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January 11, 1965

Fractures: Simple, Compound, and Complex

Author Affiliations

Chairman, Musculoskeletal Section, Standard Nomenclature of Diseases and Operations Birmingham, Ala


JAMA. 1965;191(2):144. doi:10.1001/jama.1965.03080020072034

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To the Editor:—  In many instances, and for years, I have emphasized what misnomers the terms "simple" and "compound" fractures are, especially when one realizes that a simple fracture can be accompanied by the most complicated pathology in surrounding tissues and can be more severe in many instances than the so-called compound fracture. In my opinion, the presently-used terms should be supplanted by the following: (1) closed fracture, in many instances complex closed fracture, and (2) open fracture."Simple" fracture does not define the injury to the soft tissues, the intramuscular hemorrhage, or the loss of sensation of the parts of the tissue close to the fracture area. Neither does it emphasize the possible marked displacement of bone fragments. Too frequently, if all these exist with no open wound, the term simple fracture is used. I believe it is important that we classify as complex closed fractures those which do

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