Common Musculoskeletal Injuries: Sprains, Fractures, Dislocations

Sprain: Ligament Injuries

A sprain is a complete or incomplete rupture of one or more ligaments, which are responsible for the stability of a joint. It can cause a momentary displacement of the articular bone surfaces of contact.

Most frequently, sprains affect the ankle. Symptoms usually include pain and swelling, often accompanied by effusion (ecchymosis and hematoma). The severity varies depending on the degree of the sprain:

• Grade I: Ligament strain without rupture.
• Grade II: Partial ligament tear.
• Grade III: Complete ligament tear.

Treatment typically involves immobilization of the affected joint with elastic bandages or casts.

Dislocation: Joint Displacement

A dislocation is a joint injury characterized by the permanent loss of contact between joint surfaces, which can be accompanied by ligament damage. Most frequently, dislocations affect the shoulder, elbow, jaw, thumb, and hip.

Subluxation: Partial Joint Separation

A subluxation is a partial loss of continuity between the joint surfaces.

Diastasis: Joint Separation

Diastasis refers to the separation of bones that are normally joined, such as in certain fibrous or cartilaginous joints.

Fracture: Bone & Cartilage Breaks

A fracture is a disruption of the continuity of bone or cartilage. The term 'fracture' often encompasses not only the break in the bone but also the injury to the surrounding soft tissues.

Fracture Classification

By Etiology

• Usual Fractures: Occur in healthy bone, with trauma as the crucial factor. These are the most frequent.
• Pathological Fractures: The key factor is weakened bones. They occur with minimal trauma in areas already compromised.
• Fatigue or Stress Fractures: Occur without pre-existing disease, due to sustained and repetitive efforts. There is usually a history of mild, repetitive trauma.

By Mechanism of Injury

• Direct Mechanism Fractures: Produced at the exact location of the impact force.
• Indirect Mechanism Fractures: Occur at a distance from the site of trauma, due to compression, bending, shear, torsion, or traction of the bone.
• Avulsion Fractures: These can occur due to sudden, strong muscle contractions, where a muscle or muscle group sharply pulls away a piece of bone at its insertion point.

By Soft Tissue Involvement

• Open Fractures: An open wound communicates directly with the fracture site. This poses a significant risk of infection and can lead to substantial bleeding.
• Closed Fractures: There is no communication with the external environment; the overlying skin remains intact.