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