Fractures

Fractures are discontinuity of the bony framework.

Causes and predisposing factors:

1- Trauma.
2- Heredity; e.g. congenital porphyria in cattle and swine (which marked by
increased bone fragility).
3- Nutrition; decreased mineral supply (e.g. Ca, P, vitamin D).
4- Age; young and aged animals more susceptible to fractures.
5- Sex; males more susceptible.
6- Use; athletic horses more susceptible.
7- Management; cohabitation of different species, sex, and size of animals increase
the chances of skeleton injuries.

Classification of fractures:

A- According to the involvement of skin:

1- Closed or simple fractures.
2- Opened or compound fractures.
B- According to the axis of the bone:
1- Transverse.
2- Oblique.
3- Spiral.
4- Longitudinal.
C- According to the involvement of the bone:
1- Complete.
2- Incomplete (e.g. greenstick fracture).
D- According to the number of bone fragments:
1- Comminuted fracture; several fracture lines communicate at a common point.
2- Multiplied fracture; bone splintered in to three or more pieces and the fracture
lines do not meet.
E- According to the position of fracture:
1- diaphyseal fracture.
2- Metaphyseal fracture.
3- Epiphyseal fracture.
F- According to the reduction:
1- Stable fracture; if the fragment remains in position after reduction.
2- Unstable fracture; tend to be unstable after reduction such as multiple oblique
fracture.
G- Pathological fracture; e.g. rickets, neoplasm, osteomalacia, osteoporosis.

Clinical signs (symptoms):

 1- Local swelling due to exudation or accumulation of blood.
2- Deformity.
3- Abnormal mobility.
4- Loss of function.
5- Pain.
6- Crepitus sound due to friction of bone fragments.

Diagnosis:

1- Case history.
2- Clinical signs.
3- Clinical examination;
a- An assessment of animal general health.
b- Determination of whether tissues or organs adjacent to the fracture have
been damaged to what extent.
4- Radiographic examination; at least to views taken to the injured area.

Bone healing:

1- Production of hematoma:
Occur due to laceration of blood vessels. Hematoma formed around fracture site
and within the medullary cavity.
2- Fibroblasts and capillary buds penetrate the hematoma which gradually becomes
organized and converted to a mass of granulation tissue.
3- The hematoma between the ends of the bone is quickly invaded by osteogenic
cells from the medullary cavity and endosteum.
4- Shortly after the fracture occurs there is proliferation of osteogenic cells beneath
undamaged periosteum which is progressively elevated from the bone on each
side of the fracture.
5- Within the medullary cavity the osteogenic cells of the endosteum and marrow
proliferate to become osteoblasts and osteoclasts and a network of bone
trabeculae is formed.
6- When the external callus and trabeculae of the internal callus bridge the site, the
fracture is united.
7- The size of the callus decreases and the bony bridge becomes remodeld into
lamellar bone by the action of osteoclasts until the normal contour of the bone is
restored.