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Open fractures Any fracture with an overlying wound should be considered an open fracture. The term previously used was a compound fracture. Open fractures require particular mention because adequate stabilisation of the bony injury and appropriate managemen...

Osteoporotic fractures Osteoporosis is a condition characterised by low bone mineral density and reduced strength. Osteoporotic bone is liable to fracture with low-energy injuries (e.g. a fall from standing height). Treatment of lower limb osteoporotic fractu...

Patellar fractures Similar to olecranon fractures, undisplaced fractures in which the extensor mechanism is intact can be treated non-operatively . - A simple assessment of this is if the patient can straight leg raise to test the extensor mechanism, but bew...

Pathological fractures When abnormal bone fails under normal load this is referred to as a pathological fracture. Depending on the cause of the pathological fracture the bone may not heal and consideration should be given to a load-bearing device not load-sha...

Peripheral nerve injury Seddon classified nerve injuries into neurapraxia, axonotmesis and neurotmesis: /uni25CF Neurapraxia – no loss of nerve sheath continuity or periph eral Wallerian degeneration. If the pressure is removed from the nerve, recovery potent...

Proximal femoral fractures The blood supply to the femoral head is a prime consideration in treating femoral neck fractures. The blood supply comes via the hip capsule and although vascular anatomy is variable - it is chiefly through the medial and lateral bran...

Reduce The first thing to consider is the degree of displacement of the fracture fragments. It is useful to ask the following question: if the bone were to heal in this position, would it be compatible with optimum function in the short and long term? In gener...

SPECIAL CONSIDERATIONS Special consideration needs to be given to osteoporotic and pathological fractures, for example the ability to hold the frac ture until union. Furthermore, open fractures require urgent appropriate treatment to ensure bone healing in the...

SPECIFIC PAEDIATRIC INJURIES Distal radial fractures Fractures of the distal radius are very common in children. The bone either fails at the physis, leading to Salter–Harris type 2 fractures of the distal radius, or the metaphysis fails. The treatment princ...

SPECIFIC PAEDIATRIC INJURIES Distal radial fractures Fractures of the distal radius are very common in children. The bone either fails at the physis, leading to Salter–Harris type 2 fractures of the distal radius, or the metaphysis fails. The treatment princ...