What Is a Comminuted Fracture?

Comminuted fracture is a complete fracture, which refers to the fracture of bone into three or more pieces, also known as T or Y fracture. Comminuted fractures require braking, reduction, fixation, and promotion of fracture healing and rehabilitation. Most of them require surgical treatment, because of comminuted fractures, a large number of fractures, poor manual reduction effect, and poor stability after reduction. Improper treatment may have sequelae.

Basic Information

nickname: T and Y fractures
Visiting department: orthopedics

Common causes: Caused by direct and indirect violence
Common symptoms: Pain, hematoma, bruising, or bleeding around the fracture,

Causes of comminuted fracture

Common causes of comminuted fractures are:

Direct violence

Violence directly affects a part of the bone and causes a fracture in the part, often accompanied by soft tissue damage to varying degrees.

2. Indirect violence

It is also a common cause of comminuted fractures. When indirect violent effects occur, distant fractures occur through longitudinal conduction leverage or torsion. For example, when the foot is dropped from a high place and the ground is bent, the trunk flexes forward due to gravity. A vertebral compression fracture occurred at the spinal junction.

Clinical manifestations of comminuted fracture

The first symptom that patients show after a fracture is undoubtedly pain. Especially when moving the injured part, the patient will feel the pain intensified. When properly treated and fixed, the pain is reduced, but tenderness will still occur when touched. If it is a closed fracture, the bone marrow, periosteum, and surrounding soft tissue will be damaged, and the blood vessels located in it will be ruptured, and hematomas and bruises will easily form around the fracture. Open fractures may also be accompanied by bleeding.

1. Horizontal, oblique and spiral fractures occur mostly in the backbone. A comminuted fracture is a comminuted fracture in which the bone is fragmented into two or more pieces.

2. When the fracture line is "T" shaped or "Y" shaped, it is also called "T" shaped fracture or "Y" shaped fracture.

3. Stellate fractures, mostly caused by violence directly on the bone surface, such as skull and sacrum fractures can occur.

4. Compression fracture, cancellous bone deformed due to compression, such as vertebra and calcaneus.

5. Depression fractures, such as partial depression of the skull due to external forces. An embedded fracture occurs at the junction of the cortical bone and cancellous bone of the metaphysis of the long tube. After a fracture, the cortical bone is inserted into the cancellous bone, which can occur at the femoral neck and the humeral surgical neck.

6. Crack fractures, such as long bones or skull fractures may have fracture lines, but did not pass all bone. A comminuted fracture is a more serious fracture. Once it occurs, it will cause serious consequences. Therefore, in daily life, it is necessary to avoid fractures as much as possible. If a comminuted fracture occurs, it must be treated in a regular hospital in time to prevent the disease from getting worse, causing irreparable regrets.

Comminuted fracture examination

CT and X-ray examination of bone imaging. X-ray films (including ortho, lateral and bone axis radiographs) can generally be used for clear diagnosis. CT scan or MRI can be used for those who have difficulty in diagnosis, especially CT scan has a greater effect on the diagnosis and prognosis of the fracture classification. For complex pelvic fractures or suspected intravertebral fractures, tomography or CT should be performed as appropriate.

Diagnosis of comminuted fracture

A clear diagnosis can be made based on medical history, symptoms, and imaging findings.

Comminuted fracture treatment

Surgical treatment

Comminuted fractures are treated with surgical fixation, and long tubular bones are treated with interlocking intramedullary needles. Non-displaced fractures can be treated with plaster external fixation and symptomatic treatment. Displaced fractures are fixed internally with steel wire for surgical reduction.

2. Drug treatment

Surgical treatment can be supplemented with medication. Use painkillers and supplement vitamins. Some proprietary Chinese medicines are also available.

In addition, pay attention to patients with surgery, add antibiotics to prevent infection, the drug can be discontinued 24 hours after the wound without infection.

Prognosis of comminuted fracture

The fracture alignment is good, the function is completely or basically restored, and the surgical wound heals. Unhealed: fracture alignment, sub-optimal alignment, limb function is significantly limited. Early reasonable fracture function exercise, raise the affected limb, place a pillow under the affected limb, which is higher than the heart to facilitate the return of blood and facilitate the formation of epiphysis. You can move the joints of the affected limb and toe flexion exercises in bed to promote the affected limb Blood circulation, reduce muscle atrophy and adhesion, maintain muscle strength, prevent joint stiffness, and promote fracture healing. For joints that are not fixed, patients should be encouraged to take active functional exercises in time. When the fracture end has reached clinical healing, weight-bearing exercises can be gradually strengthened.