Types of Fractures

Splintered fx

A comminuted fracture in which the bone is splintered into thin sharp fragments.

Butterfly fx

A comminuted fracture with two fragments on each side of a main, wedge-shaped separate fragment; it has some resemblance to the wings of a butterfly.

Segmental fx

A type of double fracture in which two fracture lines isolate a distinct segment of bone; the bone is broken into three pieces, with the middle fragment fractured at both ends.

angulation

Angulation describes loss of alignment of the fracture 1. Apex angulation: Describes the direction or angle of the apex of the fracture, such as a medial or lateral apex, wherein the point or apex of the fracture points medially or laterally. 2. Varus deformity: The distal fragment ends are angled toward the midline of the body and the apex is pointed away from the midline. 3. Valgus deformity: The distal fragment ends are angled away from the midline and the apex is pointed toward the midline.

apposition

Apposition describes how the fragmented ends of the bone make contact with each other. Three types of apposition are known: 1. Anatomic apposition: Anatomic alignment of ends of fractured bone fragments, wherein the ends of the fragments make end-to-end contact. 2. Lack of apposition (distraction): The ends of fragments are aligned but pulled apart and are not making contact with each other. 3. Bayonet apposition: The fracture fragments overlap and the shafts make contact, but not at the fracture ends

Greenstick fx (hickory or willow stick fx)

Fracture is on one side only. The cortex on one side of the bone is broken and the other side is bent. When the bone straightens, a faint fracture line in the cortex may be seen on one side of the bone, and a slight bulging or wrinkle-like defect is seen on the opposite side

Transverse fx

Fracture is transverse at a near right angle to the long axis of the bone.

Depressed Fracture (sometimes called a Ping-Pong fracture)

In this fracture of the skull, a fragment is depressed. The appearance is similar to a Ping-Pong ball that has been pressed in by the finger, but if the indentation can be elevated again, it can assume its near-original position.

Impacted Fracture

In this fracture, one fragment is firmly driven into the other, such as the shaft of the bone being driven into the head or end segment. These most commonly occur at distal or proximal ends of the femur, humerus, or radius

Spiral fx

In this fracture, the bone has been twisted apart and the fracture spirals around the long axis.

Comminuted Fracture

In this fracture, the bone is splintered or crushed at the site of impact, resulting in two or more fragments. Three types of comminuted (kom′-i-nu-ted) fractures have specific implications for treatment and prognosis because of the possible substantial disruption of blood flow: Segmental fx, Butterfly fx, and Splintered fx.

Complete Fracture

In this fracture, the break is complete and includes the cross-section of bone. The bone is broken into two pieces. There are three major types of complete fractures: Transverse fx, Oblique fx, and Spiral fx.

Stellate Fracture

In this fracture, the fracture lines radiate from a central point of injury with a starlike pattern. The most common example of this type of fracture occurs at the patella and is often caused by knees hitting the dashboard in a motor vehicle accident

Barton Fracture

It is an intra-articular fracture of the distal radius often associated with dislocation or subluxation of the radiocarpal joint.

Oblique fx

The fracture passes through bone at an oblique angle.

Pathologic Fracture

These fractures are due to disease process within the bone, such as osteoporosis, neoplasia, or other bone diseases.

Blowout and/or Tripod Fracture

These fractures, which result from a direct blow to the orbit and/or maxilla and zygoma, create fractures to the orbital floor and lateral orbital margins.

Torus fx

This buckle of the cortex (outer portion of the bone) is characterized by localized expansion or torus of the cortex, possibly with little or no displacement, and no complete break in the cortex.

Tuft or Burst Fracture

This comminuted fracture of the distal phalanx may be caused by a crushing blow to the distal finger or thumb

Incomplete (Partial) Fracture

This fracture does not traverse through the entire bone. (The bone is not broken into two pieces.) It is most common in children. Two major types of incomplete fractures are as follows: Torus fx and Greenstick fx (hickory or willow stick fx)

Chip Fracture

This fracture involves an isolated bone fragment; however, this is not the same as an avulsion fracture because this fracture is not caused by tendon or ligament stress.

Hangman Fracture

This fracture occurs through the pedicles of the axis (C2), with or without displacement of C2 or C3.

Trimalleolar Fracture

This fracture of the ankle joint involves the medial and lateral malleoli as well as the posterior lip of the distal tibia.

Baseball (Mallet) Fracture

This fracture of the distal phalanx is caused by a ball striking the end of an extended finger. The distal interphalangeal (DIP) joint is partially flexed, and an avulsion fracture is frequently present at the posterior base of the distal phalanx.

Monteggia (mon-tej′-ah) Fracture

This fracture of the proximal half of the ulna, along with dislocation of the radial head, may result from defending against blows with the raised forearm

Colles Fracture

This fracture of the wrist, in which the distal radius is fractured with the distal fragment displaced posteriorly, may result from a forward fall on an outstretched arm

Avulsion Fracture

This fracture results from severe stress to a tendon or ligament in a joint region. A fragment of bone is separated or pulled away by the attached tendon or ligament.

Boxer Fracture

This fracture usually involves the distal fifth metacarpal, with an apex posterior angulation best demonstrated on the lateral view. It results from punching someone or something.

Compound (Open) Fracture

This is a fracture in which a portion of the bone (usually the fragmented end) protrudes through the skin

Simple (Closed) Fracture

This is a fracture in which the bone does not break through the skin.

Smith (Reverse Colles) Fracture

This is a fracture of the wrist with the distal fragment of the radius displaced anteriorly rather than posteriorly, as in a Colles fracture. It commonly results from a backward fall on an outstretched arm

Epiphyseal Fracture

This is a fracture through the epiphyseal plate, the point of union of the epiphysis and shaft of a bone. It is one of the most easily fractured sites in long bones of children. Radiologists commonly use the Salter-Harris classification (Salter 1 to 5, with Salter 5 indicating the most complex) to describe the severity and reasonable indication of prognosis of these fractures.

Hutchinson (Chauffeur) Fracture

This is an intra-articular fracture of the radial styloid process. (The name originates from the time when hand-cranked cars would backfire, with the crank striking the lateral side of the distal forearm.)

Bennett Fracture

This longitudinal fracture, which occurs at the base of the first metacarpal with the fracture line entering the carpometacarpal joint, generally includes a posterior dislocation or subluxation.

Pott Fracture

This term is used to describe a complete fracture of the distal fibula with major injury to the ankle joint, including ligament damage and frequent fracture of the distal tibia or medial malleolus

Stress or Fatigue Fracture (sometimes called a "March" fracture)

This type of fracture is nontraumatic in origin. It results from repeated stress on a bone, such as from marching or running. If caused by marching, these fractures usually occur in the midshafts of metatarsals; if caused by running, they are in the distal shaft of the tibia. Stress fractures are frequently difficult to demonstrate radiographically and may be visible only through subsequent callus formation at the fracture site or on a nuclear medicine bone scan.

Compression Fracture

This vertebral fracture is caused by compression-type injury. The vertebral body collapses or is compressed. Generally, it is most evident radiographically by a decreased vertical dimension of the anterior vertebral body

Subluxation

the partial displacement of a bone from its joint