How to Describe a Fracture Flashcards
What is a winking eye onX-ray?
When lumbar pedicles are not present
What is looked at on X-ray of joint?
Joint space, cortical outline, subchondral bone, cyst, osteophytes (extra bone developed around osteoarthritic joints) and alignment
What is included in describing a fracture?
Mechanism and energy of injury
Skin and soft tissue
Site
Shape
Communication
Deformity
Associated injuries
What are the rules of 2 for trauma radiographs?
2 views at 90 degrees to each other
2 joints (above and below)
2 bones (if appropriate)
2 occasions (if scaphoid may be seen 7-14 days later)
What is involved in site description?
Side, limb, bones, region and articular involvement - intra-articular, dislocation, ligamentous avulsion and epiphyseal injury
How is the site of fracture described?
Sub capital - below head
Trans cervical - across neck
Basal cervical - below neck
Intertrochanteric - between 2 trochanters
Proximal, middle and distal 1/3
Supracondylar, intercondylar and condylar
What is the shape description for fracture?
Transverse - direct blow/ trauma
Oblique - bending movement of force
Spiral - rotational force
Complex - combination of forces
What does comminution mean?
Multiple parts of bone
Can have a butterfly comminution
Segmental - 3 pieces
What is the definition of deformity?
Movement of distal fragment with respect to supposedly stationary proximal fragment
What are the 4 types of deformity?
Displacement - % diameter of bone
Angulation - degrees
Rotation - degrees
Axial deformity - cm
What does displacement describe about bone fracture?
If it is anterior, posterior, medial or lateral
Describe % of bone which is moved
What is angulation describing about a fracture?
Distal segment relative to proximal
Can tilt anterior, posterior, varus (medial) or valgus (lateral)
Can have combined angulation
How is rotation of bone fracture described?
As internal or external
Can see from different diameters of bone from above and below
Different orientations of joint from above and below
Can get a match or mismatch of fracture
What does axial deformity describe about bone fracture?
Impaction
Distraction - soft tissue interposition possible
Overlapping - muscle spasm causing shortening
What is looked for in soft tissues?
Air - open fractures and has forming organisms
Foreign bodies in open fractures
Fluid levels - haematoma
