Classification and Relation of Fractures to the Overlying Skin
Fractures are divided into compound, or open and simple, or subcutaneous, according to whether a communication does or does not exist between the seat of fracture and a wound of the skin.
A compound fracture is one in which the cutaneous wound communicates with the seat of the fracture.
A simple fracture is one in which a wound of the skin is absent, or, if present, no communication exists between it and the seat of the fracture.
The majority of compound fractures are the result of direct violence, and the injuries of the soft parts, are, as a rule, far more extensive and serious than in a simple fracture. A fracture which is simple at first, may become compound as a result of necrosis of the skin lying over it; or as a consequence of the original injury; or of pressure upon it by a displaced fragment; or by penetration of the skin, in efforts to use the limb.
Further Classification of Fractures
Fracture. In the ordinary use of the term “fracture” is understood to indicate a complete or incomplete separation of the bone into two or more fragments, the lines of which are continuous with each other.
Multiple Fracture. The term multiple fracture is applied to the simultaneous fracture of two or more non-adjacent bones, and also to those cases in which two or more fractures of the same bone exist, and the lines are not continuous with each other. Such multiple fractures are usually the result of direct violence.
Complicated Fracture. When a fracture is accompanied by injuries of the viscera, nerves, etc., the term complicated fracture is applied. Such a fracture may be simple or compound. The term complicated, as ordinarily employed, is limited to those fractures which are accompanied by local, rather than by general complications.