Overview
Fracture Classification at the Bedside
A fracture label is a compressed clinical description, not a treatment plan.
A fracture label is a compressed clinical description, not a treatment plan. It tells you where the bone failed, how the fragments relate to one another, whether the joint or growth plate is involved, and whether the surrounding tissue makes the injury an emergency. Start with the features that change priority: - Open or closed: an open fracture communicates with the external environment through a wound, even if the wound is small or distant from the obvious deformity. - Location: identify the bone and segment—epiphysis, metaphysis, diaphysis, or a periarticular region. - Pattern: transverse, oblique, spiral, comminuted, impacted, buckle, or avulsion patterns suggest different mechanisms and stability. - Alignment: document displacement, angulation, shortening, and rotation rather than recording only that the fracture is present. - Joint or physis involvement: articular extension threatens congruence and function; physeal injury threatens future growth. - Biology: traumatic, fragility, stress, pathological, and periprosthetic fractures require different questions about healing and recurrence. The AO/OTA system supplies a common, hierarchical language for many fracture patterns. Other systems answer narrower questions: Gustilo-Anderson describes open-fracture severity, Salter-Harris describes paediatric...
