Lower Limb Flashcards
Which lower limb bone bone is most likely to have pathological fractures from mets?
Proximal femur (subtrochanteric)
What type of pathological fracture do bisphosphonates typically predispose to? What do they protect against?
Mid shaft femur fractures
Femoral neck fractures
Which innominate avulsion fracture occurs in physically active children?
Ischial tuberosity avulsion fracture (origin of the hamstring tendon)
What is the eponymous line that is used to detect slipped upper femoral epiphysis in kids?
The line of klein
drawn on the superior edge of the femoral neck, this line should intersect the lateral aspect of the epiphysis, if not then it may have slipped
What does the quadriceps fat pad (triangle) sign represent on lateral knee xray?
Located just superior to the patella and posterior to the quadriceps tendon
If overtly visible suggests a knee joint effusion
What is a segond fracture? Why is it important?
A small avulsion fracture of the lateral tibial plateau
In >75% of cases they are associated with high grade ACL tears
What is a reverse Segond fracture? why is it important?
Much less common, it is an avulsion fracture of the medial tibial plateau
>75% association with PCL tear
What is the arcuate sign on knee xray and why is it important?
An arc of bone avulsed from the fibula head
>90% associated with ACL tear
What is the typical location of the small piece in a bipartite patella?
Superolateral
Which way does the patella usually dislocate?
Lateral
Consider MRI to assess for medial patella ligament and cartilage injuries
What are the different grades in the Weber ankle fracture system?
A- Medial aspect of the fracture is below the talar dome
B- medial aspect in line with the dome
C- medial aspect above the dome
What is important about Weber C fractures?
Inherently unstable, always need OT
Associated with disruption of the syndesmosis and medial malleolus fractures
What is the importance of an isolated posterior malleolar or medial malleolar fracture? What is this combination called?
Due to the ring system there will almost always be another injury, in most cases a proximal fibula fracture
This is known as a Maisonneuve fracture and is why you should always examine the knee as well
What is a Jones fracture and why is it important?
A fracture at the base of the 5th metatarsal 1.5-3cm from the tip
Unlike avulsion and stress fractures these do not heal well and require non-weight bearing immobilisation and cast or surgery
What is the importance of a medial base of 2nd metatarsal fracture?
Often associated with Lis Franc injury
