Over the ensuing few weeks this primary callus is transformed into a bony callus by the activation of osteoprogenitor cells. Not only does this hematoma stop additional bleeding it also provides structural and biochemical support for the influx of inflammatory cells, fibroblasts, chondroblasts and the ingrowth of capillaries 1.Īt the end of this process, which usually takes approximately a week, a primary callus (also known as soft-tissue callus, or procallus) is present which is non-mineralized and not readily visible on radiography 1. Immediately at the time of fracture, the space between fracture ends is filled with blood forming a hematoma. The pathophysiological sequence of events that occur following a fracture and eventually (hopefully) lead to complete fracture healing are fairly stereotyped and can be divided into three main phases:
#PARTICULARS VS GENERALITIES SKIN#
compound fracture: extending through the skin.Many of the aforementioned fracture types can also go on to have additional complicating features, not to mention many associated soft tissue injuries beyond the scope of this article. direction: terminology will depend on the location.direction: usually of the distal part relative to the proximal part.The relationship between fracture fragments can be described using the following terms. greenstick fracture: the cortex is broken, but only on one side.buckle fracture: the cortex is buckled, often in the distal radius.incomplete fracture: does not cross the bone completely (usually encountered in children).comminuted fracture: more than two parts.spiral fracture: helical fracture path usually in the diaphysis of long bones.oblique fracture: oriented obliquely across the bone.transverse fracture: perpendicular to the axis of the bone.complete fracture: extends all the way across the bone (most common).tubercle, epicondyle, etc.įractures usually fall within a set number of patterns. general: epiphysis, physis, metaphysis, diaphysis.penile fracture) although if unqualified it is assumed one is referring to a bony fracture.Īlthough many eponymous fractures exist and the relevant particulars of a fracture will depend on its specific location, generally fractures are described in a consistent manner: Location Rarely the term 'fracture' is also used for non-osseous/chondral structures (e.g. These are known as pathological fractures. Thirdly, the bone may have a lesion that focally weakens it (e.g. Together, insufficiency and fatigue fractures are often grouped together as stress fractures. running) can result in the accumulation of microfractures faster than the body can heal, eventually resulting in macroscopic failure. Secondly, the protracted chronic application of abnormal stresses (e.g. These are known as insufficiency fractures.
osteogenesis imperfecta) and thus prone to fractures from forces that would be insufficient to cause fractures in normal bones. osteoporosis) or less frequently genetic abnormalities (e.g. Fractures can also occur, however, in a variety of other settings.įirstly, the entire skeleton may be weak due to metabolic (e.g.
Most commonly fractures occur in the setting of a normal bone with acute overwhelming force, usually in the setting of trauma. "neck of femur fracture", may be written as "#NOF". the hash symbol, although it is still pronounced as fracture, e.g. A fracture is often written as # in medical shorthand, i.e.
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