Fracture Special Classification Physical Therapy Seminar 1: Fracture

JOHN CHRISTOPHER P. EXAMEN, PTRP, MAAG

SALTER AND HARRIS FRACTURE

CLASSIFICATION

SALTER and HARRIS FRACTURE

CLASSIFICATION: MOI

• Sports related injuries

• However they have also been attributed to:

– child abuse

– Genetics

– injury from extreme cold

– radiation and medications

– neurological disorders

– metabolic diseases which all affect the growth plate

SALTER and HARRIS FRACTURE

CLASSIFICATION SALTER-HARRIS

FRACTURE

CLASSIFICATION

DESCRIPTION

TYPE I Fracture of

epiphysis

TYPE II Epiphysis +

Triangular segment

of metaphysis

TYPE III Epiphysis +

Epiphyseal plate

TYPE IV Epiphyseal plate +

epiphysis +

Metaphysis

TYPE V Crushed epiphyseal

plate

Salter and Harris Classification V

LE-FORT FACIAL FRACTURE

CLASSIFICATION

Le-Fort Fracture Classification:

Mechanism of Injury

• Maxillary fractures often result from high-

energy blunt force injury to the facial

skeleton.

• Typical mechanisms of trauma include motor

vehicle accidents, altercations, and falls.

• With increased legislation requiring seat belt

use, injuries from driver impact with the

steering wheel have shifted from chest

trauma to facial trauma.

• Le Fort type 1 – horizontal maxillary fracture, separating the teeth from the upper face

– fracture line passes through the alveolar ridge, lateral nose and inferior wall of

maxillary sinus

• Le Fort type 2 – pyramidal fracture, with the teeth at the pyramid base, and nasofrontal suture at

its apex

– fracture arch passes through posterior alveolar ridge, lateral walls of maxillary

sinuses, inferior orbital rim and nasal bones

• Le Fort type 3 – craniofacial disjunction

– fracture line passes through nasofrontal suture, maxillo-frontal suture, orbital

wall and zygomatic arch

Le-Fort Affectation

• LE-FORT 1

– Horizontal fx; low maxillary fx; floating palate

• LE-FORT 2

– Posterolateral fx; nasal bridge, inferior

lacrimal wall

• LE-FORT 3

– Superior orbital tissue, ethmoid bone,

zygomatic arch

GUSTILO-ANDERSON OPEN WOUND

CLASSIFICATION

Gustilo-Anderson Open Wound

Classification: Mechanism of Injury

• Trauma

– Stretching

– Crushing

– Tearing

– Perforating

Gustilo-Anderson Open Wound

Classification

Gustilo-Anderson Open Wound

Classification

Gustilo-Anderson Open

Wound Classification

• Grade 1 - < 1 cm

• Grade 2 - > 1 cm

• Grade 3 – high energy trauma – 3A – periosteal

trauma

– 3B – bony exposure

– 3C – circulatory problem

GARDEN CLASSIFICATION

• The Garden classification of proximal femoral fractures is the most widely used.

• In general, stage I and II are stable fractures and can be treated with internal fixation (head-preservation) and

• stage III and VI are unstable fractures and hence treated with arthroplasty (either hemi- or total arthroplasty)

• Garden stage I : undisplaced incomplete, including valgus impacted fractures.

• Garden stage II : undisplaced complete

• Garden stage III : complete fracture, incompletely displaced

• Garden stage IV : complete fracture, completely displaced