Chapter 24: Recognizing Fractures And Disolcations Flashcards
What are the characteristics of an acute fracture?
Abrupt disruption of all or part of the cortex
Acute changes in the smooth contour of a normal bone
Fracture lines are black and linear
Where fracture lines change their course, they tend to be sharply angulated
Fracture fragments are jagged and not corticated
Appearance of Acute Fractures?
Abrupt disruption of cortex
Never bilaterally symmetrical
Not sharp, jagged fracture lines
Bony fragment does NOT have cortex completely around it
Appearance of Sesamoids and accessory ossicles?
NO abrupt disruption of cortex
Almost always bilaterally symmetrical
Smooth fracture line
HAS cortex completely around the bony fragment
What types of shoulder dislocations are common?
Anterior, subcoracoid
What causes shoulder dislocations?
Combination of abduction, external rotation, and extension
What fractures are most associated with shoulder dislocations?
Hill-Sachs deformity of numeral head
Bankart fractures of glenoid
Where are hip dislocations most common?
Posterior and superior
What causes hip dislocations?
Knee striking dashboard, transmitting force to hip
What fractures are associated with hip dislocation?
Fractures of posterior rim of the acetabulum
How are Fractures Described?
Number of fracture fragments
Direction of fracture line
Relationship of one fragment to another
Open to the atmosphere
What are the terms used for number of fracture fragments?
Simple or comminuted
What are the terms used for direction of fracture line?
Transverse
Oblique
Spiral
What are the terms used for Relationship of one fragment to another?
Displacement
Angulation
Shortening
Rotation
What are the terms used for open to the atmosphere?
Closed or Open/compound
What causes a transverse fracture line?
Force is applied perpendicular to long axis of bone
Fracture occurs at site of force
What causes an oblique fracture line?
Force applied along the long axis of bone
Fracture occurs somewhere along shaft
What causes spiral fracture line?
Twisting or torque injury
Common Avulsion Fractures around the pelvis?
Anterior, superior iliac spine = sartorius m.
Anterior, inferior iliac spine = Rectus femoris m.
Ischial Tuberosity = hamstring
Lesser trochanter of femur = iliopsoas m.
What are indirect signs of possible fracture?
Soft tissue swelling
Disappearance of normal fat stripes
Joint effusion
Periosteal reaction
Factors that accelerate fracture healing?
Youth Early immobilization adequate duration of immobilization Good blood supply Physical activity after adequate immobilization Adequate mineralization
Factors that delay fracture healing?
Old age Delayed immobilization Too short a duration of immobilization Poor blood supply Steroids Osteoporosis, osteomalaciah
What is a fracture?
A disruption in the continuity of all or part of the cortex of a bone
What are complete fractures?
Involve the entire cortex
Most common
Typically occur in adults
What are incomplete fractures?
Involve only a portion of the cortex
Typically occur in bones that are softer, like child’s bones
Torus and Greenstick
How to fracture lines typically appear?
Blacker, more sharply angled, and more jagged
What mimics acute fractures?
Sesamoids
Accessory ossicles
Unhealed fractures
What is dislocation?
Two bones that originally formed a joint are no longer in contact with each other
What is sublaxation?
When two bones that originally formed a joint are in partial contact with each other
How many fragments do simple fractures have?
2
How many fragments do comminuted fractures have?
More than 2
Segmented and butterfly fractures
Which fractures are more common: open or closed?
Closed fractures
What are avulsion fractures?
Produced by the forceful contraction of a tendon or ligament
They can occur at any age but are particularly common in younger, athletic individuals
What are stress fractures?
Occur as a results of numerous micro fractures and frequently are not visible on Xray when the pain first begins
Only seen when a sclerosis becomes visible
What is a Colles fracture?
Fracture of the distal radius with dorsal angulation; often caused by FOOSH
What is a Smith fracture?
Fracture of the distal radius with palmar angulation of distal radial fracture fragment; caused by fall on the back of flexed hand
What is a Jones Fracture?
Transverse fracture of the 5th metatarsal about 1 to 2 cm. From its base caused by plantar flexion of the foot and inversion of the ankle
What is a Boxer’s fracture?
Fracture of the neck of the 5th metacarpal with palmar angulation of the distal fracture fragment; often the result of punching someone or a wall
What is a march fracture?
Type of stress fracture often seen in the shafts of the 2nd and 3rd metatarsals
What are commonly missed fractures?
Scaphoid fracture Buckle fracture of the radius and ulna Radial head fractures Supracondylar fractures Posterior dislocations of the shoulder Hip fractures
How do fractures heal?
With a combo of endosteal callus and external callus’s
What does delayed union mean?
Refers to a fracture that is taking longer to heal than is usually required for that site
What does malunion mean?
The fracture is healing but in a mechanically or cosmetically unacceptable way
What does nonunion mean?
A radiologic diagnosis that implies there is little, if any, likelihood the fracture will heal
