Fracture Special Classification Physical Therapy Seminar 1: Fracture
JOHN CHRISTOPHER P. EXAMEN, PTRP, MAAG
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
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: Mechanism of Injury
• Trauma
– Stretching
– Crushing
– Tearing
– Perforating
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
• 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
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