fracture = break in the fracture = break in the bone, produced following bone, produced following a trauma ;a trauma ; fractures : - Direct ;fractures : - Direct ;- indirect- indirect energy after traumatic agent :energy after traumatic agent : Low-energy trauma fractures ( low Low-energy trauma fractures ( low velocity trauma - LVT ) ;velocity trauma - LVT ) ; high-energy trauma fractures ( high velocity high-energy trauma fractures ( high velocity trauma - !" # $trauma - !" # $ pats cross - produced !y LVT ;pats cross - produced !y LVT ; "#in comminuted - produced !y $VT ;"#in comminuted - produced !y $VT ;- %ssociated wit damage to oter - %ssociated wit damage to oter e&uipment and systems ( polytrauma )e&uipment and systems ( polytrauma )' compression' compression( !y !ending( !y !ending) !y te torsion ) !y te torsion

( twist )( twist )*+ traction*+ traction

( tinned) ( tinned)

incompleteincomplete ,-%.T/-0",-%.T/-0" completecompletefracturi fracturi incomplete cild :incomplete cild : fracture 12 in te fracture 12 in te column ead 12column ead 12 fracture 12 green fracture 12 green wood 12wood 12fracturi fracturi incomplete adult :incomplete adult : clogging clogging ( settlement ) ;( settlement ) ; crac#crac# following address:following address: epipyseal (intra epipyseal (intra -articular ) ;-articular ) ; metapyseal ;metapyseal ; diapyseal +diapyseal + !y ,erry:!y ,erry:comminuted o!li&ue cross spiroid3 !ifocaldup3 no+ dup3 no+ fragments fragments fracturing :fracturing : ( fragments ;( fragments ; ) pieces : ) pieces : - 4n .one !ending ; - 4n .one !ending ; - Te tor&ue- Te tor&ue comminutedcomminutedfracturile comminutedfracturile comminuted after moving fragments :after moving fragments :% % fractures without displacementfractures without displacement% % fracture displacementfracture displacement1 angulation ( angle )1 angulation ( angle )Fractures - General ? Fracture Fractures - General ? Fracture displacement : ?? 2 . ranslation ! displacement : ?? 2 . ranslation ! lateral mo"ement #lateral mo"ement #Fractures - General ? Fracture Fractures - General ? Fracture displacement : ?? $ . sliding displacement : ?? $ . sliding ! o"erlapping #! o"erlapping #Fractures - General ? Fracture Fractures - General ? Fracture displacement : ?? % . rotationdisplacement : ?? % . rotationtegument : wounds or secondary necrosis ;tegument : wounds or secondary necrosis ; muscles , fascia , tendons : contusions, fractures , muscles , fascia , tendons : contusions, fractures , interpo&i'ii ;interpo&i'ii ; vessels : bruises , punctures , tears hemorrhage vessels : bruises , punctures , tears hemorrhage and peripheral ischemia ;and peripheral ischemia ; nerves : contusions ( neurapra(ia # , elongation nerves : contusions ( neurapra(ia # , elongation ( a(onotmesis # , tearing ( neurometsis # ;( a(onotmesis # , tearing ( neurometsis # ; )oints : wounds intra -articular , intra- articular )oints : wounds intra -articular , intra- articular fractures ;fractures ; visceral in)uries ( polytrauma #visceral in)uries ( polytrauma #

++A. Signs of probabilityA. Signs of probabilityB. Safety SignsB. Safety Signs# Bronchopneumonia pulmonary congestion # Bronchopneumonia pulmonary congestion etc Not . resp .; etc Not . resp .;# Tulbea . ITU urinary drainage IR ;# Tulbea . ITU urinary drainage IR ;# !" latent metabolic imbalance coma ;# !" latent metabolic imbalance coma ;# #mbolism$ pulmonary in%arction or cerebral # #mbolism$ pulmonary in%arction or cerebral %atty %atty & & consolidation delay ;consolidation delay ; osteitisosteitis ' (ascular In)ury' (ascular In)ury Pressure : acute ischemic syndromesPressure : acute ischemic syndromes Total (IAT )Total (IAT ) partial (IAP )partial (IAP ) localized ( IAL ) - shingles . localized ( IAL ) - shingles . compartment compartment

5 5 restoring vascular a6isrestoring vascular a6is de7o!struc8iede7o!struc8ie4%T suture4%T suture plastyplasty 5 5 osteosyntesis farmosteosyntesis farm ))#A* ( re&ucing fracture #A* ( re&ucing fracture

+it! , +it!out+it! , +it!out

restoring $ascular a'isrestoring $ascular a'is) ) #AL ( apone$rotomie emergency #AL ( apone$rotomie emergency venous in9uries - ligationvenous in9uries - ligation

- %6 venous reconstruction- %6 venous reconstruction venous trom!osis anticoagulantsvenous trom!osis anticoagulants interpo7i8ii soft partsinterpo7i8ii soft parts

e*tend assete*tend assetTreatmentTreatment

surgical cure surgical cure 2 .onunion - neconsoli&area a fracture in t!e ma'imum2 .onunion - neconsoli&area a fracture in t!e ma'imum time nee&e& t!at type of fracture. time nee&e& t!at type of fracture.

3 /alusul $icious - angulation 0u113e 21 23 /alusul $icious - angulation 0u113e 21 2

+ ,hortening -u../e / cm+ ,hortening -u../e / cmTreatment0 osteocla1ie + + osteosynthesis Treatment0 osteocla1ie + + osteosynthesis osteotomyosteotomy

6.Necroza bone avascular ( ischemic 6.Necroza bone avascular ( ischemic aseptic) aseptic) 7 post- traumatic arthrosis 7 post- traumatic arthrosis 8 Inection o bone ( osteitis post - 8 Inection o bone ( osteitis post - traumatic ) traumatic ) ) clinical anatomical forms :- Acute post- traumatic osteitis ;- osteitis callus ;- #nfecte& nonunion Fistulising orthopedic treatmentorthopedic treatment surgerysurgery functional treatmentfunctional treatment&& ma)or orthopedic emergencies are0 ma)or orthopedic emergencies are022 open %racture 3 must be operated in the %irst 4 hours o% production5 ; open %racture 3 must be operated in the %irst 4 hours o% production5 ;22 %racture complicated 6ith ma)or arterial lesion 3 necessary to stabili1e the%racture complicated 6ith ma)or arterial lesion 3 necessary to stabili1e the %racture $ 6ith restoration o% continuity 7ascular a*is 5 $ including complicated%racture $ 6ith restoration o% continuity 7ascular a*is 5 $ including complicated by compartment syndrome 3 re8uired decompressi7e apone7rotomie 5 ; by compartment syndrome 3 re8uired decompressi7e apone7rotomie 5 ;22 dislocations and %racture+dislocation 3 must be resol7ed 6ithin '9 hours o%dislocations and %racture+dislocation 3 must be resol7ed 6ithin '9 hours o% in)ury 5 ; in)ury 5 ;22 unstable pel7ic %ractures associated 6ith hemodynamic instabiliate 3 re8uiredunstable pel7ic %ractures associated 6ith hemodynamic instabiliate 3 re8uired primary %racture stabili1ation basin + e*ternal %i*ator in order to reduceprimary %racture stabili1ation basin + e*ternal %i*ator in order to reduce bleeding 5 ; bleeding 5 ;22 6ounds 6ith hea7y bleeding 3 hemostasis re8uired surgery 5 ; 6ounds 6ith hea7y bleeding 3 hemostasis re8uired surgery 5 ;22 intra+ articular contusion 6ounds 3re8uires debridement due to the ris: o%intra+ articular contusion 6ounds 3re8uires debridement due to the ris: o% septic arthritis 5 ; septic arthritis 5 ;22 any %racture or traumatic musculos:eletal in)ury $ 6hich in the conte*t o%any %racture or traumatic musculos:eletal in)ury $ 6hich in the conte*t o% multiple trauma $ ad7ersely a%%ect the patient;s 7ital prognosis . multiple trauma $ ad7ersely a%%ect the patient;s 7ital prognosis .orthopedic treatmentorthopedic treatment +