Bone fracture classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Classification

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In orthopedic medicine, fractures are classified as closed or open (compound) and simple or multi-fragmentary (formerly comminuted).

* Closed fractures are those in which the skin is intact, while open (compound) fractures involve wounds that communicate with the fracture and may expose bone to contamination. Open injuries carry an elevated risk of infection; they require antibiotic treatment and usually urgent surgical treatment (debridement). This involves removal of all dirt, contamination, and dead tissue.

* Simple fractures are fractures that only occur along one line, splitting the bone into two pieces, while multi-fragmentary fractures involve the bone splitting into multiple pieces. A simple, closed fracture is much easier to treat and has a much better prognosis than an open, contaminated fracture. Other considerations in fracture care are displacement (fracture gap) and angulation. If angulation or displacement is large, reduction (manipulation) of the bone may be required and, in adults, frequently requires surgical care. These injuries may take longer to heal than injuries without displacement or angulation.

Another type of bone fracture is a compression fracture. An example of a compression fracture is when the front portion of a vertebra in the spine collapses due to osteoporosis, a medical condition which causes bones to become brittle and susceptible to fracture (with or without trauma).

Other types of fracture are:

* Complete Fracture- A fracture in which bone fragments separate completely.
* Incomplete Fracture- A fracture in which the bone fragments are still partially joined.
* Linear Fracture- A fracture that is parallel to the bone's long axis.
* Transverse Fracture- A fracture that is at a right angle to the bone's long axis.
* Oblique Fracture- A fracture that is diagonal to a bone's long axis.
* Compression Fracture-A fracture that usually occurs in the vertebrae.
* Spiral Fracture- A fracture where at least one part of the bone has been twisted.
* Comminuted Fracture- A fracture causing many fragments.
* Compacted Fracture- A fracture caused when bone fragments are driven into each other
* Open Fracture- A fracture when the bone reaches the skin

### OTA Classification

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The Orthopaedic Trauma Association, an association for Orthopaedic surgeons, devised an elaborate classification system to describe the injury accurately and guide treatment.[1][2] There are five parts to the code:

* Bone: Description of a fracture starts by naming the bone
* (1) Humerus
* (2) Radius/Ulna
* (3) Femur
* (4) Tibia/Fibula
* (5) Spine
* (6) Pelvis
* (24) Carpus
* (25) Metacarpals
* (26) Phalanx (Hand);
* (72) Talus
* (73) Calcaneus
* (74) Navicular
* (75) Cuneiform
* (76) Cuboid
* (80) LisFranc
* (81) Metatarsals
* (82) Phalanx (Foot);
* (45) Patella
* (06) Clavicle
* (09) Scapula
* Location: the part of the bone involved (e.g. shaft of the femur).
* 1) Proximal
* 2) Diaphyseal
* 3) Distal
* Type: It is important to note whether the fracture is simple or multifragmentary and whether it is closed or open.
* A = Simple fracture
* B = Wedge fracture
* C = Complex fracture
* Group: The geometry of the fracture is also described by terms such as transverse, oblique, spiral, or segmental.
* Subgroup: Other features of the fracture are described in terms of displacement, angulation and shortening. A stable fracture is one which is likely to stay in a good (functional) position while it heals; an unstable one is likely to shorten, angulate or rotate before healing and lead to poor function in the long term.

### Other Classification Systems

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There are other systems used to classify different types of bone fractures:

* "Neer classification": Humerus[3][4]

* "Denis classification": Spine[5]

* "Seinsheimer's Classification": Femur[6]

## References

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1. ↑ "Fracture and dislocation compendium. Orthopaedic Trauma Association Committee for Coding and Classification" (pdf). J Orthop Trauma. 10 Suppl 1: v–ix, 1–154. 1996. PMID 8814583. Retrieved 2007-11-28.
2. ↑ "Orthopaedic Trauma Association/ Committee for Coding and Classification: Fracture and Dislocation Compendium". Orthopaedic Trauma Association. Retrieved 2007-11-28.
3. ↑ Mourad L (1997). "Neer classification of fractures of the proximal humerus". Orthop Nurs. 16 (2): 76. PMID 9155417.
4. ↑ "eMedicine - Proximal Humerus Fractures : Article by Mark Frankle, MD". Retrieved 2007-12-15.
5. ↑ Template:GPnotebook
6. ↑ "Seinsheimer's Classification of Subtrochanteric Frxs - Wheeless' Textbook of Orthopaedics". Retrieved 2007-12-15.

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