III. Exam

  1. Document neurovascular examination (and address deficits immediately)
    1. Perform on initial exam and repeat before and after any intervention
    2. Keep high index of suspicion for Compartment Syndrome
    3. Check Capillary Refill and distal pulses
    4. Check motor and Sensory Examination
  2. Evaluate skin over Fracture site
    1. Signs of open Fracture
    2. Signs of displaced Fracture (Skin Tenting)
    3. Clues suggesting Fracture (swelling, Ecchymosis, and point tenderness over Fracture site)
    4. Devitalized skin at risk of necrosis
  3. Evaluate joints, muscles, ligaments, and tendons above and below the Fracture

IV. Indications: Referral to Orthopedics

  1. Emergent referral indications
    1. Fracture with neurologic deficit
    2. Fracture with vascular deficit
    3. Fracture with secondary Compartment Syndrome
    4. Open Fracture
    5. Severe crush or shearing injury resulting in skin devitalization
  2. Prompt referral indications
    1. Fracture site and type specific
    2. See High Risk Fractures

Images: Related links to external sites (from Google)

Ontology: Fracture (C0016658)

Definition (NCI) A traumatic injury to the bone in which the continuity of the bone is broken.-2003
Definition (NCI) A finding of traumatic injury to the bone in which the continuity of the bone is broken.
Definition (MEDLINEPLUS)

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls or sports injuries. Another cause is osteoporosis, which causes weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are

  • Out-of-place or misshapen limb or joint
  • Swelling, bruising or bleeding
  • Intense pain
  • Numbness and tingling
  • Limited mobility or inability to move a limb

You need to get medical care right away for any fracture. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.

Definition (CSP) breaks or rupture in bones or cartilages.
Definition (MSH) Breaks in bones.
Concepts Injury or Poisoning (T037)
MSH D050723
ICD9 E887, 829, 800-829.99
ICD10 T14.8
SnomedCT 208739000, 157169007, 307182008, 367344001, 157255002, 269102008, 208744007, 217171007, 269323009, 72704001, 125605004
English Fractures, Fracture of unspecified bones, BONE FRACTURE, FRACTURE, FRACTURE BONE, FRACTURES, Fracture NOS, Fracture of bones NOS, Fracture, NOS, Fracture, cause unspecified, Fractured, Bone fracture, Fracture - lesion, bone fracture (diagnosis), fracture, bone fracture, 12 FRACTURES, fractured bone, Fracture: [of unspecified bones] or [NOS] (disorder), Fracture (disorder), Fracture - lesion (morphologic abnormality), Fracture - lesion (disorder), Fracture NOS (disorder), Fracture bone, Fracture, cause NOS, Broken bones, Fracture of bones NOS (disorder), Fracture, cause unspecified (disorder), Fracture of unspecified bones (disorder), FRACTURE(S), Fractures, Bone [Disease/Finding], fractures, bone fractures, broken bones, bone fractured, fractured, broken bone, fracture of bone, bones fractured, Broken bone, Fracture of bone, Fracture (morphologic abnormality), Fracture of bone (disorder), bone; fracture, fracture; bone, Fracture: [of unspecified bones] or [NOS], Fracture, Broken Bones, Bone Fractures, Bone Fracture, Bone, Broken, Bones, Broken, Broken Bone, Fractures, Bone, Fracture, Bone, Fracture, cause unspecified (finding)
Spanish fractura, causa no especificada (trastorno), Fractura de huesos no especificados, Fractura ósea, Fractura NEOM, fractura, causa no especificada (hallazgo), Fracture: [of unspecified bones] or [NOS], Fracture - lesion, Fracture NOS, Fracture, Fracture of unspecified bones, Huesos rotos, fractura de hueso (trastorno), fractura ósea (trastorno), fractura ósea, fractura de hueso, fractura (anomalía morfológica), fractura de huesos no especificados (trastorno), fractura de huesos no especificados, fractura de huesos, SAI (trastorno), fractura de huesos, SAI, fractura, SAI (trastorno), fractura, SAI, fractura, causa no especificada, fractura, Fracturas, Fractura, Fracturas Oseas, Fracturas del Hueso, Fracturas Óseas
Italian Fratture, Frattura, Frattura ossea, Frattura NAS, Fratture di ossa non specificate, Rotture ossee, Fratture ossee
Dutch breuk van niet-gespecificeerde botten, botbreuk, breuk NAO, gebroken botten, bot; fractuur, fractuur; bot, breuken, breuk
French Fracture osseuse, Fracture d'os non précisés, Fracture SAI, Fracture, Fractures, Fractures de l'os, Fractures des os, Fractures osseuses, Os fracturés
German Fraktur NNB, Fraktur, Knochen, Fraktur unspezifischer Knochen, gebrochene Knochen, Frakturen, Fraktur, Frakturen, Knochen-, Gebrochene Knochen, Knochenbrüche
Portuguese Fractura de ossos NE, Fractura óssea, Fractura NE, Ossos partidos, Fracturas, Fractura, Fraturas de Ossos, Fraturas Ósseas
Japanese 骨折NOS, コッセツ, コッセツNOS, 骨折, タハツコッセツ, 多発骨折
Swedish Benbrott
Czech kosti - zlomeniny, fraktury kostí, Zlomenina kosti, Zlomenina NOS, Zlomenina, Zlomenina neurčených kostí, Zlomeniny, Zlomené kosti
Finnish Luunmurtumat
Polish Złamania kości
Hungarian Törés k.m.n., Törések, Törés, Csonttörés, Törött csontok, Nem meghatározott csontok törése