4. PROXIMAL
END
▪ Intracapsular
▪ Capital : Fracture of the head
▪ Subcapital :below the femoral head
▪ Transcervical :across the mid-femoral neck
▪ Basicervical :across the base of the femoral neck.
▪ These injuries (last three)may be correctly termed
fractures of the 'neck of femur' (NOF).
5. ▪ Extra Capsular
▪ Intertrochanteric
▪ Subtrochanteric
Shaft
▪
▪ Distal end
▪ Supracondylar
▪ Condylar
10. THE GARDEN CLASSIFICATION OF
FEMORAL
NECK FRACTURES
▪ Based on the degree of displacement on the anteroposterior
radiographs.
Differentiation has therapeutic as well as prognostic value.
▪
▪ Type I and II fractures have a low incidence of avscular
necrosis .
11. GRADI
NG
Grade 1: incomplete impacted fracture of the femoral neck.
Grade 2: complete undisplaced fracture.
Grade 3: complete fracture with moderate displacement.
▪
▪
▪
▪ Grade 4: severely displaced fracture.
25. SUPRACONDYLAR
FRACTURES
• The lower fragment is drawn backward by the gastrocnemius and plantaris, and
the popliteal vessels and internal popliteal nerve may either be wounded or
stretched over its sharp upper edge. The artery lying deepest is the most liable
to injury, then the vein, and finally the nerve.
32. TIBIAL PLATEAU
FRACTURES
▪ Fractures of the tibial plateau can be subtle or wide
displacement with varying degrees of comminution.
▪ There may be depression of the plateau surface,
displacement of a fracture fragment or both.
▪ Lipohaemarthrosis.
33. Lateral tibial plateau fracture
The fracture fragment is displaced and depressed from its normal
position
38. ANKLE FRACTURES
Lateral malleolar fractures
▪ Lateral malleolar fractures are categorized according to their
position in relation to the distal tibiofibular syndesmosis at
the level of the ankle joint.
44. MAISONNEUVE
FRACTURE
Spiral fracture of the proximal third of the fibula associated
with a tear of the distal tibiofibular syndesmosis and the
interosseous membrane.
There is an associated fracture of the medial malleolus or
rupture of the deep deltoid ligament.
46. OSTEOCHONDRAL
FRACTURES
Occasionally ankle trauma causes a fracture of the
talus bone surface. These 'osteochondral' injuries are
often subtle and so this area should be assessed
carefully on all post-traumatic ankle X-rays.
48. CALCANEAL
FRACTURES
• Falling from height can lead to severe calcaneal fractures, which may be
accompanied by axial loading fractures of the spine.
▪
▪ Calcaneal fractures due to a fall from height are often
comminuted and intra-articular.
49. BOHLER’S
ANGLE
▪ A line is drawn from the tuberosity to the most superior part
of the posterior facet.
▪ Another line is drawn from the most superior part of the
facet to the anterior process.
Normally the angle created is between 20 and 40 degrees.
▪
▪ If the angle is less than 20 degrees, this indicates depressed
fracture.
51. THE CRITICAL ANGLE OF
GISSANE
• It is formed by a line along the lateral margin of the posterior facet and another
line extending anterior to the beak of the calcaneus. The normal value is 95 to
105 degrees with an increase representing posterior facet collapse
52.
53. TYPES OF CALCANEAL
FRACTURES
• Intra and Extrarticular fractures on the basis of subtalar joint involvement.
▪ Intrarticular fractures are more common and involve the
posterior talar articular facet of the calcaneus.
▪ Extrarticular fractures are less common, and located
anywhere outside the subtalar joint.
54. THE SANDERS SYSTEM
CLASSIFICATION
Is the most commonly used system for categorizing
intrarticular fractures.
Classifies these fractures into four types, based on the location
of the fracture at the posterior articular surface.
55. TYPES
▪ Type I fractures are non-displaced fractures (displacement <
2 mm).
▪ Type II fractures consist of a single intrarticular fracture that
divides the calcaneus into 2 pieces.
▪ Type III fractures consist of two intrarticular fractures that
divide the calcaneus into 3 articular pieces.
▪ Type IV fractures consist of fractures with more than three
intrarticular fractures.
56.
57. METATARSAL
FRACTURES
▪
▪
▪
Oblique fracture of 5thmetatarsal shaft
5TH Metatarsal base fracture
Metatarsal stress fractures
Stress fractures of the metatarsals are common in athletically
active individuals. These may not be visible on initial X-rays
but follow up images show periosteal stress reaction. This
has the appearance of fusiform bone expansion.
58.
59. NORMAL UNFUSED 5TH METATARSAL bone apophysis is
aligned more longitudinally along the bone