- Apposition:Contact of the ends of the fracture frag-
ments - Avulsion: Bony fragment is pulled away from its
native bone by muscle contraction (e.g., mallet finger)
or a passive opposing force to a ligament (e.g., tibial
avulsion fracture of ACL). - Butterfly fragment: Wedge-shaped fracture frag-
ment that is separated from the main fracture frag-
ment in a comminuted fracture - Closed:Intact skin
- Comminuted:More than two fracture fragments
- Compression: Usually refers to vertebral fracture
where impaction occurs - Delayed union:Failure of union in the duration of
time that healing usually takes place for that bone. - Depression:An impaction-type fracture where the
hard surface of one bone is driven into a second softer
surface of bone (e.g., tibial plateau fracture). - Diastasis:Abnormal separation of two bones, e.g.,
symphysis pubis diastasis secondary to ruptured liga-
ments, widened ankle mortise secondary to syn-
desmosis disruption - Displacement:Degree of loss of anatomic position
- Distraction:Opposing ends of fracture fragments are
not in contact, e.g., secondary to musculotendinous
forces, interposed soft tissue, and the like suboptimal
for fracture healing. - Extra-articular:Does not penetrate the joint
- Fibrous union: Healing with fibrous tissue rather
than bony callus - Fracture (fx or #):Complete or incomplete disconti-
nuity (break) of bone or cartilage - Impaction:One fracture fragment is forcibly driven
(telescoped) into another adjacent fragment, e.g.,
Colles fracture. - Incomplete fractures:Only one cortex of the bone
has been broken and the other remains intact. - Intra-articular:Involves articular surface of a joint
- Malunion:Healing of the fracture in an unacceptable
position - Nonunion:Failure of bony union with cessation of
healing process - Pseudoarthrosis:Nonunion of a fx resulting in a
false joint - Oblique:Fracture line is oblique to the long axis of
the bone. - Open:Fracture site communicates with ambient envi-
ronment (old term was compound). - Pathologic:Fractures occurring in bones that have
been weakened by disease. - Remodeling:Occurs in skeletally immature patients
with healed fractures such that future bony growth
will serve to correct bony deformity, if it is not rota-
tional in nature. Potential for remodeling is greatest in
younger children, fractures occurring in close proxim-
ity to the physis and if the bony displacement is in the
plane of motion of the affected joint.- Segmental:Comminuted fracture where a long bone
is separated into at least three segments - Spiral:Caused by a torsional force and is akin to an
oblique fracture that encircles the long bone. - Transverse:Fracture is perpendicular to the long axis
of the bone. - Union:Healing of fracture
FRACTURE EPONYMS- Aviator’s astralgus:General term referring to frac-
ture or fracture-dislocation involving the talus - Barton’s fracture:Dorsal articular margin fracture of
the distal radius - Bennett’s fracture:Triangular-shaped intra-articular
fracture involving the radial portion of the base of the
thumb metacarpal with proximal dislocation of the
metacarpal shaft - Boxer’s fracture:Fracture of the neck of the small
metacarpal. This term is often incorrectly used to
describe a similar fracture in other metacarpal bones. - Chance fracture:This is usually caused by a flexion
injury to the spine resulting in a sagitally oriented
fracture through the posterior spinous process and
neural arch exiting the superior articular surface of the
involved vertebral body just anterior to the neural
foramina (spinal canal). - Chauffeur’s fracture: Triangular-shaped oblique
articular fracture involving the radial portion of the
distal radius - Chopart’s fracture and dislocation:Injury involv-
ing the midtarsal joints (talonavicular and calca-
neocuboid) of the foot - Clay-shoveler’s fracture:Fracture of the posterior
spinous process(es) of the lower cervical and/or upper
thoracic vertebrae - Colles fracture:Comminuted fracture of the distal
radius occurring in osteopenic bone as a result of a fall
on an outstretched hand resulting in dorsal angulation
of the fracture fragments - Dashboard fracture:Posterior wall acetabular frac-
ture - Essex-Lopresti fracture:Comminuted radial head
fracture with associated dislocation of the distal
radioulnar joint - Galeazzi’s fracture:Radius fracture at the junction
of the middle and distal thirds with concomitant sub-
luxation of the distal ulna - Greenstick fracture:Incomplete, angulated fracture
that occurs in skeletally immature patients that results
32 SECTION 1 • GENERAL CONSIDERATIONS IN SPORTS MEDICINE