How to Describe a Fracture Flashcards
Identification of X ray - what is needed?
- Right person
- Right time
- Right part
- Right views – are they adequate enough to diagnose what you are trying to diagnose
how is identification of a x-ray done?
what do you look at in an x-ray?
Cortical outline
Cancellous architecture (make up of bone), also look at pedicles
Soft Tissue (triangles)
Joints (sacroiliac joints and hip joints
Alignment (this patient has scoliosis)
what things are important to look at in a joint?
Joint Space
Cortical outline (shape)
Subchondral bone (bone under cartilage)
Cyst
Osteophytes
Alignment
what things are used to describe a fracture?
- Mechanism & energy of injury
- Skin & soft tissues
- Site
- Shape
- Comminution
- Deformity
- Associated injuries
when describing a fracture, what are radiological features and what are clinical features?
radiological:
- Site
- Shape
- Comminution
- Deformity
clinical:
- Mechanism & energy of injury
- Skin & soft tissues
- Associated injuries
what are the Rules of 2 for Trauma Radiographs?
- 2 views, at 90° to each other (often AP & lateral, but others possible, sometimes obliques)
- 2 joints (above and below)
- 2 bones (if appropriate – e.g. radius and ulna, tibia and fibula)
- 2 occasions (e.g. for scaphoid # which may not show up on initial X-ray, but may be evident 7-14 days later)
when describing a fracutre, how is the site described?
SIDE (RIGHT / LEFT ! – clear & consistently correct)
LIMB
BONE(S)
REGION
ARTICULAR INVOLVEMENT:
- Intra-articular
- +/- Dislocation / Subluxation
- Ligamentous avulsion
- Epiphyseal (in children if epiphyseal injury)
whata re the different sites a fracture can occur? (on a femur)
what is shown here?
Left is AP of the elbow, right elbow
Inner side of right elbow in right picture
Olecranon fracture
what are the different shapes (configuration)of a fracture?
TRANSVERSE (usually due to direct trauma/blow)
OBLIQUE (usually due to a bending moment of force)
SPIRAL (always due to a rotational force)
COMPLEX (combination of forces, often causing comminution +++)
what shape of fracture is shown here?
TRANSVERSE (usually due to direct trauma/blow)
AP
Straight
Child due to growth plate
tibia
what shape of fracture is shown here?
OBLIQUE (usually due to a bending moment of force with slight rotation)
Slightly squint
what shape of fracture is shown here?
SPIRAL (always due to a rotational force)
Rotates its way up
Spiral fracture
One part of tibia overlapping another
what shape of fracture is shown here?
COMPLEX (combination of forces, often causing comminution +++)
A lot of bits
Maybe 8 different bits of bone
High velocity injuries normally