From the Guidelines
Fractures can be classified into several types, including osteoporotic, traumatic, pathologic, and stress fractures, with each type having distinct characteristics and implications for treatment and management. The main types of fractures include:
- Osteoporotic fractures, which are associated with impaired bone strength and can be further divided into major and minor fractures [ 1 ]
- Traumatic fractures, which are caused by a significant external impact force or injury [ 1 ]
- Pathologic fractures, which occur secondary to altered skeletal physiology and mechanics in the setting of a benign or malignant lesion [ 1 ]
- Stress fractures, which are associated with a major recent increase in physical activity or repeated excessive activity with limited rest [ 1 ] Other important types of fractures include:
- Fatigue fractures, which result from repetitive submaximal stress on normal bone [ 1 ]
- Insufficiency fractures, which occur due to normal activity on bones that are deficient in microstructure and/or mineralization [ 1 ] It is essential to accurately classify fractures to determine the appropriate treatment and management plan, which can include immobilization, surgical intervention, or traction, and to improve patient outcomes in terms of morbidity, mortality, and quality of life. The classification of fractures can also help identify individuals at high risk of future fractures, such as those with vertebral fractures, which can increase the risk of non-vertebral fractures and mortality [ 1 ].
From the Research
Types of Fractures
- Destructive fractures:
- Closed diaphysis destructive fracture (a1 type)
- Open diaphysis destructive fracture (a2 type)
- Closed joint-involved destructive fracture (b1 type)
- Open joint-involved destructive fracture (b2 type)
- Closed mixed destructive fracture (c1 type)
- Open mixed destructive fracture (c2 type) 2
- Open fractures:
- Classified based on skin injury, muscle injury, arterial injury, contamination, and bone loss 3
- Non-unions:
- Occur when a fracture insufficiently consolidates without further treatment, regardless of the duration of prior treatment 4
- Atraumatic fractures:
- Include stress fractures, atypical femoral fractures, and pathologic fractures 5
- Traumatic fractures:
- Often associated with high-energy trauma, and can be open or closed 6
Classification of Fractures
- Based on the location and severity of the fracture, as well as the presence of soft tissue damage 2, 3
- Can be classified as stable or unstable, and as open or closed 6
- Imaging characteristics, such as the presence of bone loss or soft tissue damage, can also be used to classify fractures 4, 5
Imaging Characteristics of Fractures
- X-rays and CT scans can be used to diagnose and classify fractures 4, 6
- MRI and ultrasound can also be used to evaluate soft tissue damage and fracture severity 4, 5
- Imaging characteristics, such as the presence of a fracture line or bone fragmentation, can be used to guide treatment decisions 2, 3, 6, 5