OPEN FRACTURE OF DISTAL TIBIA AND FIBULAI. Introduction
A fracture is a break in the structural continuity of bone. It
may be no more than a crack, a crumpling or a splintering of the
cortex; more often the break is complete and the bone fragments are
displaced. If the overlying skin remains intact it is a closed (or
simple) fracture; if the skin or one of the body cavities is
breached it is an open (or compound) fracture, liable to
contamination and infection. Open fracture means that skin around
the fracture site has been punctured and exposed to external
environment, it increases the risk for bacterial
infection.(1)Fracture divides into fracture because of trauma,
stress, and pathological fracture. Trauma fracture divides into
direct trauma and indirect trauma. Stress fracture usually happens
to athletic people with repetitive movement on the same place.
Pathological fracture happens may occur even with normal stresses
if the bone has been weakened by a change in its structure example
in osteoporosis.(1)
There are two types of fracture : 1. Complete fracture, the bone
is split into two or more fragments. The fracture pattern on x-ray
can help predict behavior after reduction: in a transverse fracture
the fragments usually remain in place after reduction; if it is
oblique or spiral, they tend to shorten and re-displace even if the
bone is splinted. In an impacted fracture the fragments are jammed
tightly together and the fracture line is indistinct. A comminuted
fracture is one in which there are more than two fragments; because
there is poor interlocking of the fracture surfaces, these are
often unstable. 2. Incomplete fracture, the bone is incompletely
divided and the periosteum remains in continuity. In a greenstick
fracture the bone is buckled or bent (like snapping a green twig);
this is seen in children, whose bones are more springy than those
of adults. Children can also sustain injuries where the bone is
plastically deformed (misshapen) without there being any crack
visible on the x-ray. In contrast, compression fractures occur when
cancellous bone is crumpled. This happens in adults and typically
where this type of bone structure is present, e.g. in the vertebral
bodies, calcaneum and tibial plateau.Tibial plafond fractures also
known as pilon fractures, occur at the end of shin bone and just
above the ankle joint and often involve the cartilage surface of
the ankle joint.
