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DIAGNOSTIC IMAGING II > Fractures 4 > Flashcards

Fractures 4 Flashcards

1
Q

What is the Pretzel principle?

A
  • Pelvis is a ring-shaped structure
  • Difficult to break in one spot only
  • More than 1 fracture in the pelvis, consider it unstable
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2
Q

Tile Classification: Stable

A
  • Iliac wing
  • Avulsion
  • Transverse sacral
  • Ischiopubic rami
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3
Q

Tile Classification: Unstable

A
  • Malgaigne
  • Bucket handle
  • Straddle
  • Vertical sacral
  • Sprung
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4
Q

What is a Duverney (Iliac Wing) Fracture?

A

It is a vertical or oblique break of the iliac wing fragment from the pain of the iliac bone.
Usually caused by direct trauma.
There is separation of the lateral iliac wing fragment.

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5
Q

What should you refer for when a Duverney fracture is present?

A

Refer for crutches or a walker

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6
Q

What are some complications caused by a Duverney fracture?

A
  • Malunion
  • Injury to the iliac artery or bowel perforation
  • Other fractures
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7
Q

What is an Avulsion fracture?

A

It is a fracture due to forceful contractions of attached muscles as seen in soccer or gymnastics.
The secondary ossification centers
[apophyses] are the most likely parts of the bones of the pelvis to
avulse [pull apart].

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8
Q

What muscle is involved in an ASIS avulsion?

A

Sartorius muscle

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9
Q

What is the treatment for an Avulsion fracture?

A
  • Rest for 6-8 weeks
  • Return when all movements are
    painless
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10
Q

Describe an avulsion fracture of the ischial tuberosity.

A
  • Hamstring muscles are involved
  • Seen commonly in jockeys
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11
Q

What is Rider’s Bone?

A

Bone formation in the upper part of
the hamstring muscles due to chronic irritation caused by sitting on the saddle during riding.

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12
Q

What is an example of Rider’s Bone?

A

Myositis Ossificans

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13
Q

What muscle is involved in an AIIS avulsion?

A

Rectus Femoris muscle

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14
Q

What are the three types of Sacral fractures?

A
  1. Stress
  2. Transverse
  3. Longitudinal
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15
Q

Describe a stress fracture.

A

Happens from repetitive injury from high intensity athletic training.
Seen best on CT scan.

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16
Q

Describe a transverse fracture.

A

Happens from direct injury.
Seen in stable fractures.

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17
Q

Describe a longitudinal fracture.

A

Usually happens from oblique injury.
Seen in unstable fractures.

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18
Q

What are the two types of Acetabular fracture?

A
  1. Posterior Rim
  2. Central Acetabulum
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19
Q

What is a Posterior Rim Acetabular fracture also known as?

A

Dashboard fracture

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20
Q

What is the MOI for a Posterior Rim acetabular fracture?

A

Hip flexion and Abduction

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21
Q

Posterior Rim Acetabular fracture: stable or unstable?

A

Stable fracture

22
Q

What is a Posterior Rim Acetabular fracture associated with?

A

Femoral Dislocation (posterior)

23
Q

What is a Central Acetabulum fracture also known as?

A

Acetabular blow-out fracture

24
Q

What is the MOI of a central Acetabulum fracture?

A

Side-impact (think T-bone)

25
Q

Central Acetabulum fracture: stable or unstable?

A

Unstable fracture

26
Q

What is a Malgaigne fracture?

A

Ipsilateral vertical fracture of the pelvis. There is a radiolucent break through the iliac, pubic, and ischial bones on the same side.

27
Q

What bones are impacted in Malgaigne fractures?

A
  • Superior pubic rami
  • Inferior pubic rami
  • Posterior arch
28
Q

What specific parts of the Posterior arch are impacted in Malgaigne fractures?

A
  • Vertical sacral fracture
  • SI joint diastasis
  • Ilium fracture
29
Q

What is the MOI for a Malgaigne fracture?

A

MVAs or falls from a great height

30
Q

Malgaigne fracture: stable or unstable?

A

Unstable fracture

31
Q

What is the treatment for a Malgaigne fracture?

A

Surgical fixation is necessary

32
Q

What might a Malgaigne fracture be associated with?

A

May be associated with a rupture of the diaphragm or bowel

33
Q

What is a Bucket-handle fracture?

A

Contralateral vertical fracture of the pelvis caused by vertical shearing.

34
Q

What are common MOIs of a Bucket-handle fracture?

A
  • MVA
  • Vehicle-pedestrian Injuries
  • Walls collapsing in people
35
Q

Bucket handle fracture: stable or unstable?

A

Unstable fracture

36
Q

How do you treat a Bucket-handle fracture?

A

Surgical fixation is needed

37
Q

What might a Bucket-handle fracture be associated with?

A

May be associated with head,
chest and abdominal injuries

38
Q

What is a Straddle fracture?

A

Bilateral ischiopubic rami fractures caused by direct trauma
Originally described in horseback riders
Radiolucent vertical break through each side of the obturator foramina

39
Q

Straddle fracture: stable or unstable?

A

Unstable fracture

40
Q

How do you treat a Straddle fracture?

A

Surgical fixation is needed

41
Q

What might a Straddle fracture be associated with?

A

May be associated with urethral or
bladder rupture with extravasation of urine

42
Q

What is a Pubic diastasis?

A

Shearing separation of the pubic articulation

43
Q

Pubic diastasis: What is the normal measurement for non-pregnant adults?

A

8 mm

44
Q

Pubic diastasis: What is the normal measurement for children?

A

10 mm

45
Q

What is the treatment for a Pubic diastasis?

A

Must scrutinize the SI joint and
sacrum for associated injuries

46
Q

What is a Sprung Pelvis also known as?

A

Open book pelvis

47
Q

Describe a Sprung Pelvis.

A

Severe crushing injury with SI joint space > 4mm and Pubic symphysis > 5mm

48
Q

What is a Sprung Pelvis associated with?

A

Genitourinary injuries with pain, crepitus and hematuria

49
Q

What imaging modality is mandatory to confirm a Sprung Pelvis?

A

CT Scan

50
Q

How do you treat a Sprung Pelvis?

A

Surgical stabilization is required

51
Q

What MIGHT be associated with a Sprung Pelvis?

A

GU injuries

DIAGNOSTIC IMAGING II (9 decks)

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