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• History of injury
• Inability to use the injured limb
• The mechanism of injury are important
• The fracture is not always at the site of the
injury
• Trivial trauma suspect a pathological lesion
• Pain, bruising, swelling are common symptoms
• Deformity is much more suggestive
Mechanism of Injury
Mechanism of Injury
General Signs
Life saving
Local Signs
LOOK
• Swelling, bruising, deformity, angulation,
lumps, limb shortening, bleeding (open),
discolored skin around the affected area
• The intact skin & soft tissue involvement
open (compound) or closed
• The distal extremity and the color of the skin
Local Signs
FEEL
• Gently palpated for localized tenderness/pain,
swelling, tense, deformity, steps on bone,
crepitus, instability.
• The associated injuries also should be felt
• Vascular and peripheral nerve abnormalities
should be tested for both before and after
treatment.
Local Signs
MOVE
• Loss/decrease of function of the affected part
• Active and passive movement
• Abnormal movement (false movement)
• Abnormal range of movement
• Muscle power
• It is more important to ask if the patient can
move the joints distal to the injury.
False movement
Diagnostic Imaging
Histologically
• osteogenic cells differentiate into osteoblasts,
primary woven bone
• osteogenic cells differentiate into chondroblasts
cartilage initially
Stage of Clinical Union
• Malunion
• Delayed union
• Non union
– Fibrous union
– Pseudoarthrosis
Thank You…