Fracture Types and Classifications

A fracture is a break in the continuity of bone resulting from mechanical stress that exceeds the bone's structural strength. Bone is a dynamic tissue composed of an organic matrix (collagen providing flexibility) and inorganic minerals (hydroxyapatite crystite providing rigidity). Fractures are classified by multiple parameters. By skin integrity: closed (simple) fractures have intact skin over the fracture site; open (compound) fractures have broken skin with bone potentially exposed, creating infection risk. By fracture pattern: transverse (perpendicular to bone axis, from direct force), oblique (diagonal, from twisting), spiral (helical, from rotational force -- suggestive of abuse in children), comminuted (multiple fragments, from high-energy trauma), greenstick (incomplete fracture with cortical buckling in children, whose bones are more flexible), and pathological (through weakened bone from disease: osteoporosis, cancer metastasis, Paget disease). By anatomical location: proximal, midshaft, distal, intra-articular (involving the joint surface, more complex healing). Fracture healing occurs in four stages: hematoma formation (days 1-5), soft callus formation (weeks 1-3, fibrocartilaginous bridging), hard callus formation (weeks 3-12, woven bone deposition), and bone remodeling (months to years, replacement with lamellar bone). The practical...