Overview
What the Classification Captures
A fracture is a loss of bone continuity that occurs when applied force exceeds the bone’s ability to deform safely.
A fracture is a loss of bone continuity that occurs when applied force exceeds the bone’s ability to deform safely. The label attached to the fracture is more than a description: it communicates contamination risk, mechanical stability, joint involvement, and the likelihood that reduction or fixation will be needed. The first bedside distinction is closed versus open. A closed fracture has intact skin over the injury. An open fracture communicates with the external environment through a wound, even when bone is not visible. Open injuries are urgent because bacteria can enter the fracture site and devitalized tissue can prevent healing. If a wound may communicate with the fracture, treat the injury as open until the surgical team establishes otherwise. Fractures are also described by their pattern and geometry: - Transverse: the fracture line crosses the shaft relatively directly. - Oblique: the line runs diagonally. - Spiral: the line winds around the bone, usually reflecting rotational force. - Comminuted: the bone has several fragments, often after high-energy trauma. - Incomplete: the bone is only partly disrupted; this is more common in...