – active
exercise either by static or isotonic muscle activity
Maintain muscle function by active or static
contraction
Maintain joint range where possible
Maintain as much function as allowed by the particular
injury and the fixation
Teach the patient how to use special appliances such
as crutches, sticks, frames, and how to care for these
or any other apparatus
63. PHYSIOTHERAPY AFTER THE
REMOVAL OF FIXATION
To reduce any swelling
To regain full range of joint movement
To regain full muscle power
To re-educate full function
65. Information contained in this presentation are intended for
academic purpose only for the students of orthopaedic
surgery.
The guidelines mentioned cannot be used absolutely for
management of patients.
I am not responsible for any controversies that arise out of
this presentation.
For clarifications/ suggestions please contact
ssaseendar@yahoo.co.in or call at 91-9500366970.