Bones of Lower Limb

Question 1

what are the most common lower limb injuries?

Answer 1

knee, leg, and foot

Question 2

epiphyseal plates

Answer 2

discs of hyaline cartilage b/w the metaphysis and epiphysis of a mature long bone that permit the bone to grow longer

Question 3

osteochondrosis

Answer 3

irritation and injury of the plates and developing bone

Question 4

what does the term ‘hip fracture’ refer to?

Answer 4

fractures of the femoral head, neck, or trochanters

Question 5

when might avulsion fractures of the hip bone occur?

Answer 5

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

Question 6

where do avulsion fractures of the hip bone occur?

Answer 6

• at apophyses

- where muscles are attached: anterior superior and inferior iliac spines, ischial tuberosities, and ischio-pubic rami

Question 7

apophyses

Answer 7

bony projections that lack secondary ossification centers

Question 8

coxa vara

Answer 8

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

Question 9

coxa valga

Answer 9

increased angle of inclination b/w long axis of the femoral neck and the femoral shaft

Question 10

dislocated epiphysis of femoral head

Answer 10

epiphysis of femoral head may slip away from the femoral neck b/c of a weakened epiphyseal plate

Question 11

how is dislocated epiphysis of femoral head confirmed?

Answer 11

radiographic exam of superior end of the femur

Question 12

what part of the femur is most commonly fractured?

Answer 12

neck of femur - narrowest and weakest part of bone and lies at a marked angle to the line of weight-bearing

Question 13

what type of femoral fractures usually occur due to indirect trauma?

Answer 13

transcervical (middle of neck) and intertrochanteric - cause impaction

Question 14

impaction

Answer 14

overriding of fragments resulting in foreshortening of the limb

Question 15

intracapsular fractures

Answer 15

occur w/i the hip joint capsule - complicated by degeneration of femoral head

Question 16

what type of femoral fractures usually occur due to direct trauma?

Answer 16

fractures of the greater trochanter and femoral shaft

Question 17

spiral fracture of femoral shaft

Answer 17

results in foreshortening as the fragments override

Question 18

complications of fractures of the inferior or distal femur

Answer 18

• 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

Question 19

where is the tibia narrowest - most common site of fracture?

Answer 19

at junction of its middle and inferior thirds

Question 20

clinical significance of the anterior surface of the tibial shaft being subcutaneous

Answer 20

most common site of compound fracture

Question 21

bumper fracture

Answer 21

compound tibial fracture caused when a car bumper strikes the leg

Question 22

transverse march (stress) fractures

Answer 22

strain fractures the anterior cortex of the tibia - on inferior third of tibia

Question 23

what kind of fracture can be caused by severe torsion during skiing?

Answer 23

diagonal fracture of the tibial shaft at jxn of middle and inferior thirds + fracture of the fibula

Question 24

what are diagonal fractures often associated with?

Answer 24

limb shortening caused by overriding of the fractured ends

Question 25

boot-top fracture

Answer 25

fracture resulting from a high-speed forward fall (skiing) which angles the leg over the rigid ski boot

Question 26

where do fibular fractures commonly occur and what are they often associated with?

Answer 26

2-6 cm proximal to the distal end of the lateral malleolus - associated w/ fracture-dislocations of the ankle joint

Question 27

what type of fractures are relatively common in soccer and basketball players?

Answer 27

fractures of the lateral and medial malleoli

Question 28

what bone is used for bone grafts?

Answer 28

middle third of the fibula - so that the nutrient foramen is included so graft has blood supply to the medullary cavity and compact bone

Question 29

what is the anterior tibia used for in children?

Answer 29

• bone grafting b/c of subQ location

- intramedullary infusion in dehydrated or shocked children

Question 30

why are calcaneal fractures disabling?

Answer 30

disrupts the subtalar (talocalcaneal) joint

Question 31

what fracture may be caused by severe dorsiflexion of the ankle?

Answer 31

fractures of talar neck - sometimes body of talus is also dislocated posteriorly

Question 32

dancer’s fracture

Answer 32

dancer loses balance, putting full body weight on the metatarsal and fracturing the bone

Question 33

what fractures may occur from repeated stress on the metatarsals (like prolonged walking)?

Answer 33

fatigue fractures of the metatarsals

Question 34

avulsion fracture of the tuberosity of the 5th metatarsal

Answer 34

when foot is suddenly and violently inverted, tuberosity may be avulsed by the tendon of the fibularis brevis

Question 35

who are avulsion fractures of the tuberosity of the 5th metatarsal common in?

Answer 35

tennis and basketball players

Question 36

os trigonum

Answer 36

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

Question 37

what fracture may occur from a crushing injury?

Answer 37

fracture of the sesamoid bones