Lower limb fractures types
Mar 22, 2016
Lower limb fractures types
Fractures Of The Femoral Neck (Intra-Capsular)• Gardens Classification: • grade1: incomplete impacted fracture of the femoral neck. • grade 2: complete undisplaced fracture. • grade 3: complete fracture with moderate displacement. • grade 4: severely displaced fracture. • 1+2 – AO screws 3+4 - hemiarthroplasty
Clinically the patient complains of pain in the hip and the limb may be shortened and externally rotated.
Femur – intertrochanteric (extracapsular)
• Less commonly associated with AVN• Mx – dynamic hip screw
Jensons
Femoral Shaft fractures• Spiral – twisting w/ anchored foot• Transverse/oblique – direct
trauma• Communited/segmental
Supracondylar fractures
• Transverse or communited
Tibial plateau• Often from MVA, varus or valgus force• Type 1: Wedge fracture of lateral tibial plateau. Lag screws alone suffice for fixation • Type 2: lateral tibial wedge fracture with a associated depression. Fixation is with a buttress
plate and bone grafting. • Type 3: Depression of lateral.tibial plateau but no associated wedge fracture • Type 4: Medial tibial plateau fracture • Type 5: bicondylar fracture of both plateau.• Type 6: The hallmark of this fracture is the separation of the metaphysis and the diaphysis
Patella fractures
• Direct/indirect trauma to knee• Most commonly transverse #, rarely vertical• Displaced fracture of patella treated with
circalage wire and screws
tibfib
• Fairly common cos tib is superficial, most common open fracture of longbone.
• Ring principle• Most often spiral fractures from rotational
force Weber Classification Weber A Fibula Fracture below syndesmosis
Weber B Fibula Fracture at syndesmosis, may tear ligament
Weber C Fibula Fracture, above syndesmosis, ligament tornUnstable
Ankle• The ankle is usually injured by indirect forces with the foot either being externally rotated, inverted, everted or less commonly internally rotated on the tibia.
CLASSIFICATION
First degree: fracture of one malleolus, no talar shift with a stable ankle mortice. Second degree: bimalleolar fracture or a fracture of one malleolus with ligament tear leading to instability of the ankle. Third degree: trimalleolar fracture with instability in the mediolateral and anteroposterior direction. Fourth degree: supra-syndesmotic fracture of the fibula, possible tearing of the inferior tib- fibular ligament and diastasis. Fifth degree: vertical impaction fracture of the distal articular surface of the tibia.
bimalleolar