Juvenile nasopharyngeal angiofibroma| aetiology, diagnosis, treatment

What is the difference between fracture, dislocation, Fracture dislocation and sublaxation ? 

- Fracture : discontinuity of bone.
- Dislocation : disruption of the continuity of a joint.   " joint surfaces are no longer in continuity".

- Subluxation : partial disruption of the continuity of a joint.  " Joint surfaces are still opposed."
- Fracture dislocation : dislocation together with a fracture of one or more of the bones forming the joint.

What are the types of bone fracture ?

According to Etiology

1. Traumatic fracture (major trauma):

. Direct: fracture occurs at the point of trauma. e.g. crush fracture.

. lndirect :

- Avulsion e.g. patella (due to separation of long process with its attached muscles as a result of sudden undue movement).

- Angulation. 

- Rotation.

- Compression " Burst fracture" e.g. vertebra.

2. Patholoqical fracture:

* A minor trauma to already weakened bone by pre-existing disease, by a degree

of stress or trauma . . The disease may be local e.g. metastasis or generalized e.g. osteoporosis.

3. Stress fracture (Fatigue fractures):

* Fractures that occur 2ry to repeated loads applied to the skeleton e.g. harsh fracture in 2nd & 3rd
metatarsal bones due to prolonged walking.

According to relation to surrounding structures

1 . Closed (simple) fracture: does not communicate with the exterior environment

2. Open (compound) facture: communicates with the exterior environment or body cavity e.g. skull fracture communicating with air sinus.

3. Complicated fracture: there is associated damage to nerve, blood vessels or internal structure.

According to Shape of Fracture Line

1. Transverse (angle < 30o ). 

2. Oblique (angle r30o ).

3. Spiral.

4. Comminuted = > 2 fragments.

5. Double level fracture or segmental fracture.

6. Epiphyseal separation

According to extent

1. Gomplete fracture.

2. lncomplete fracture:

- Fissure fracture: incomplete fracture in adult bone. 

- Greenstick fracture: incomplete fracture in child (soft bones & thick periosteum.).

- Compression fracture.

According to lmpaction

1. Non-impacted.

2. lmpacted:

- A fragment is driven into the other fragment.

- Mainly occurs in epiphyseal areas e.g. with Colles'fracture.

According to stability

1. Stable fracture: unlikely to displace further.

2. Unstable fracture: will continue to displace further, if action isn't taken to keep the fracture secure.

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