Bones of Lower Limb Flashcards
what are the most common lower limb injuries?
knee, leg, and foot
epiphyseal plates
discs of hyaline cartilage b/w the metaphysis and epiphysis of a mature long bone that permit the bone to grow longer
osteochondrosis
irritation and injury of the plates and developing bone
what does the term ‘hip fracture’ refer to?
fractures of the femoral head, neck, or trochanters
when might avulsion fractures of the hip bone occur?
during sports that require sudden acceleration or deceleration forces - a small part of bone with a piece of tendon or ligament attached is torn away
where do avulsion fractures of the hip bone occur?
- at apophyses
- where muscles are attached: anterior superior and inferior iliac spines, ischial tuberosities, and ischio-pubic rami
apophyses
bony projections that lack secondary ossification centers
coxa vara
decreased angle of inclination b/w long axis of the femoral neck and the femoral shaft
- causes mild shortening of lower limb
- limits passive abduction of the hip
coxa valga
increased angle of inclination b/w long axis of the femoral neck and the femoral shaft
dislocated epiphysis of femoral head
epiphysis of femoral head may slip away from the femoral neck b/c of a weakened epiphyseal plate
how is dislocated epiphysis of femoral head confirmed?
radiographic exam of superior end of the femur
what part of the femur is most commonly fractured?
neck of femur - narrowest and weakest part of bone and lies at a marked angle to the line of weight-bearing
what type of femoral fractures usually occur due to indirect trauma?
transcervical (middle of neck) and intertrochanteric - cause impaction
impaction
overriding of fragments resulting in foreshortening of the limb
intracapsular fractures
occur w/i the hip joint capsule - complicated by degeneration of femoral head
what type of femoral fractures usually occur due to direct trauma?
fractures of the greater trochanter and femoral shaft
spiral fracture of femoral shaft
results in foreshortening as the fragments override
complications of fractures of the inferior or distal femur
- separation of the condyles, resulting in misalignment of the articular surfaces of the knee joint
- hemorrhage from popliteal artery
- compromises blood supply to the leg
where is the tibia narrowest - most common site of fracture?
at junction of its middle and inferior thirds
clinical significance of the anterior surface of the tibial shaft being subcutaneous
most common site of compound fracture
bumper fracture
compound tibial fracture caused when a car bumper strikes the leg
transverse march (stress) fractures
strain fractures the anterior cortex of the tibia - on inferior third of tibia
what kind of fracture can be caused by severe torsion during skiing?
diagonal fracture of the tibial shaft at jxn of middle and inferior thirds + fracture of the fibula
what are diagonal fractures often associated with?
limb shortening caused by overriding of the fractured ends
boot-top fracture
fracture resulting from a high-speed forward fall (skiing) which angles the leg over the rigid ski boot
where do fibular fractures commonly occur and what are they often associated with?
2-6 cm proximal to the distal end of the lateral malleolus - associated w/ fracture-dislocations of the ankle joint
what type of fractures are relatively common in soccer and basketball players?
fractures of the lateral and medial malleoli
what bone is used for bone grafts?
middle third of the fibula - so that the nutrient foramen is included so graft has blood supply to the medullary cavity and compact bone
what is the anterior tibia used for in children?
- bone grafting b/c of subQ location
- intramedullary infusion in dehydrated or shocked children
why are calcaneal fractures disabling?
disrupts the subtalar (talocalcaneal) joint
what fracture may be caused by severe dorsiflexion of the ankle?
fractures of talar neck - sometimes body of talus is also dislocated posteriorly
dancer’s fracture
dancer loses balance, putting full body weight on the metatarsal and fracturing the bone
what fractures may occur from repeated stress on the metatarsals (like prolonged walking)?
fatigue fractures of the metatarsals
avulsion fracture of the tuberosity of the 5th metatarsal
when foot is suddenly and violently inverted, tuberosity may be avulsed by the tendon of the fibularis brevis
who are avulsion fractures of the tuberosity of the 5th metatarsal common in?
tennis and basketball players
os trigonum
accessory ossicle that forms when a partly or even fully ossified center fractures and progresses to non-union - prevalent in soccer players and ballet dancers
what fracture may occur from a crushing injury?
fracture of the sesamoid bones
