Lower extremity trauma/ Flashcards
foot fractures
5th metatarsal fractures (3)
zone 1 - etiology
zone 2 - complication, treatment
zone 3 - etiology
- Which of the 3 fractures is most common?
- Peroneal brevis avulsion. Treatment is conservative (think Ehab)
- Jones fracture - reduced blood supply to metaphyseal junction (think KD)
- stress fracture.
- Most common: Peroneal brevis
Metatarsal lesions
- name of infarction of 2nd metatarsal infarction (cause)
- metatarsal stress fracture. What is first radiographic sign of metatarsal stress fracture
- Freiberg’s infarction. Avascular necrosis of 2nd metataarsal head. Caused by repetitive stress or poorly fitting shoes (like high heals)
- Linear cortical lucency is first sign of metatarsal stress fracture. Then periostitis and callus will form.
Sesamoid fracture of great toe
(Turf toe is used to describe a wide range of injuries, which includes Sesamoid fracture)
- cause of fracture
- what tendon attaches to great toe sesamoid?
- extreme hyperextension of 1st MTP.
- flexor hallucis brevis ataches to sesamoids (medial head attaches to medial sesamoid.Lateral head attaches to lateral sesamoid).
Lisfranc injury
- Lisfranc ligament connects what 2 bones? What is Lisfranc joint?
- treatment?
- Which view helps to deliniate fracture?
- name the 2 classfications and
- 1st cuniform to 2nd metatarsal. Lisfrac joint is the entire tarso-metatarsal joint.
- Surgical. A missed lis-franc can lead to debilitating ostoarthritis.
- Weight bearing view
- 1st metatarsal moves medially (Divergent). First metatarsal moves laterally (Homolateral)
Navicular osteonecrosis
- name in childhood and adulthood
- Kohler disease in childhood. Mueller-Weiss disease in adults. Kholer is typically self limited and occurs in boys, but Muelller Weiss is more severe and occurs in adult women.
midfoot fractures
Name of joint formed by talonavicular and calcaneocuboid joints. Mechanism of fracture
Chopart Joint
Chopart fracture-dislocation is typically cased by high impact trauma.
Calcaneal fracture (most commonly fractured tarsal bone).
Describe bohler angle
-caused by high impact fracture (Lover’s fracture). High association with spine fractures, traumatic aortic rupture, renal vascular pedicle avulsion. If a fracture is found, imaging these other portions is recommended.
Boehler ange is normally 20-40. If under 20, its diagnostic for calcaneal fracture.
Angle is made up of Posterior tuberosity of calcaneus and superior aspect of anterior process of calcaneus both going to superior aspect of posterior subtalar facet.
2 classifications of calcaneal fractures
Essex-Lopresti classification (those sparing the subtalar joint. those extending into subtalar joint)
Sanders classification - based on number of comminuted fragments.
Calcaneal stress fracture appearance
Fluffy band of sclerosis with intact cortex. Boehler’s angle is normal.
Talar fractures
- can be divided anatomically into what?
- Talar neck fracture complication
- Describe Hawkins sign
- lateral process, posterior process, head, body, and neck fractures
- Osteonecrosis
- Hawkins sign is a subchondral lucent band seen on frontal ankle radiograph 6-8 weeks after immobilization. A lucent band represents increased bone reabsorbtion from active hyperemia, and is a good sign. Abscence of Hawkins sign is a sign of avascular necrosis.
Osteochondral lesion of the Talus is an umbrella term for what entities?
Lesions present as crescentic lucency of talar dome.
Osteochondrosis dissecans, chronic repretitive microtrauma, and acute traumatic osteochondral fracture.
Hindfoot coalition - name to 2 most common ones, and their signs
Talocalcaneal coalition; Middle subtalar facet. Complete “C” sign. Talar beak sign
Calcaneonavicular coalition - Ant-eater sign.
Midfoot bony problems (5)
Chopart fracture dislocation. Calcaneal fracture. Talar fracture. Osteochondral lesions. Hindfoot Coalition.
