Fractures Flashcards
The most common skeletal abnormalities seen in general radiography
Fractures
Bone infection
Osteomyelitis
What is a bone fracture?
-disruption of bones normal structure
-crack, break rupture
-caused by mechanical forces directly to bone or along shaft
What are some secondary signs of underlying fractures (fracture that is thin, overlooked)
-inflammation
-pain
-loss of function
-obvious deformity
-bruising
-bleeding
What are fractures described and classified by?
-their extent
-direction
-position
-# of fracture lines
-integrity of overlying skin
A fracturing which the bone penetrates through skin
-open to air
Open fracture/compound fracture
Fracture with intact overlying skin
Closed fracutre
Complete cortical circumference involved
Fragments are completely separated
Complete fracture
Not fractured all the way through
“Only one cortex” involved
Incomplete
What is an example of an incomplete fracture?
Green stick
Fracture that involves the articular surface
Intra-articular fracutre
Ex. Distal end of radius
A severe injury in which both fracture and dislocation take place simultaneously
Fracture-dislocation
Fracture runs at a right angle to the long axis of the bone
Transverse
Runs 45 degrees to the long axis of the bone
Usually from twisting
Oblique fracture
Encircles the shaft of the bone
-Longer than oblique fracture
-caused by torsion forces
Spiral fracture
Fracture runs parallel to the long axis of a bone
Linear fracture
Also called “fissured fracture”
Fracture follows the long axis of the bone
-more irregular in shape than a linear fracture
Longitudinal fracture
Bone broken in 2+ places
Fracture lines do not connect
Segmental fracture
Broken, splintered or crushed into more than 2 pieces
Comminuted fracture
Happens when force exerted on tendon or ligament tears away chunk of bone
Avulsion fracture
Extent to which fractured fragments are not anatomically aligned
*in an angular fashion
Angulation
If the patients foot is pointing laterally, and the greater trochanter is not in profile, but seen perpendicular to the IR, what might this indicate?
Broken hip
Apex medial
Valgus angulation
Apex lateral
Varus angulation
When the plane of cleavage exists in the bone without angulation
Undisplaced
Separation of bone fragments
Direction of displacement describes the realtionship of distal to proximal fragment
Displaced
Extent to which fragments are rotated relative to eachother
Rotation
Displacement of a bone that is no longer in contact with the normal articulation
Dislocation
Partial loss of continuity of normal joint surfaces
Subluxation
What are some other signs of fractures?
-periosteal reaction
-callus/osteoclerosis
-fat pads (form “sail sign”, triangle)
Fracture through a growth plate; unique to pediatric patients
Salter-Harris fractures
A burst fracture of the ring of C1
-bursting the ring in 4 places
-normally sustained by axial loading
Jefferson’s fracture
Avulsion fracture of the tuberosity of the 5th MT
-inversion injury
Jones fracture
Oblique intra-articular metacarpal fracture dislocation
-caused by axial force directed against the partially flexed metacarpal
*punching hard surface
Bennett fracture
Fracture of the distal radius with dorsal (posterior) displacement
-also called dinner fork/bayonet
*FOOSH injury
Colles fracture
FOOSH
Fall on outstretched hand
Fracture of the distal end of the radius with anterior (ventral) displacement
Caused by direct blow or a fall with a flexed wrist
Smiths fracture
**opposite of colles fracture
Fracture of the proximal third of the ulnar with dislocation of the radial head
FOOSH with the forearm in excessive pronation
Monteggia fracture
A fracture of the shaft of the radius and a dorsal (posterior) dislocation of the ulnar at the wrist
Galeazzi fracture
Monteggia vs. Galeazzi
GRIMUS
G - Galeazzi
R - radius
I - inferior (distal)
M - Monteggia
U - unla
S - superior (proximal)
Complex fractures of the midrange
Le Fort fractures
Horizontal magically fracture, separating the teeth from the upper face
Le Fort type 1
Pyramidal fracture, with the teeth at the pyramid base, and nasofrontal suture at its apex
Le Fort type 2
Craniofacial disjunction
Le Fort type 3
Break of the neck or shaft of the metacarpal, usually 4/5
Due to Axial loading
Boxers fracture
Also known as a stress fracture or fatigue fracture of the metatarsals most commonly the second and third
*named after soldiers marching
Caused by prolonged stress and weight bearing
March fracture
A fracture of both pars interarticularis or pedicles of C2 (axis)
Usually goes right through the spinal cord causing quick death
*now caused by falls or MVA
Hangman’s fracture
Avulsion fracture of the spinous process in the lower cervical or upper thoracic spine
Clay shovelers fracutre
Orbital floor fracture, or “blowout” fracture
MOI is blow to the eye
Blow out fracture
*xray is done erect to see fluid levels (bleeding into sinuses)
An injury occurring at a site opposite to the point of impact
Seen commonly in skull, pelvis, and mandible
Contrecoup fracture
*french for backlash
Skull - a small object + great force = comminuted fracture with the fragment driven inward
Knee - lateral femoral condyle (hard) impacts lateral tibia (soft) and pushes the cortical surface into underlying bone
Depressed fracture
Microscopic fractures that occur from repetitive microtrauma
Not often seen on xray
*best images with nuclear medicine
Stress/fatigue fracture
From compression force, compaction of bone trabeculae, result in shortening of length or width, mostly seen in the spine
Compression fracture
*ballon can be inserted to uncompressed the vertebrae
One broken end of the bone gets wedged into the other broken edge
Impacted fracture
Also called buckle fracture
One side of the bone may buckle upon itself without disrupting the other side of the bone; also known as incomplete fracture
Torus fracture
*children often sustain this by FOOSH
Occurs when a bone breaks in an area that is weakened by other disease
Can be caused by: tumors, infection, bone disorders
Pathological fractures
Dislocation of the radial head
Caused by: pulling children’s arms…
Nursemaid dislocation
Fracture of the the radial head with or without displacement
Most common cause is breaking a fall on outstretched arm
Radial head fracture
Hip fracture: an intertrochanteric hip fracture occurs between the greater and lesser trochanter
Intertrochanteric fracture
Fractured involving both medial and lateral malleoli
Fracture of distal tib and fib
Bimalleolar fracture
Also known as Potts fracture
With outwards displacement of the foot - dislocstion
Involves lateral, medial malleolus and distal posterior tibia
Associated with ligament injuries
Trimalleolar fracture
*often needs surgery screws (ORIF)
Happens above condoles of elbow “supracondylar”
Commonly caused by FOOSH
*usually send in children 5-15
Supracondylar fracutre
Periaeticular injuries of the proximal tibia frequently associated with soft tissue injuries
-high energy trauma in young patients
-low energy falls in old patients
Tibial plateau fracture
*60% of tibial plateau fractures involve lateral plateau
Fractures of :
Zygomatic arch
Inferior orbital rim
ant/post maxillary sinus walls
Lateral orbital rim
*displaces zygoma
Tripod fracture
Manipulation of the affected body part without surgical incision
Also refers to percutaneous pining
CRPP
closed reduction, percutaneous pinning
Surgical procedures
Insertion of devices to maintain the reduction
ORIF
open reduction, internal fixation
Metal plates, screws, wires, rods, nails to maintain reduction
Internal fixation
Use of splints, external reduction devices, casts
External fixation
