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Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Related Experiment Video

Updated: Oct 22, 2025

Pseudofracture: An Acute Peripheral Tissue Trauma Model
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"One Note Higher": A Unique Pediatric Hand Fracture.

Scott Szymanski1, Michael Zylstra1, Aicha Hull1

  • 1Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington.

Clinical Practice and Cases in Emergency Medicine
|August 26, 2021
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Summary

An "extra-octave" fracture, a type of Salter-Harris II fracture in the fifth digit, requires reduction if displaced. Prompt orthopedic follow-up is crucial to prevent complications like malunion.

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Hand Surgery

Background:

  • Salter-Harris II fractures involve the physis and epiphysis.
  • The "extra-octave" fracture specifically affects the proximal phalanx of the fifth digit with ulnar deviation.

Purpose of the Study:

  • To describe the diagnosis and management of an "extra-octave" fracture.
  • To highlight potential complications and recommend follow-up protocols.

Main Methods:

  • Case presentation of a 12-year-old male with an "extra-octave" fracture.
  • Radiographic diagnosis of Salter-Harris II fracture.
  • Closed reduction and short-arm casting by orthopedic surgery.

Main Results:

  • Successful closed reduction and casting of the displaced fracture.
  • Patient discharged with orthopedic follow-up.
  • Fracture identified as an "extra-octave" type.

Conclusions:

  • "Extra-octave" fractures necessitate reduction if displaced to avoid malunion and functional deficits.
  • Management includes closed reduction techniques (e.g., "90-90", "pencil") and casting/splinting.
  • Potential complications include tendon entrapment, ligament disruption, and "pseudo-claw" deformity; orthopedic follow-up is essential.