Impaction occurs when the broken parts of bone get jammed into each other, while they may remain normally aligned.Ī combination of these types of displaced fracture can also be seen, which commonly include angulation and rotation or angulation, rotation and shortening along with displacement in displaced fracture.Īnother important type of fracture includes open and closed fracture, which can also be seen as types of displaced fracture. Distraction or widening occurs when the broken parts of bone get spaced out, widened causing distraction, which increases the overall length of the bone. Distraction and impaction are also types of displaced fracture.Shortening type of displaced fracture occurs more often in an oblique fracture. Displacement and shortening fracture is noted when the broken part of bone, gets displaced and moves towards the upper part of bone, reducing the total length of the bone.If the broken part of bone forms an angle on the inner side or medial angulation, it is called varus and if the angle is on the outer side or lateral angulation, it is called valgus. An angulated fracture, this is a type of displaced fracture where the broken bone ends move from their alignment and form an angle with each other.A rotated fracture, where the broken bone turns around or rotates, either external or internal. 2006 44:213–224.Some of the common types of displaced fracture includes: Chest wall, lung, and pleural space trauma. Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT. Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank. Operative fixation of rib fractures after blunt trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma. Kasotakis G, Hasenboehler EA, Streib EW, et al. Consensus statement: surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines. Pieracci FM, Majercik S, Ali-Osman F, et al. Springer-Verlag GmbH Germany, part of Springer Nature. Pain regimens and SSRF considerations should be adjusted accordingly.Ĭhest trauma Displacement Pain Rib fixation Rib fracture. Average fracture displacement was significantly increased for all rib groupings except 11-12 in all planes (p < 0.002). Missed RF rate for CT1 was 10.1% (p = 0.11). Median time between CT1 and CT2 was 6 days (IQR, 3-12). Median Injury Severity Score was 21 (IQR, 13-27) with Chest Abbreviated Injury Score of 3 (IQR, 3-4). Significance was set at p < 0.002.ħ8 of 477 patients with RF on CT1 had CT2 during the study period: primarily male (76%) and age 55.8 ± 20.1 with blunt mechanism of injury (99%). Non-parametric sign test and paired t test were used for analysis. Secondary outcome included number of missed RF on CT1. Given anatomic and clinical characteristics, ribs were grouped (1-2, 3-6, 7-10, 11-12), averaged, and analyzed for displacement. Displacement was calculated by subtracting CT1 fracture displacement from CT2 displacement for each rib. Primary outcomes included RF displacement in millimeters (mm) between CT1 and CT2 in three planes (AP = anterior/posterior, O = overlap/gap, and SI = superior/inferior). Patients with initial chest CT (CT1) followed by repeat CT (CT2) within 84 days were included. Retrospective review of all RF patients from 2016-2017 at our institution. The purpose was to examine RF patterns hypothesizing RF become more displaced over time. Lack of displacement is often cited as a reason for non-operative management. Despite advancing technology of surgical stabilization of rib fractures (SSRF), treatment and indications remain controversial. Rib fractures (RF) occur in 10% of trauma patients associated with significant morbidity and mortality.
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