Fracture

골절(fracture)은 외상성 musculoskeletal injuries 중에 하나로 뼈의 연속성이 소실된 것이다.

Mechanism

• Stress fracture
  • Fatigue fracture
  • Insufficiency fracture
• Direct or indirect
  • Direct forces include gunshot, explosion, stabbing, and crushing injuries.
  • Most indirect fractures occur in reasonably predictable patterns.
• closed fracture or open fracture
  • closed: intact skin of the involved body part
  • open: skin of the involved body part is disrupted
• Osteoporotic fracture vs Pathologic fracture

종류

• complete fracture, incomplete fracture
• skull: linear fracture, depressed fracture, diastatic fracture
• green stick fracture(소아 골절)

주요 골절

• 비골 골절
• 늑골 골절
• 손배뼈 골절(주상골 골절, scaphoid fracture): snuff box td, oblique or scaphoid view, thumb spica splint
• 콜리스 골절(Colles fracture): distal radius fracture, 손을 뻗으면서 넘어진 경우
• 몬테지아 골절(Monteggia fracture): fracture of the proximal third of the ulna with dislocation of the head of the radius, hyper-pronation injury
• 갈레아찌 골절(Galeazzi fracture): fracture of the radius with dislocation of the distal radioulnar joint
  • MUGR(Monteggia Ulna, Galeazzi Radius); 머거로 암기
• 반달뼈 골절(lunate fracture)
• Jefferson fracture: Atlas의 burst fracture
• Segond fracture: lateral capsular ligament(anterolateral ligament)에 의한 the tibial plateau의 lateral aspect avulsion fracture로 ACL rupture나 lateral meniscus tear와 관련

Union type

• Nonunion
• malunion
• partial union
• delayed union

뼈 외의 기타 fractures

• catheter fracture, implant fracture

치료

• open reduction internal fixation(ORIF)
• closed reduction internal fixation(CRIF)
• conservative care