Fractures and Their Classifications

### Fractions

Severity:
- Incomplete fracture:
  - Green stick
  - Fissured
  - Splintered
  - Differed
- Complete fracture:
  - Transverse
  - Oblique
  - Longitudinal
  - Spiral
Shape of Fracture Lines:
- Single
- Segmental
- Multiple/comminuted
Anatomical Location:
- Diaphyseal
- Metaphyseal
- Epiphyseal plate
- Epiphyseal
- Condylar
- Articular
Surrounding Tissues:
- Simple
- Compound
- Complicated

### Types of Fractures

Illustrations demonstrate different types of fractures:
- Transverse
- Oblique
- Spiral
- Longitudinal

Overlapping (overriding) fracture: One fracture fragment overlaps another, oblique fracture line.
Spiral fracture: The long bone's continuity is interrupted, and the upper fragment rotates due to muscle pull.
Star fracture: A number of cracks radiate from the fracture center; bone fragments may become detached.

Pain: Common, due to pressure in bone's long axis; felt at fracture site
Swelling: Trauma causes bleeding and inflammatory exudates. Peaks within 24-48 hours, then subsides gradually.
Dysfunction: Possible lameness or paralysis due to pain or loss of mechanical support
Abnormal Mobility: Present in complete shaft fractures, absent in incomplete or impacted fractures
Abnormal Posture: Departure from normal anatomical structure; often caused by displaced bone fragments.
Crepitus: Gritting sensation from broken bone ends contacting each other.

History: Trauma details, lameness, pain information
Visual examination: Assessing apparent lameness, gross anatomical changes, and skin lacerations
Physical examination: Palpating for swelling, pain, abnormal positions, and crepitus.
Active and passive motion: Assessing range of motion
Neurological Examination: Evaluating possible paralysis from vertebral, femoral, or humeral fractures.
Radiological examination: Identifying discontinuity of the cortex, medullary canal

Bone contusion: Lameness, local sign
Dislocation of joint: Restricted motion, range increase in one direction while diminishing in another; rocking sound instead of crepitus

Species: Large animals often unsuitable for treatment due to impaction, difficulty with immobilization.
Age: Immature animals generally heal better than adults.
Sex: Males often more aggressive, hindering healing.
Temperament: Aggressive animals more difficult to manage.
Economic Value: Sentimental value of animal or need for its continued use may outweigh costs.
Fracture Location: Forelimb fractures often simpler to manage than hindlimb fractures.
Length of Healing: Generally 10-12 weeks, but complications are possible if immobilization prolongs.

Stages of healing (histological):
- Hematoma formation (one week)
- Granulation tissue formation
- Osteoid tissue formation (3-5 weeks)
- Consolidation
- Osseous tissue reconstruction (six months)

Animal health: Age, general health, nutritional/hormonal problems can hinder healing
Fracture limb location: Forelimbs often heal better than hind limbs.

Emergency management: Prevent further damage to soft tissue, prevent open fracture, prevent shock.
Reduction: Reconstructing normal bone shape.
Immobilization: Stabilize fractured bone segments until healing.
Preservation of function: Mobilize affected joints during healing to prevent stiffness.

Control of animal: (anesthesia, casting)
Aseptic precautions: (especially for open fractures)
Reduction Procedure: Extension, counterextension, manipulation until approximate original position
Checking: Palpation, comparison of joint points, radiological examination

External Fixation: Immobilization of joints above or below fracture
- Splints: Types of materials used Characteristics of an ideal splint Methods for splint application
- Casts: Material properties How a cast is applied, preparation, padding.
External Skeletal Fixation: Fixation by pins spanning fracture sites, fixed to external frame.
- Kirschner–Ehmer apparatus: Description of device.
- Pin Application Methods: - Procedure using pin chuck - Pin angles and insertion techniques
Internal Fixation: Fracture fragments are fixed using surgical implants.
- Bone Plates: Indication types of fractures - Procedures: -Exposure of fractured bone - placement of the bone plate
- Intramedullary pinning: Indication, types of pins used. Examples of procedures -Retrograde insertion

Delayed Union: Slow healing, imperfect bone alignment, soft tissue interference, impaired blood supply, functional disease, infection.
Osteoporosis
Senile changes (age)
Operative interference
Stripping the periosteum
Reaction to plates and screws
Area of fracture (oblique vs. transverse)
Metabolic disorders (affecting matrix mineralization)
Starvation
Radiation, burns