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DIAGNOSTIC IMAGING II > Fracture/Dislocations Upper Extremity > Flashcards

Fracture/Dislocations Upper Extremity Flashcards

1
Q

What do we see with scapular fractures?

A
  • Requires severe trauma
  • Radiographs will typically demonstrate other fractures/injuries
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2
Q

___% of fractures are seen involving the scapular body and neck

A

80%
Other locations:
- Coracoid
- Acromion

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3
Q

Describe a Bankart lesion (Glenoid Rim)

A
  • Impaction fracture from an anterior glenohumeral dislocation
  • Avulsion fracture from Triceps tendon
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4
Q

What is a Bankart fracture?

A

Fracture including the anterior inferior glenoid rim
- May be osseous, soft tissue or both

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5
Q

What is a Bankart fracture seen with?

A

Seen with an anterior-inferior glenoid dislocation

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6
Q

What is the treatment for a Bankart fracture?

A
  • Typically heal without severe complications
  • Labral fragment can be sutured back to the glenoid rim
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7
Q

What condition can show a Bankart fracture?

A

Can be seen with a Hill-Sachs defect

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8
Q

Where is a Hill-Sachs defect commonly found?

A

On the humerus

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9
Q

What is the MOI of a Bankart fracture?

A

FOOSH (Fall On Outstretched Hand)

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10
Q

Describe a Hill-Sach deformity

A
  • Seen with an anterior-inferior shoulder dislocation
  • Compression/impaction fracture involves the posterior-lateral aspect of the humeral head on the inferior glenoid rim
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11
Q

What imaging should you use for a Hill-Sach deformity?

A
  • Best seen on an internal rotation view
  • May require MR arthrogram to assess the rotator cuff and labrum
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12
Q

How do you manage a Hill-Sach deformity?

A

Deformity will persist for life
- Must consider if the injury is acute or chronic
- Consider injury to the rotator cuff tendons

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13
Q

Describe a Flap fracture

A

Greater tuberosity fracture due to avulsion from the supraspinatus tendon

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14
Q

What is the MOI of a Flap fracture?

A

Commonly seen following an anterior shoulder dislocation

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15
Q

What is the most common Glenohumeral dislocation?

A

Anterior (95%)

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16
Q

What is the most common location that the humerus may be found with anterior shoulder dislocations?

A

Subcoracoid

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17
Q

What injuries are associated with an anterior shoulder dislocation?

A

Hill-Sach fracture (60%)
Flap fracture (15%)
Bankart lesion

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18
Q

Posterior Glenohumeral dislocation: Common or Uncommon?

A

Uncommon

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19
Q

What signs and symptoms is a Posterior Glenohumeral dislocation associated with?

A
  • Seizures
  • Electric shock
  • Trauma
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20
Q

What injuries is a Posterior Glenohumeral dislocation associated with?

A
  • Reverse Hill-Sach deformity
  • Reverse Bankart lesion
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21
Q

Describe a Proximal Metaphyseal fracture

A

Fracture through the surgical neck of the humerus

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22
Q

What do we see radiographically with a Proximal Metaphyseal fracture?

A

Cortical disruption between the anatomical and surgical necks of the humerus

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23
Q

What may be damaged with a Proximal Metaphyseal fracture?

A

Axillary nerve may be damaged

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24
Q

What is the MOI of a Proximal Metaphyseal fracture?

A

FOOSH (Fall On Outstretched Hand)

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25
Q

What is the MOI of a Mid-diaphyseal Humeral fracture?

A
  • Direct blunt force trauma
  • Indirect trauma from a fall or twisting action
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26
Q

What do we see radiographically with a Mid-diaphyseal Humeral fracture?

A

Cortical disruption in the middle of the diaphysis of the humerus

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27
Q

What may be damaged with a Mid-diaphyseal Humeral fracture?

A

Radial nerve may be damaged

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28
Q

What is the most common elbow fracture in the pediatric patient?

A

Supracondylar fracture

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29
Q

What is the MOI of a Supracondylar fracture?

A

FOOSH injury with elbow hyperextended

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30
Q

What do we see radiographically with a Supracondylar fracture?

A

Abnormal location of the capitellum in relation to the anterior humeral line and the radio capitellar line

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31
Q

What are two important lines used when assessing a Supracondylar fracture?

A
  • Anterior Humeral Line
  • Radiocapitellar Line
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32
Q

What sign do we see in a Supracondylar fracture?

A

SAIL Sign

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33
Q

Medial Epicondyle fracture: More common in boys or girls?

A

80% of these avulsion fractures occur in boys

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34
Q

What is a Medial Epicondyle fracture associated with?

A

50% are associated with elbow dislocations

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35
Q

What nerve is damaged in a Medial Epicondyle fracture?

A

Ulnar nerve damage

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36
Q

What is the MOI of a Lateral Epicondyle fracture?

A

Hyperextension injury with extreme valgus stress

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37
Q

What do we see radiographically with a Lateral Epicondyle fracture?

A

Cortical disruption between the lateral epicondyle and the lateral supracondylar ridge

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38
Q

What may be associated with a Lateral Epicondyle fracture?

A

Dislocation or fracture of the radius

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39
Q

Head of the radius fracture AKA

A

Chisel fracture

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40
Q

What is the most common elbow fracture in an adult?

A

Head of the radius (Chisel) fracture

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41
Q

Chisel fracture: More common in women or men?

A

More common in women
- Ages 30-40 years old

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42
Q

What is the MOI of a Chisel fracture?

A

FOOSH

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43
Q

What is the MOI of a neck of radius fracture?

A

FOOSH

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44
Q

What do we see radiographically in a neck of radius fracture?

A

Cortical disruption through the neck of the radius
- Transverse break

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45
Q

What is the most frequently dislocated joint in children?

A

Elbow

46
Q

What is the MOI of an elbow dislocation?

A

FOOSH with elbow partially flexed

47
Q

Elbow dislocation: Posterior or Anterior more common?

A

Posterior dislocation most common

48
Q

What do we see radiographically with an elbow dislocation?

A

Separation of the distal humerus from the proximal ends of the radius and ulna

49
Q

What are some complications seen with elbow dislocations?

A
  • Ulnar nerve injury
  • Coronoid process fx.
50
Q

What are the MOIs of an Olecranon fracture?

A
  • Direct trauma in children
  • Indirect trauma due to pull of triceps in the elderly
51
Q

What do we see radiographically with an Olecranon fracture?

A

Cortical disruption through the olecranon

52
Q

What signs will be present with an Olecranon fracture?

A
  • Anterior sail sign
  • Posterior fat pad sign
53
Q

What type of fracture is a Coronoid fracture?

A

Avulsion fracture

54
Q

What is the MOI of a Coronoid fracture?

A

Excessive pull from the brachialis muscle

55
Q

What do we see radiographically with a Coronoid fracture?

A

Impaction of the coronoid process into the trochlea fossa of the humerus (posterior elbow dislocation)

56
Q

Describe a Monteggia Ulnar fracture/dislocation

A
  • Proximal radioulnar dislocation
  • Proximal ulnar fracture
    (need both for true Monteggia ulnar fracture)
57
Q

What is the MOI of a Monteggia Ulnar fracture/dislocation?

A

FOOSH

58
Q

What do we see radiographically with a Monteggia Ulnar fracture/dislocation?

A

Cortical disruption through the proximal diaphysis of the ulna

59
Q

Describe a Galeazzi fracture/dislocation

A
  • Distal radial diaphyseal fracture
  • Dislocation of the distal radioulnar joint
60
Q

What is the MOI of a Galeazzi fracture/dislocation?

A

FOOSH

61
Q

What do we see radiographically with a Galeazzi fracture/dislocation?

A

Positive ulnar variance

62
Q

What are the MOIs of a Nightstick fracture?

A
  • Direct blow to the ulnar
  • Forearm often held in defensive position at time of injury
63
Q

What do we see radiographically with a Nightstick fracture?

A

Cortical disruption through the ulnar diaphysis

64
Q

Describe a Colles fracture

A

Break through the distal end of the radius

65
Q

What is the MOI of a Colles fracture?

A

FOOSH

66
Q

What do we see radiographically with a Colles fracture?

A

Posterior displacement of the distal radial fragment

67
Q

What population has increased risk of Colles fracture?

A

Older white women with osteoporosis

68
Q

What type of deformity do we see with a Colles fracture?

A

Dinner fork deformity

69
Q

Describe a Smith fracture

A

Break in the distal radius with anterior displacement of the distal radial fragment

70
Q

What are common MOIs of a Smith fracture?

A
  • FOOSH with wrist in flexion
  • Direct blow to the back of wrist
71
Q

What type of deformity do we see with a Smith fracture?

A

Garden spade deformity

72
Q

Describe a Barton’s (Rim) Fracture

A
  • Intra-articular fracture of the posterior (dorsal) margin of the distal radius
  • Proximal displacement of the distal fragment
73
Q

What is the MOI of a Barton’s (Rim) fracture?

A

FOOSH

74
Q

Describe a Reverse Barton’s fracture

A
  • Intra-articular fracture of the anterior (volar) margin of the distal radius
  • Anterior displacement of the distal fragment
75
Q

What is the MOI of a Reverse Barton’s fracture?

A

FOOSH with wrist in flexion

76
Q

Chauffeur fracture AKA

A

Hutchinson’s or Backfire fracture

77
Q

Describe a Chauffer fracture

A

Oblique break in the styloid process of the radius

78
Q

What is the MOI of a Chauffeur fracture?

A

Direct blunt force trauma

79
Q

Describe a Scaphoid fracture

A

Break through the waist (most common) or poles of the scaphoid bone

80
Q

What is the MOI of a Scaphoid fracture?

A

FOOSH

81
Q

What is a possible complication of a Scaphoid fracture?

A

Possible disruption of the blood supply in some proximal pole fractures

82
Q

Scaphoid fracture: In ___% of people, the proximal pole is supplied by a branch from the distal half

A

11%

83
Q

Describe SNAC?

A

Scaphoid Non-Union Advanced Collapse
- Capitate migrates proximal via the scaphoid fx. site

84
Q

What is the MOI of a Lunate dislocation?

A

Hyperextension injury

85
Q

What sign do we see with a Lunate dislocation?

A

Pie Sign

86
Q

Perilunate dislocation: common or rare?

A

Extremely rare

87
Q

Perilunate dislocation: lunate bone displaced or not?

A

Lunate bone is not displaced

88
Q

What is the MOI for a Perilunate dislocation?

A

FOOSH with hyperextended hand

89
Q

Describe a Scapholunate disassociation

A

Severe instability of the wrist due to disruption of the scapholunate ligament

90
Q

What sign do we see in Scapholunate disassociation?

A

Terry Thomas Sign
- widening greater than 4 mm

91
Q

What complications are seen with a Scapholunate disassociation?

A

Scapholunate Advanced Collapse (SLAC) Wrist
- Proximal migration of the capitate due to the widening of the scapholunate joint

92
Q

Bennet fracture/dislocation: Rare of Common

A

Extremely rare

93
Q

Describe a Bennet fracture/dislocation

A

Intra-articular break of the base of the first metacarpal bone with a subluxation of the first carpo-metacarpal joint

94
Q

What is the MOI of a Bennet fracture/dislocation?

A

Axial loading (bearing weight) on a partially flexed 1st metacarpal bone with forced abduction

95
Q

Describe a Rolando fracture

A

Comminuted intra-articular fracture through the base of the first metacarpal bone

96
Q

What is the MOI of a Rolando fracture?

A
  • Fall on the radial side of the thumb
  • Punching a wall with a closed first with the thumb tucked inside the palm
97
Q

What do we see radiographically with a Rolando fracture?

A

T-shaped or Y-shaped fracture with more than 3 fragments

98
Q

Worse Prognosis: Bennet or Rolando fracture?

A

Rolando fracture

99
Q

Describe a Boxer fracture

A

Break just below the head of the second (or 3rd) metacarpal

100
Q

What is the MOI of a Boxer fracture?

A
  • Punching with the fist
  • Axial loading
101
Q

Describe a Bar room fracture

A

Break just below the head of the fifth (or 4th) metacarpal

102
Q

What is the MOI of a Bar room fracture?

A
  • Punching with the fist
  • Oblique or glancing force
103
Q

Mallet finger AKA

A

Baseball finger

104
Q

What is the MOI of a Mallet finger?

A

Axial loading causing hyperflexion of the distal interphalangeal joint

105
Q

What is a Mallet finger associated with?

A

Rupture of one of the extensor digitorum tendons

106
Q

Describe a Chip fracture

A

Forced flexion involving the attachment of one of the tendons of extensor digitorum

107
Q

What is the MOI of a Chip fracture?

A

Hyperflexion of the distal interphalangeal joint

108
Q

What can a Chip fracture result in?

A

Avulsion fracture

109
Q

Gamekeeper fracture AKA

A

Skier’s thumb

110
Q

Describe a Gamekeeper fracture

A

Avulsed bone is attached to the ulnar collateral ligament

111
Q

What is the MOI of a Gamekeeper fracture?

A

FOOSH, abducted hyperextended thumb against a ski pole

112
Q

What kind of fracture is a Gamekeeper fracture?

A

Avulsion fracture

DIAGNOSTIC IMAGING II (9 decks)

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