Fracture x-rays Flashcards
What type of fracture is displayed ? [1]
Explain how you can tell [4]
Intracapsular fracture - Subcapital - AP:
1. Shortened femoral neck
2. Increased density of femoral neck (due to impacted bone)
3. Less troch. is more prominent
4. Shenton’s line is disrupted
Which type of Garden classification is shown [1]
I
II
III
IV
III - Complete - partially displaced
Which type of Garden classification is shown [1]
I
II
III
IV
I - Incomplete or impacted bone injury with valgus angulation of the distal component
What type of Garden classification is this? [1]
IV - Complete - totally displaced
What type of Garden classification is shown here? [1]
II - Complete (across whole neck) - undisplaced
What classification of Garden fracture is this? [1]
Garden IV fracture
* Loss of Shenton’s line
* Complete fracture of the full diameter of the femoral neck
* Total displacement of the 2 fracture components
Describe the type of fracture depicted [1]
Intertrochanteric fracture
* A fracture line runs between the trochanters
* There is comminution with separation of the lesser trochanter
* Note the fracture does not involve the femoral neck
Describe the type of fracture depicted [1]
Subtrochanteric fracture
This fracture passes distal to the trochanters
The femoral neck remains intac
Describe what has happened in this x-ray [1]
Describe the fracture in this x-ray [1]
Describe this x-ray [1]
Transverse fracture with rotational displacement and shortening
Describe the anatomical components to the knee joint [+]
Describe the fracture seen in this X-ray [1]
Lateral tibial plateau fracture
* The fracture fragment is displaced and depressed from its normal position (dotted line)
What type of fracture is depicted [1]
Comminuted fractures of the tibial and fibular shafts with medial displacement and posterior angulation
What type of fracture is depicted [1]
Tibial stress fracture
* Periosteal stress reaction are signs of stress injury (often not present on the initial X-ray)
* History of chronic pain worsened by activity
The ankle is stabilised by multiple ligaments not visible with X-ray.
What are they? [3]
What type of Weber’s fracture classification is pictured? [1]
Weber A = Distal to ankle joint (this case)
What type of Weber’s classification is this? [1]
B
What type of fracture is shown? [1]
Potts fracture
Radiographs demonstrating a disruption of the distal tibiofibular syndesmosis along with a fracture of the proximal fibula, consistent with a Maisonneuve fracture.
Name for this fracture? [1]
Pilon fracture
- These fractures involve the distal tibia and its articular surface.
A Lisfranc injury is a tarsometatarsal fracture dislocation characterized by traumatic disruption between the articulation of the medial cuneiform and base of the second metatarsal.
* Diagnosis is confirmed by radiographs which may show widening of the interval between the 1st and 2nd ray.
What’s going on in this x-ray? [1]
Calcaneal fracture - Lateral view
Where is the fracture? [1]
Name the fracture depicted [1]
Subcapital fracture - AP
Neck of femur - Transcervical fracture - AP
Which Weber’s classification? [1]
B
Which Weber’s classification? [1]
C
Which Webers classification? [1]
What should you suspect from this x-ray? [1]
This x-ray X ankle instability = ?
Name for this fracture? [1]
On a calcaneal fracture, what are you spefically looking for? [1]
Calcaneus fracture - Reduced Bohler’s angle - Lateral
What is the type of fracture? [1]
What is the mechanism of impact that causes this impact? [1]
Boxer’s fracture
- The X-ray shows a transverse fracture through the neck of the right fifth metacarpal bone, which is consistent with a Boxer’s fracture.
- The mechanism of injury is almost always a result of direct impact to a clenched fist against a solid surface (eg. human face or wall).
An x-ray is requested and reported as “vertical pattern patella fracture with minimal displacement”.
What is the most appropriate management plan?
Conservative management with cricket pad splint and full-weight bearing
Maisonneuve injury
Lisfranc Injury
Galeazzi fracture
The radiograph shows AP and lateral projections of a transverse patellar fracture
X-ray features consistent with a Bennett fracture include an intra-articular fracture of the base of the first metacarpal bone. The mechanism for this injury is forced abduction of the thumb.
Monteggia fracture
X-ray features of a Monteggia fracture include an ulnar shaft fracture with an associated radial head dislocation. T
Bennett fracture
Describe this x-ray [1]
Acromioclavicular joint disruption
Describe this x-ray [1]
Shoulder - Normal Y-view
The Y-view is so named because of the Y shape of the scapula formed when looking at it laterally
The humeral head is correctly aligned - it overlies the glenoid and is positioned posterior to the coracoid
Describe this x-ray [1]
Anterior shoulder dislocation - AP view
- Humeral head and glenoid surfaces are not aligned
- The humeral head lies below the coracoid
What pathology is depicted? [1]
Describe the findings in this x-ray [1]
How would the patient present? [1]
Posterior shoulder dislocation - AP view
- The glenohumeral joint is widened
- Following posterior dislocation the humerus is held in internal rotation
Describe this pathology [1]
Glenoid fracture - (Bony Bankart)
What angulation is the fracture? [1]
Draw and label normal elbow anatomy [4]
Describe this fracture [1]
Colles fracture:
* Distal radius fracture - Dorsal displacement
Describe this fracture [2]
Distal radius fracture - Palmar displacement
* Palmar (volar) displacement and angulation
* Shortened radius
* This injury is often referred to as a ‘reverse Colle’s’ fracture or ‘Smith’s’ fracture
Forearm fracture/dislocation - Monteggia type
Paediatric case
Torus fracture
Anterior or posterior dislocation? [1]
Anterior
Describe this fracture [1]
Flattening or indentation of the posterior humeral head following shoulder dislocation is known as a ‘Hill-Sachs’ lesion
Shoulder - Anterior dislocation/glenoid fracture - AP
- A fracture of the anterior glenoid following shoulder dislocation is known as a ‘bony Bankhart’ lesion
Monteggia fracture-dislocation - Lateral
Galeazzi fracture-dislocation - AP
- A ‘Galeazzi’ injury is a fracture of the radial shaft with dislocation of the ulna from its articulation with the radius at the distal radio-ulnar joint
