Fractures

Question 1

Fracture types

Answer 1

Open: gas or foreign body material in site; Complete/incomplete: fracture involve both cortices.
Complete Simple -> 1 fracture line – transverse, oblique, spiral. Complete Comminuted -> 2 or more fracture lines
- Butterfly fragment -> wedge shaped
- Segmental -> two fracture lines isolating a segment of the shaft of a long bone
Incomplete
- Hairline or fissure -> thin fracture line, no displacement
- Greenstick -> cortex broken on convex side
- Torus -> cortex buckles on concave side
Avulsion: bony insertion of a ligament or tendon (non articular)
Compression -> bones impacted into one another
Fatigue/stress fractures -> from repeated minor trauma
Condylar -> involving metaphysis and condyles of a bone
Shearing fracture -> Surface fracture, with irregular soft tissue

Question 2

Salter Harris fractures

Answer 2

Degree of physeal involvement and increasing probability of growth deformities
I -> fracture plane passes all the way through the growth plate – good prognosis
II -> through growth plate and up through the metaphysis – good prognosis
III -> through growth plate and down through epiphysis – poorer prognosis
IV -> directly through metaphysis, growth plate and down through epiphysis – poor prognosis
V -> crushing type injury that does not displace the growth plate – worst prognosis

Question 3

Describing fractures

Answer 3

• Bone involved and location
• Type of fracture
• Physeal involvement
• Displacement, rotation and angulation
• Underlying bone pathology
• Joint involvement
• Age of fracture
• Soft tissue injuries
• Presence of foreign material

Radiological interpretation: A: Alignment/Apposition, B: Bone, C: Cartilage, D: Devices, S: Soft tissue.
Roentgen signs: Number, Size, Opacity, Position/Location, Margin/Contour and Shape