Understanding Fracture Types: Definitions and Classifications

Fracture classification guides treatment and prognosis. Key descriptive categories:

By Skin Integrity

• Closed (simple): Skin intact.
• Open (compound): Bone communicates with exterior; graded I–III (Gustilo-Anderson) by wound size, contamination, soft tissue damage.

By Fragmentation

• Comminuted: ≥3 fragments.
• Segmental: Two fracture lines creating a free-floating segment.

By Pattern (Long Bones)

• Transverse: Perpendicular to axis.
• Oblique: Angled.
• Spiral: Helical (torsional force).
• Compression: Vertebral body collapse (axial load).
• Impacted: Fragments driven into each other.
• Avulsion: Ligament/tendon pulls off bony fragment.
• Greenstick: Incomplete, cortex intact one side (pediatric).
• Torus (buckle): Cortex buckles without fracture line (pediatric).

By Etiology

• Stress fracture: Repetitive submaximal load (athletes, military).
• Pathologic fracture: Pre-existing bone weakness (tumor, osteoporosis, infection).
• Insufficiency fracture: Normal stress on abnormal bone (osteoporosis).

By Displacement/Alignment

• Non-displaced, minimally displaced, displaced (angulation, translation, rotation, shortening).

Pediatric-Specific

• Salter-Harris (physeal) types I–V.
• Plastic deformation (bowing without fracture line).

Orthopedic surgeons combine these descriptors (e.g., "open, comminuted, spiral tibial shaft fracture, Gustilo type II") for precise communication.