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Bone Pathology 1 > Final > Flashcards

Final Flashcards

1
Q

Open Fracture

A

A fracture that penetrates the skin

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2
Q

Comminuted fracture

A

Fracture in which two or more bony fractures have separated

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3
Q

Butterfly fragment

A

A comminuted fracture that has an isolated triangular shape

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4
Q

Non-Comminuted fracture

A

One that penetrates completely through the bone separating it into two parts

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5
Q

Avulsion fracture

A

Tearing of a portion of bone from muscular or ligamentous force

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6
Q

Impaction fracture

A

When a portion of bone is driven into an adjacent segment. DEPRESSED and COMPRESSION

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7
Q

Depressed (impaction) fracture

A

An inward bulging of the outer bone surface (tibial plateau and frontal bone).

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8
Q

Compression (impaction) fracture

A

Decreased size of the involved bone. Vertebral endplates are driven toward each other and compress intervening spongy bone

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9
Q

Greenstick Fracture

A

Primarily in infants and children under ten. Bone bends applying tension to the convex side and fracturing while concave side is intact.

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10
Q

Torus (buckling) fracture

A

Compression forces cause the cortex to bulge outward. Most occur in metaphysis and are a painful variation of greenstick

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11
Q

Infraction

A

This fracture is acutally a form of impaction fracture that is only moderately severe. Used to explain a minor localized break in cortex, leaving minimal bone deformity.

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12
Q

Chip corner fracture

A

A form of avulsion fracture that is a “chip” from the corner of a phalanx or other similar bone

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13
Q

Stress fracture

A

Caused by repetitive stress that creates microfractures until eventually the fracturing is faster than the rate of bone repair.

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14
Q

Occult fracture

A

(bone bruise)
Represents hemorrhage and bone marrow edema associated with trabecular microfracture
On T2 weighted images it appears as a high signal area and on T1 it appears as a speckled low intensity area.

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15
Q

Psuedo-fracture

A

Not an actual fracture
An insufficiency fracture or the result of vascular pulsations
Discrete areas of uncalcified osteoid

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16
Q

Fracture Orientation (oblique, spiral, transverse)

A

Oblique: Occurs along the shaft of the long tubular bone
Spiral: Torsion coupled with axial compression and angulation
Transverse: Occurs at a right angle to the shaft of the bone. uncommon in healthy bone but common in diseased bone.

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17
Q

Diastasis

A

Displacement or separation of a slightly moveable joint. MC pubic symphysis, skull, tib-fib syndesmosis

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18
Q

Chondral or osteochondral fracture

A

Fracture through a joint surface that may result from shearing, rotary or tangential impaction fractures. May consist of cartilage only or cartilage and bone. osteochondritis dissecans (convex surfaces of femoral condyles, talar dome and capitulum

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19
Q

Salter-Harris classification of epiphyseal injuries

A 
Type 1: Growth Plate
Type 2: GP and metaphysis
Type 3: GP and epiphysis
Type 4: All
Type 5: compression
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20
Q

S-H type I

A

fracture through GP and usually radiograph is normal. DX is clinical because of tenderness and swelling over epiphyseal plate.
Complicated with scurvy, rickets, osteomyelitis, hormone imbalance.
can present as slipped capital femoral epiphysis

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21
Q

S-H type II

A

Injury is through the displaced GP and taking some of the metaphysis with it.
MC epiphyseal injury making 75% of cases. MC sites are radius (50%), tibia, fibula, femur, ulna

22
Q

S-H type III

A

Fracture line is directed along the GP and then turns towards the epiphysis. It is an intra-articular fracture that may require open reduction treatment

23
Q

S-H Type IV

A

Obliquely oriented vertical fracture that passes through the epiphysis, GP, and metaphysis.
MC distal humerus in those under 10 and distal tibia in those over 10.

24
Q

S-H Type V

A

least common of all epiphyseal fracture.

Radiographs are normal until shortening of growth causes short bones or angular cessation.

25
Q

Circulatory or inflammatory phase of healing

A

Cellular phase - Cellular inflammatory response creates a blastema of undifferentiated mesenchymal cells that replaces hematoma
Vascular phase - diverts blood and creates a swamp that induces osteoclastic activity
Primary callus phase - primary exudate that and tissue that develops around the edge of the fracture fragments

26
Q

Reparative or metabolic phase

A

more orderly secretion of callus and replacing osteoid with a more mature version of bone

27
Q

Remodeling or mechanical phase

A

Remodeling and realignment of bone and callus along the lines of stress. restoration of medullary cavity and bone marrow.

28
Q

Pathologic fracture

A

Fx through a bone that is weakened by a local or systemic disease process. Usually transeverse and often appear quite smooth

29
Q

Spatial relationships of fractures

A

Alignment - position of distal fragment compared to proximal fragment. Good is no angulation

Apposition - Closeness of the bony contact of the fracture site. Good - near complete, partial - partial bony contact, distraction - pulled apart

Rotation - inclusion of both segments is needed to determine if there has been rotation

30
Q

Radiologic features of bone healing

A

within first 5 days resorption occurs widening the fracture line
within 10-30 days a veil of new bone formation occurs adjacent to the callus.
Callus is remodeled and the whole process takes 4-6 weeks in young patients and 6-12 in geriatric patients

31
Q

Complications of fracture healing - immediate

A

Arterial injury - MC popliteal with femur tibia, knee disloc
Compartment syndrome - high pressure in compartment may cause necrosis of contained muscles dt lack of perfusion
Gas gangrene - appearnace of thin parallel linear streaks within muscle planes
Fat embolism syndrome - fracture of a major bone leaks fat for 1-5 days after
Thromboembolism - injuries that result in immobilization and bedrest may cause DVT. Hip, pelvis, LE

32
Q

Complications of fracture healing - intermediate

A 
Osteomyelitis
Hardware failure
Reflex sympathetic dystrophy syndrome 
Post-traumatic osteolysis
Refracture
Myositis Ossificans
Synostosis
Delayed union
33
Q

Complications of fracture healing - Delayed

A 
Osteonecrosis
DJD
Lead arthropathy and toxicity
Osteoporosis
Aneurysmal bone cyst
Non-union
Malunion
34
Q

Delayed union

A

Slow bony union across a fracture may follow inappropriate immobilization, intrinsically poor vascularity, and age
Scaphoid, proximal femur and tibia

35
Q

Non-union

A

Failure to complete oseous fusion across fracture
Distraction, infection poor immobilization and vasculature.
Midclavicle, ulna, tibia
Signs: Slow to appear rounding, lack of callus, sclerosis and pseudo arthrosis

36
Q

Malunion

A

union in poor position can lose function, shorten limb

37
Q

Aseptic necrosis

A

Necrosis from lack of blood to bone

Femoral, head, humeral head, scaphoid, talus

38
Q

Disuse osteoporosis

A

Following healing there may be delay to full use due to pain, low function, nerve palsy,or failure to mobilize. Done density will then be affected and incomplete

39
Q

Jefferson’s fracture

A

Bursting fracture of the ring of the atlas

Fracture through anterior and posterior arches

40
Q

Posterior arch fracture of atlas

A

MC fx of atlas. Result of being compressed between occiput and posterior arch of axis during hyperextension. 80% have another Cx spine fx.

41
Q

Transverse ligament rupture

A

Rare, odontoid usually breaks before ligament ruptures. Seen in jefferson’s, arthritis, 20% of down’s.
Abnormally wide ADI >3 mm adults and >5 mm kids. cord compression with 10 mm anterior displacement.

42
Q

Steele’s rule of thirds

A

atlas ring into thirds
1/3 cord
1/3 space
1/3 odontoid

43
Q

Hangman’s fracture

A

40% of axis fractures
Abrupt deceleration from high speed and fracture occurs during hyperextension.
Bilateral disruption of the pedicles of the axis. A teardrop fracture often occurs simultaneously

44
Q

Teardrop fracture

A

Avulsion of the triangular-shaped fragment from the anteroinferior corner of the axis body

45
Q

Odontoid type I, II, III

A

40-50% of axis fx
TI - Avulsion of the tip of odontoid process as a result of apical or alar lig stress
TII - Fx between odontoid and body. MC and MC results in non-union. may require surgery if >5 mm. unstable
TIII - Takes some of the body with it. heals better.

46
Q

Wedge fracture

A

Compression of involved vertebrae bodies from forced hyperflexion. 2/3 occur at C5-7
Looks like a wedge

47
Q

Burst fracture (Cx)

A

Vertical compression to the head causes NP to break through endplate and go into vertebral body. posterior fragments may cause neuro deficits.

48
Q

Articular pillar fracture

A

MC at C4-7 and C6 esp
Altered shape of vertical height and may cause anterolisthesis.
On radiograph may appear as rotation or loss of segment height

49
Q

Clay shoveler’s fracture

A

Avulsion to the SP. may appear as a double SP on image
Abrupt flexion of the head.
MC at C7 and surrounding. Stable Fx

50
Q

LAmina and TP fractures

A

MC C5-6
Trauma with lateral flexion
Fx line tends to localize near its junction with pedicle
May produce VA injury

51
Q

unilateral or bilateral facet dislocation

A

teardrop fracture may cause severe and unstable injuries dt forward dislocation of vertebra and rupture of posterior ligaments
Localized kyphosis and widening of interlaminar spaces and interspinous spaces

Bone Pathology 1 (1 decks)

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