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DIAGNOSTIC IMAGING II > Fractures 5 (Hip and Knee) > Flashcards

Fractures 5 (Hip and Knee) Flashcards

1
Q

How many Proximal Hip Fractures occur annually?

A

240,000

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2
Q

What percentage of patients with a Proximal Hup Fracture die within a year?

A

12-20% die within a year

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3
Q

What percentage of patients with Proximal Hip Fractures are unable to live independently afterwards?

A

50% of survivors are unable to live independently

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4
Q

What are the average patient demographics for a Proximal Hip Fracture?

A
  • Average of 70
  • Females>Males
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5
Q

Where do Intra-capsular femoral fractures commonly occur?

A
  • epiphyseal plate
  • subcapital
  • midcervical
  • Basicervical
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6
Q

How much higher of a risk is there of avascular necrosis in an Intra-capsular fracture?

A

8-30%

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7
Q

What percentage of Intra-capsular femoral fractures are Nonunion?

A

25%

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8
Q

How does avascular necrosis occur in a Proximal Femoral fracture?

A

AVN from disruption of the lateral
and/or medial femoral circumflex
arteries

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9
Q

How long does it take to see radiographic changes in a proximal femoral fracture?

A

1 year after injury

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10
Q

What advanced imaging is best when a proximal femoral fracture is present?

A

Bone scan/MRI
* Sensitive modalities

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11
Q

What percentage of acute fractures cannot be detected until 24 hours after injury?

A

20%

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12
Q

What percentage of proximal femoral fractures are not visible for the first 72 hours?

A

5-10%

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13
Q

Where do Extra-capsular fractures commonly occur?

A
  • intertrochanteric
  • trochanteric
  • Subtrochanteric
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14
Q

Extra-capsular femoral fractures are typically not affected with AVN or non-union: true or false?

A

True

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15
Q

Where is the most common site for a Subcapital fracture?

A

Head-neck junction

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16
Q

What are some common features of a Subcapital fracture?

A
  • Often difficult to visualize
  • Disruption of the cortex
  • Zone of impaction
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17
Q

For a Subcapital fracture, what type of imaging would be appropriate for osteoporotic patients, if clinically indicated?

A

MRI

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18
Q

What is an Intracapsular (midcervica) fracture?

A

It is an Intra-capsular fracture in the
middle of the neck of the femur. There is loss of cortical continuity and increased radiopacity secondary to impaction.

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19
Q

What are the MOIs for an Intracapsular (midcervical) fracture?

A
  • Falls
  • MVAs
  • Pathological
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20
Q

What angle changes when an Intracapsular (midcervical) fracture is present?

A

femoral angle

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21
Q

How do you treat an Intracapsular (midcervical) fracture in younger patients?

A

Surgical stabilization is required in younger patients

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22
Q

How do you treat an Intracapsular (midcervical) fracture in older patients?

A

Hip replacement may be needed in older osteoporotic patients

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23
Q

What complicates an Intracapsular (midcervical) fracture?

A

Avascular necrosis

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24
Q

What is an Anterior Hip dislocation?

A

The head of the femur is displaced
anterior and inferior to the
acetabulum.

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25
Q

What is the MOI of an Anterior Hip dislocation?

A

Direct blow to the posterior aspect
of the hip or head-on collisions with the flexed hip in abduction, in which the flexed knee hits the dashboard

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26
Q

What is the incidence rate of an Anterior Hip dislocation?

A

15%

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27
Q

How do you treat an Anterior Hip dislocation?

A

Reduction under anesthesia with
bracing afterwards

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28
Q

What may occur with an Anterior Hip dislocation?

A

Avascular necrosis

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29
Q

What is an Posterior Hip dislocation?

A

Head of the femur is displaced
posterior and superior to the
acetabulum

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30
Q

What is the MOI of a Posterior Hip dislocation?

A

Direct blow in head-on collisions
on the flexed knee with the hip in
flexion and adducted or a fall from
a height

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31
Q

What is the incidence rate of a Posterior Hip dislocation?

A

85%

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32
Q

How do you treat a Posterior Hip dislocation?

A

Reduction under anesthesia with
bracing afterwards

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33
Q

What may occur in a patient with Posterior Hip dislocation?

A

Avascular necrosis and damage to
the sciatic nerve may occur

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34
Q

What is a Central Hip dislocation?

A

The head of the femur is displaced medial through the acetabulum (traumatic protrusio acetabuli)

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35
Q

What is the MOI of a Central Hip dislocation?

A

Direct blow forcing the femoral
head into the fractured acetabular
floor

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36
Q

What line is disrupted in a Central Hip dislocation?

A

Disrupted Kohler’s line

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37
Q

How do you treat a Central Hip dislocation?

A

Reduction under anesthesia with
bracing afterwards

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38
Q

What may occur in a Central Hip dislocation?

A
  • Avascular necrosis may occur
  • May damage the obturator
    neurovascular bundle
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39
Q

What is a Slipped Capital Femoral Epiphysis?

A

Intra-capsular fracture through the
epiphyseal plate - Type I Salter Harris fracture.

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40
Q

What population is a Slipped Capital Femoral Epiphysis commonly seen in?

A

Overweight teenagers

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41
Q

Slipped Capital Femoral Epiphysis bilateral ____% within ____ year.

A

20-30%;1 year

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42
Q

Slipped Capital Femoral Epiphysis: Males or Females more?

A

Males

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43
Q

Slipped Capital Femoral Epiphysis: Left or Right more?

A

Left

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44
Q

What are the clinical features of a Slipped Capital Femoral Epiphysis?

A
  • MC hip disorder of adolescence
  • Hip pain referred to thigh and knee
  • Limp + Trendelenberg
  • Gluteus medius weakness
  • Limitation of abduction and internal rotation
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45
Q

Slipped Capital Femoral Epiphysis: What happens at the head of the femur?

A

Offset epiphysis of the head of the femur

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46
Q

Slipped Capital Femoral Epiphysis: Which line is disrupted?

A

Klein’s line is disrupted

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47
Q

Slipped Capital Femoral Epiphysis: What lies lateral to the acetabulum?

A

Metaphysis lies lateral to the acetabulum (Capener’s sign)

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48
Q

Slipped Capital Femoral Epiphysis: What deformity is at the proximal femur?

A

Pistol-grip deformity of the proximal femur

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49
Q

Slipped Capital Femoral Epiphysis: What sign do we see?

A

Ice cream falling off the cone sign

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50
Q

How do we treat a Slipped Capital Femoral Epiphysis?

A

Surgical fixation is necessary

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51
Q

What a Slipped Capital Femoral Epiphysis result in?

A

May result in permanent short leg,
premature OA and coxa vara deformity
- Hip replacement around the age of 40 is typically seen

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52
Q

What is an Extracapsular Intertrochanteric fracture?

A

Extra-capsular fracture through
the trochanteric region.
There is loss of cortical continuity.

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53
Q

What does the fracture line pass through in an Extracapsular Intertrochanteric fracture?

A

Fracture line passes through the
greater and lesser trochanters

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54
Q

What are the MOIs of an Extracapsular intertrochanteric fracture?

A
  • Falls
  • MVAs
  • Pathological
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55
Q

What angle is decreased in an Extracapsular Intertrochanteric fracture?

A

Femoral angle may be
decreased

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56
Q

How do you treat an Extracapsular Intertrochanteric fracture?

A

Surgical stabilization is
necessary

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57
Q

What is a Subtrochanteric Proximal Femoral fracture?

A

Extra-capsular fracture below
the trochanteric region.
Fracture line passes 2 inches
below the greater and lesser
trochanters.
There is also loss of cortical continuity.

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58
Q

What are the MOIs of a Subtrochanteric Proximal Femoral Fracture?

A
  • Falls
  • MVAs
  • Pathological
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59
Q

Subtrochanteric Proximal Femoral Fracture: Stable or Unstable?

A

Unstable fracture

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60
Q

How do you treat a Subtrochanteric Proximal Femoral Fracture?

A

Surgical stabilization is
necessary

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61
Q

What are the Ottawa Knee Rules? (5)

A
  • Age 55 or under
  • Fibular head tenderness
  • Isolated patellar tenderness
  • Inability to flex 90 degrees (inability to flex 60 degrees increases specificity)
  • Inability to bear weight for 4 steps after injury AND in the clinic
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62
Q

Describe a Comminuted Supracondylar Fracture.

A
  • Distal metaphyseal fracture occurring above the femoral condyles
  • Severe impaction forces
  • Radiolucent breaks above the femoral condyles with loss of cortical continuity
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63
Q

What artery may be damaged in a Comminuted Supracondylar fracture?

A

Femoral Artery

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64
Q

How do you treat a Comminuted Supracondylar fracture?

A

Surgical stabilization is needed

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65
Q

Describe an Intercondylar Femoral Fracture.

A
  • Intra-articular longitudinal fracture between the medial and lateral femoral condyles
  • Severe impaction forces
  • T or Y shaped radiolucent break between the femoral condyles into the articular surface
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66
Q

Intercondylar Femoral Fracture: Stable or Unstable?

A

Unstable fracture

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67
Q

What artery may be damaged in an Intercondylar femoral fracture?

A

Popliteal artery

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68
Q

How do you treat an Intercondylar femoral fracture?

A

Requires surgical stabilization

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69
Q

Describe a Salter Harris Type II Lower Femur fracture.

A
  • Fracture involving both the epiphyseal plate and the distal metaphysis
  • Salter Harris Type II fracture (M.C. one)
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70
Q

What is the MOI for a Salter Harris Type II Lower Femur fracture?

A

Falling on the flexed knee in a teenager

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71
Q

What may be damaged in a Salter Harris Type II Lower Femur fracture?

A

Growth Plate

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72
Q

How do you treat a Salter Harris Type II Lower Femur fracture?

A

Surgical intervention is needed

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73
Q

Describe a Patellar fracture.

A
  • Fracture through the patella
  • Potential for severe displacement
  • May be undisplaced (contour is retained) or displaced (contour is abnormal)
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74
Q

What are the MOIs for a Patellar fracture?

A
  • Falls
  • Direct trauma
  • Avulsion
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75
Q

What are the 4 main types of patellar fracture orientations?

A
  • Transverse (60%)
  • Stellate (25%)
  • Vertical (15%)
  • Osteochondral fracture (secondary to dislocation)
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76
Q

How do you treat a Patellar fracture?

A

Surgical stabilization is required from the displaced patella fracture

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77
Q

Describe a displaced patellar fracture.

A
  • Fracture through the patella
  • Fragments are widely separated
  • Loss of cortical continuity
  • Contour is abnormal
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78
Q

What are the MOIs for a displaced patellar fracture?

A
  • Falls
  • Direct trauma
  • Avulsion
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79
Q

How do you treat a displaced patellar fracture?

A

Surgical stabilization is required to approximate the displaced patella fracture fragments

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80
Q

Describe a patellar dislocaiton.

A

Transient and recurrent

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81
Q

What type of patellar dislocation is most common?

A

Lateral dislocation is most common

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82
Q

What might a Lateral patellar dislocation be associated with?

A

Medial patellofemoral ligament tear

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83
Q

What conditions can a patellar dislocation be seen with?

A

Osteochondral fracture or Bone Bruise

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84
Q

What view is a Patellar dislocation best seen on?

A

Sunrise view

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85
Q

Describe a Femorotibial dislocation.

A
  • Severe injury
  • Anterior or posterior injury
  • All intracapsular and extracapsular ligaments are usually ruptured
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86
Q

What are the MOIs for a Femorotibial dislocation?

A
  • MVC
  • Fall from a height
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87
Q

Which damaged artery and nerve are associated with a Femorotibial dislocation injury?

A
  • Popliteal artery
  • Peroneal nerve
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88
Q

Anterior Cruciate Ligament (ACL): Common or uncommon injury?

A

Common

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89
Q

ACL Injuries: More common in Males or Females?

A

Females

90
Q

What is the MOI of an ACL injury?

A

Pivot- shift mechanism

91
Q

What do patients feel with ACL injury?

A

Patients fell a “pop” and knee giving out

92
Q

What is necessary for ACL injury diagnosis?

A

MRI is necessary for diagnosis

93
Q

What is the MOI of Kissing contusions?

A

Patellofemoral dislocations or pivot shift injuries

94
Q

Components of Kissing Contusions (4):

A
  • Lateral femoral condyle
  • posterior tibial plateau
  • Medal patellar facet
  • Lateral femoral condyle
95
Q

What are the components of O’Donoghue Unhappy Terrible Triad?

A
  • ACL tear
  • Posterior horn of the medial meniscus
  • Medial collateral ligament
96
Q

PCL Injury: More or Less common than ACL injury?

A

Less common

97
Q

What is the MOI of a PCL injury?

A

Direct blow to the tibia (Anterior to Posterior)
- traumatic posterior drawer

98
Q

Tibial Plateau fracture aka

A

Bumper or Fender fracture

99
Q

Describe a Tibial Plateau fracture (3)

A
  • Depressed impacted fracture of the tibial plateau
  • Femoral condyle impacting the tibial plateau
  • Lateral part of the tibial plateau is depressed
100
Q

Tibial Plateau fracture: Lateral or Medial more?

A

Lateral (80%) more than medial

101
Q

What demographic are tibial plateau fractures commonly seen in?

A

Elderly osteoporotic patient

102
Q

What do we also seen frequently with Tibial Plateau fractures (2)?

A
  • loss of cortical continuity
  • Fat-Blood interface (FBI sign) AKA Lipohemarthrosis
103
Q

How do we treat tibial plateau fractures?

A

Surgical stabilization is needed

104
Q

What may a Tibial plateau fracture lead to?

A

May lead to secondary OA

105
Q

What is a Segond fracture?

A

Small avulsion fracture of the anterolateral rim of the tibia
- Avulsion of the IT band insertion

106
Q

What is the MOI for a Segond fracture?

A

Excessive varus (bowed legs) force with internal rotation of the leg (Pivot-shift)

107
Q

What do you order if there is a Segond fracture?

A

Order an MRI
- 75-100% are associated with rupture of the ACL
- 70% have meniscal tears

108
Q

What is needed if the ACL is torn in a Segond fracture?

A

Surgical repair

109
Q

What is a Reverse Segond fracture?

A

Small avulsion fracture of the posteromedial rim of the tibia condyle

110
Q

What is the MOI of a Reverse Segond Fracture?

A

Excessive Valgus (knocked knees) force with external rotation of the leg

111
Q

Reverse Segond fracture: Medial or Lateral side?

A

Medial side

112
Q

What % of Reverse Segond fractures are associated with rupture of the PCL?

A

75%

113
Q

What % of Reverse Segond fractures have meniscal tears?

A

70%

114
Q

How do you treat a Reverse Segond fracture?

A

Surgical repair is needed for the torn PCL

115
Q

What is the DDX for a Reverse Segond fracture?

A

Pelligrini-Stieda Process

116
Q

What is the aka for an Osteochondral fracture?

A

Osteochondritis Dissecans

117
Q

Describe an Osteochondral fracture

A
  • Osteochondral fracture
  • Traumatic etiology
118
Q

What population are osteochondral fracture commonly seen in?

A

Children and adolescents

119
Q

What is the most common location for an Osteochondral fracture?

A

Knee
- seen on the non-weight bearing surface of the lateral aspect of the medial femoral condyle

120
Q

How do patients present with an Osteochondral fracture?

A

Patients present with locking and clicking of the knee

121
Q

What type of fragments are observed in an Osteochondral fracture?

A

Elliptical or ovoid osseous or cartilaginous fragment

122
Q

What kind of defect is seen at the femoral condyle in an Osteochondral fracture?

A

Concave defect

123
Q

Osteochondral fracture: Define displaced.

A

Loose body or joint mice

124
Q

Osteochondral fracture: Define non-displaced.

A

Separated from the femur but in situ (in its original place)

125
Q

What is the aka for a Spontaneous Insufficiency Fracture of the Knee (SIFK)?

A

AKA Spontaneous Osteonecrosis of the knee (SONK)

126
Q

What portion of the medial femoral condyle is impacted in SIFK?

A

Weight-bearing portion

127
Q

Describe SIFK

A
  • Articular surface is flattened with collapse
  • Concave articular defect
128
Q

What is Osgood-Schlatter’s disease?

A

Traction apophysitis causing partial separation of the tibial tuberosity

129
Q

What population is Osgood-Schlatter’s disease commonly seen in?

A
  • Adolescents
  • Males > Females
130
Q

What activities can cause Osgood-Schlatter’s?

A

Jumping sports like basketball and volleyball

131
Q

How does a patient with Osgood-Schlatter’s present?

A
  • Anterior knee pain
  • Swelling and tenderness over the tibial tuberosity where the patellar tendon is inserted
132
Q

What do we see radiographically in a patient with Osgood-Schlatter’s?

A
  • Soft tissue swelling
  • Fragmentation of the tibial tuberosity
133
Q

How do you treat a patient with Osgood-Schlatter’s?

A
  • Ice
  • Limiting provocative activities
134
Q

What is Sinding-Larsen Johansson disease?

A
  • Chronic traction injury
  • Anterior knee pain with point tenderness at the inferior pole of the patella
135
Q

What demographic is Sinding-Larsen Johansson disease commonly seen in?

A
  • 10-14 year old
  • Males > Females
136
Q

What may be present radiographically at the patellar tendon in Sinding-Larsen Johansson disease?

A

Dystrophic calcification may be present in the upper end of the patellar tendon

137
Q

How do you treat Sinding-Larsen Johansson disease?

A
  • Ice
  • Limiting activities
138
Q

What is a Maisonneuve fracture?

A

Spiral fracture of the proximal fibula with an associated fracture of the medial malleolus

139
Q

What is the MOI of a Maisonneuve fracture?

A

Forceful inversion and rotation of the ankle as seen in soccer injuries

140
Q

What do we see radiographically with a Maisonneuve fracture?

A
  • Radiolucent spiral fracture of the proximal fibula just below the neck
  • Loss of cortical continuity of the distal end of the tibia
  • Separation of the distal tibiofibular joint (fibrous)
141
Q

How do you treat a Maisonneuve fracture?

A

Surgical stabilization is required

142
Q

Describe a Salter Harris Type I Fracture of the Lower Tibia

A
  • Fracture passes through the distal epiphyseal plate of the tibia
  • Salter Harris type I
143
Q

How do you treat a Salter Harris Type I Fracture of the Lower Tibia?

A
  • Immobilization for 6-8 weeks is needed
  • Weight-bearing cast is used
144
Q

What is needed to treat Salter Harris types III and IV?

A

Surgical intervention

145
Q

What Salter Harris type may require surgery?

A

Type II

146
Q

Describe a Salter Harris Type II Fracture of the Lower Tibia

A
  • Fracture passes through the distal metaphysis and distal epiphyseal plate of the tibia
  • Salter Harris type II
147
Q

How do you treat a Salter Harris Type II Fracture of the Lower Tibia?

A
  • Immobilization for 6-8 weeks is needed
  • Weight-bearing cast is used
148
Q

What may be required in a Salter Harris Type II Fracture of the Lower Tibia?

A

Surgery may be required depending on the degree of displacement of the metaphyseal fragment

149
Q

What is a Medial Malleolar fracture?

A

Isolated (single) malleolar fracture of the distal tibia

150
Q

What is the MOI for a Medial Malleolar fracture?

A

Inversion injury

151
Q

What do we see radiographically with a Medial Malleolar fracture?

A
  • Radiolucent transverse or oblique fracture line through the medial malleolus
  • Loss of cortical continuity
152
Q

How do you treat a Medial Malleolar fracture?

A

Closed reduction plus a weight bearing cast for 6-8 weeks

153
Q

What might complicate a Medial Malleolar fracture?

A

Non-healing

154
Q

What is a Lateral Malleolar fracture?

A

Isolated (single) fracture through the distal end of the fibula

155
Q

What is the MOI of a Lateral Malleolar fracture?

A

Eversion injury

156
Q

What do we see radiographically with a Lateral malleolar fracture?

A

Radiolucent transverse or oblique fracture line through the distal end of the fibula

157
Q

How do you treat a Lateral Malleolar fracture?

A

Closed reduction plus a weight bearing cast for 6-8 weeks is necessary

158
Q

What may complicate a Lateral malleolar fracture?

A

May be complicated by instability due to concomitant torn ligaments

159
Q

What is a Bimalleolar fracture?

A

Fracture involving the medial and lateral malleoli

160
Q

What do we see radiographically with a Bimalleolar fracture (3)?

A
  • Outwards and posterior displacement of the leg while the foot is fixed
  • Radiolucent oblique or transverse fractures through both malleoli
  • Loss of cortical continuity
161
Q

How do we treat a Bimalleolar fracture?

A

Opening fixation is often needed

162
Q

What may complicate a Bimalleolar fracture?

A

Ankle instability may complicate this injury due to torn ligaments

163
Q

Describe a Cotton’s (Trimalleolar) fracture

A
  • Fractures involving the medial, lateral, and posterior malleoli
164
Q

What is the MOI of a Cotton’s (Trimalleolar) fracture?

A

Severe external rotation of the foot

165
Q

What radiographic features are present in a Cotton’s (trimalleolar) fracture (3)?

A
  • Radiolucent oblique or transverse fracture lines
  • Loss of cortical continuity
  • Fragments are often displaced
166
Q

What is needed to treat a Cotton’s (trimalleolar) fracture?

A

Surgical intervention

167
Q

What may follow due to torn ligaments in a Cotton’s (trimalleolar) fracture?

A

Instability

168
Q

What is a Pott’s Fracture?

A

Fractures of the distal fibula and subluxation of the distal tibiofibular joint due to an upward displacement of the distal fragment

169
Q

What is the MOI of a Pott’s fracture?

A

Combination of abduction and internal rotation forces from an eversion injury

170
Q

What are the radiographic features of a Pott’s fracture?

A

Radiolucent fracture line in the fibula with an offset of the tibiotalar joint

171
Q

How do you treat a Pott’s fracture?

A

Surgical immobilization is needed

172
Q

What can a Pott’s fracture lead to?

A

Ankle stability due to torn ligaments

173
Q

What is a Pilon fracture?

A

Comminuted fractures of both lower ends of the tibia and fibula

174
Q

What is the MOI of a Pilon fracture?

A

High-energy axial force

175
Q

What demographic are Pilon fractures commonly seen in?

A

Common between 35 and 40 years of age

176
Q

What radiographic features are seen in Pilon fractures?

A

Multiple radiolucent fracture lines with several displaced fragments

177
Q

How do you treat a Pilon fracture?

A

Surgical reduction and fixation is necessary

178
Q

What can complicate a Pilon fracture?

A

Instability

179
Q

What are AKAs for a Jumper fracture?

A

Lover’s Heel and Don Juan Fracture

180
Q

Jumper Fracture: What is seen in the calcaneus?

A

Comminuted compression fracture of the calcaneus with disruption of Boehler’s angle (>28 degrees)

181
Q

Jumper Fracture: What is seen in the lower thoracic spine?

A

Burst fracture in the lower thoracic spine with widening of the AP diameter with disruption of George’s line posteriorly

182
Q

What is needed to treat a Jumper fracture?

A

Spinal surgery is needed

183
Q

What is the normal range for Boehler’s angle?

A

28-40 degrees

184
Q

What is a Break fracture?

A

Fracture through the tuberosity of the calcaneus

185
Q

Break Fracture: ___ displacement of the ___ fragment

A

upward; superior

186
Q

A break fracture is due to the pull of the ___ and ___ muscles.

A

soleus; gastrocnemius

187
Q

Break fracture: What is the appearance of the fractured bone and the gap?

A

Appearance of a bead

188
Q

Break fracture: Boehler’s angle increased or decreased?

A

Decreased; <28 degrees

189
Q

What population commonly experiences Break fractures?

A

Osteoporotic people

190
Q

Describe a Calcaneal fracture through the anterior process

A

Avulsion fracture through the anterior process of the calcaneus

191
Q

What is the MOI for a Calcaneal fracture through the anterior process?

A

Inward twisting or compression injury when the foot is twisted outwards

192
Q

What is seen radiographically in a Calcaneal fracture through the anterior process?

A

Bone fragment is displaced above the root of the anterior tubercle of the calcaneus

193
Q

Calcaneal fracture through the anterior process: Boehler’s angle affected or unaffected?

A

Unaffected

194
Q

How do you treat a Calcaneal fracture through the anterior process?

A

Management may be conservative or surgical depending on the extent of the injury

195
Q

What are two DDX for a Calcaneal fracture through the anterior process?

A
  • Congenital ossicle
  • Chronic Fx.
196
Q

What is the MOI for a Calcaneal Stress fracture?

A
  • Repetitive stress on the heel
  • Jumping or brisk walking with excessive weight
197
Q

How do patients with a Calcaneal stress fracture present?

A

Pain on the inner or outer aspect of the heel which increases with impact

198
Q

What population are more prone to Calcaneal stress fractures?

A

More prone in overweight postmenopausal women

199
Q

What do we see radiographically with Calcaneal stress fractures?

A

Linear amorphous whitish area posterior and inferior to the sustentaculum tali

200
Q

What are the management options for a Calcaneal stress fracture?

A
  • Rest and wear walking shoes
  • For persistent pain, refer to a podiatrist or an orthopedist
201
Q

What is a Snowboarder’s fracture?

A

Fracture of the lateral process of the talus

202
Q

What population are Snowboarder’s fractures common in?

A

Snowboarders

203
Q

What is the MOI of a Snowboarder’s fracture?

A

Axial loading on a foot that is held in dorsiflexion and inversion

204
Q

What are the radiographic features of a Snowboarder’s fracture?

A

Radiolucent break on the lateral aspect of the talus

205
Q

How do you treat a Snowboarder’s fracture?

A

Weight bearing cast for 6-8 weeks

206
Q

What is a Shepherd fracture?

A

Fracture of the posterior process of the talus

207
Q

What is the MOI of a Shepherd fracture?

A

Sudden extension of the foot when its plantar flexed

208
Q

What is a DDX for a Shepherd fracture?

A

Os Trigone

209
Q

What are treatment options for a Shepherd fracture?

A
  • Conservative care with a non-weight bearing cast for 6-8 weeks
  • Surgery is needed if there is non-union or a large displaced fragment
210
Q

What is an Aviator astragulus fracture?

A
  • Vertical fracture through the neck of the talus
211
Q

What is the most common Talar fracture?

A

Aviator astragulus fracture

212
Q

What is the MOI for an Aviator astragulus fracture?

A

Head on collisions with shearing force on the pedals applied to the foot

213
Q

What do we see radiographically with an Aviator astragulus fracture?

A

Vertical radiolucent break through the neck of the talus with superior displacement of the distal fragment

214
Q

How do you treat an Aviator astragulus fracture?

A

Surgical immobilization is needed

215
Q

What complication can be seen with an Aviator astragulus fracture?

A

Avascular necrosis

216
Q

What is the aka of a Fracture of the dome of the talus?

A

Osteochondral fracture

217
Q

Describe a Fracture of the dome of the talus

A
  • Impaction injury
  • Changes may be subtle
  • May not be seen right away
218
Q

What is the least common talar fracture?

A

Fracture of the dome of the talus (Osteochondral fracture)

219
Q

What can be seen radiographically with a fracture of the dome of the talus?

A

Radiolucent break through the lateral edge of the dome of the talus

220
Q

How do you treat a fracture of the dome of the talus?

A
  • rest, immobilization with a non-weight bearing cast for 6 weeks (conservative)
  • Surgical intervention may be needed

DIAGNOSTIC IMAGING II (9 decks)

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