Describing Fractures Flashcards
What do you say at the start when describing X-ray
Views of X-ray e.g. AP - Always require 2 perpendicular for ortho - If give one in OSCE ask for another Person name Person age Time Part / anatomical site - make sure you know Abnormality / fracture pattern
Example AP + lateral X-ray of Jane Doe 58 years Taken yesterday Shows a transverse fracture of tibia mid-shaft
What do you look at
Cortical outline and look for break Soft tissue Joints Alignment Any other material
What is important to look at with joint
Joint space Subchondral bone Presents of cysts / osteophytes Cortical outline Alignment
What clinical features should you mention
Mechanism of fracture - Trauma / stress / pathological Energy - High or low Skin and soft tissue - Open or closed - Air suggest gas forming organism - Fluid = haematoma - FB Associated injury - NV
What radiological features
Site Articular involvement Shape of fracture / pattern Comminution / Multi-fragmentation Deformity Displacement Any specific fractures e.g. Colles
What is the site
R or L
Limb affected
Name of bone
Region e.g. proximal 3rd
What is articular involvement
Does fracture line extend into a joint Intra-articular - Dislocation - Subluxation Ligamentous Epiphyseal
What can shape of fracture or fracture pattern be
Transverse - perpendicular
Oblique
Spiral - severe oblique due to rotation
Multi-fragmented / Comminuted
Avulsion - tendon or ligament pulls bone
Impacted - bone squashed through fracture and in contact
Complex= mixed
What does complex often lead too
Multi-fragmented
- Break into 2+ segment or smaller bit
Butterfly segment
What is segmental
Fracture line dividing bone into a segment
What do simple fractures have
No mutli-fagmentation
What is deformity
Movement of distal fragment with respect to station proximal
What 4 things make up
STAR Shortening Translation Angulation Rotation
What is translation
% bit of bone no longer in contact
What is angulation
Angle between one segment relative to another typically distal segment Medial or lateral and degrees Dorsal vs volar if wrist Colles = dorsal Smith = volar (palm down)
