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Radiologic Pathologies 3461 > Mod 4-4A Fractures > Flashcards

Mod 4-4A Fractures Flashcards

1
Q

What is a fracture?

A

A break in a bone. *most common skeletal abnormality seen in general radiography.

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2
Q

Who is most affected by fractures due to trauma?

A

Males between 20 and 40 yo and mostly involve extremities.

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3
Q

What bones are most often fractured in children?

A

Humerus and clavicle

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4
Q

What are elderly women prone to fracture?

A

The femoral neck and spine as a result of osteoporosis.

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5
Q

What other structures may be damaged along with a fracture?

A
  • Soft tissue damage with hemorrhage into muscles and joints.
  • Joint dislocations
  • Ruptured tendons
  • Severed nerves
  • Damaged blood vessels
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6
Q

What are the primary classifications of fractures?

A

Open and closed

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7
Q

What are some descriptions of fractures besides open/closed?

A
  • Extent of fracture
  • Direction of fracture lines
  • Position of fragments
  • Number of fragments
  • Complete or Incomplete
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8
Q

What is an incomplete fracture?

A

Leaves the cortex intact on one side or the other.

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9
Q

What are three terms used to describe the direction of a fracture relative to the long axis of a bone?

A
  • Transverse
  • Oblique
  • Spiral
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10
Q

What are three different fragment descriptors?

A
  • Comminuted
  • Butterfly
  • Segmental
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11
Q

What is a comminuted fracture?

A

Has more than 2 fragments

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12
Q

What is a butterfly fragment?

A

Elongated triangular fragment of cortical bone generally detached from 2 other larger fragments of bone.

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13
Q

What is a segmental fracture?

A

A segment of the shaft isolated by the proximal and distal lines of the fracture.

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14
Q

When is a fracture undisplaced?

A

When a plane of cleavage exists in the bone without angulation or separation.

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15
Q

What does displacement refer to?

A

Separation of bone fragments; the direction of displacement is described by the relation of the distal fragments to the proximal fragment and is usually measured in terms of the thickness of the shaft.

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16
Q

What does an angulation fracture indicate?

A

An angular deformity between the axes of the major fragments and is also described by the position of hte distal fragment with respect ot the proximal one.

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17
Q

What must all cases of trauma demonstrate in radiography?

A

A minimum of 2 views at 90 degrees to each other.

*Also demonstrate the joints above and below the injury.

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18
Q

What do compression and depression fractures indicate?

A

That a compressive force was received by the part.

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19
Q

When are compression/impaction fractures commonly seen? And where?

A

As a result of falls at the humeral and femoral heads as well as the spine.

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20
Q

What type of fractures are common skull injuries? What do they require?

A

Depression fractures. Requires tangential radiographic views to demonstrate the depth of the fracture if CT methods are not available.

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21
Q

What is an avulsion fracture?

A

When ligaments and tendons are stronger than the bone and pulls a gragment of the bony prominence under stress rather than detaching as the result of a blow.

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22
Q

What is a torus fracture?

A

Also known as a buckle fracture, a torus fracture leaves one cortex intact while the other is buckled or compacted.

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23
Q

How many types of salter fractures are there?

A

5

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24
Q

What is a salter fracture?

A

It involves the epiphyseal growth plate. There is bleeding into the growth plate resulting in NO further growth of teh part.

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25
Q

What can happen as a result of a salter fracture in a lower limb?

A

A significant shortening of the limb and a permanent limp.

26
Q

Pathologic fractures most commonly occur through ________ lesions or _______ _______ lesions.

A

metastatic; multiple myeloma

27
Q

What can cause an increased risk for injury to the skeleton?

A

Any process that causes a loss in bone mass.

28
Q

What are the most common sites for pathologic fractures (3)?

A

Spine, femur and humerus

29
Q

What should someone over 40 with a compressed vertebra that is not trauma related get checked for?

A

Multiple myeloma or metastatic disease

30
Q

How do stress fractures occur?

A

With repeated stress to a bone.

31
Q

What are the most common sites of stress fractures?

A
  • Shafts of 2nd and 3rd metatarsals
  • Os Calcis
  • Proximal and distal ends of the upper and lower leg
  • Rami of the pelvis
32
Q

When do stress fractures become radiographically visible? How will they appear?

A

2-3 weeks after the injury. They appear as a thin line of lucency when the cortex is separated OR as a fluffy callus that represents periosteal new bone callus.

33
Q

What can demonstrate stress fractures more quickly than routine radiography?

A

Bone scans

34
Q

What is a callus?

A

An external bridge of calcium that is radiographic evidence of bone healing. The callus extends along the line of fracture and unites the bony fragments.

35
Q

What is malunion? What type of fractures does this occur?

A

The healing of fragments in a faulty position. Occurs in displaced fractures that were not set and may affect normal function of the part.

*Surgery may be required to correct deformity/appearance.

36
Q

What is delayed union? What are the causes (4)?

A

Slower than normal rate of healing.

  • Infection
  • Inadequate immobilization
  • Limited blood supply
  • Lack of bone at the site
37
Q

What is nonunion?

A

Failure in teh healing process that leads to a non-joining of fracture ends six months after an injury.

38
Q

How does a nonunion appear radiographically?

A

Fracture ends will show smooth band of sclerosis with medullary canal occluded by sclerotic bone.

*Persistent defect between fragments that consist of fibrous tissue and cartilage.

39
Q

What is the goal of fracture treatment?

A
  • To restore function and stability
  • Minimal residual deformity
  • Acceptable cosmetic result
40
Q

What are some methods to treat fractures?

A

Closed reduction and open reduction with internal fixation device. (Cast)

41
Q

What is the most common fracture of the wrist?

A

Colles fracture that is associatedc with a fall on the outstretched hand. Distal radius presents with a posterior angulation and a displaced distal fracture fragment.

42
Q

What is associated iwth 50% of Colles’ fractures?

A

An accompanying avulsion fracture of the ulnar styloid.

*Be sure technical factors are set well or disruptions will not be diagnosed until sclerosis is seen radiographically.

43
Q

What carpal bones are most commonly fractured? And what type of fractures are they usually?

A

The waist of the navicular or scaphoid. Often transverse fractures.

44
Q

Scaphoid fractures can be identified on _______ projections of the wrist, but often are best demonstrated on ______ projections

A

PA; oblique

45
Q

What can happen with undiagnosed or untreated scaphoid fractures?

A
  • May be complicated by non-union
  • Poor blood supply to the proximal fragment may lead to an ischemic necrosis of that portion
  • Necrotic area would be seen radiographically as increased density perhaps associated with loss of bone volume or collapse of that fragment of the bone.
46
Q

What is a boxers fracture?

A

Transverse fracture through the neck of the 5th metacarpal with a volar (palmar) angulation of the distal fragment.

47
Q

Because elbow fractures are sometimes hard to identify, where will radiologists look?

A

Evidence of the fat pad sign on teh lateral view. Anterior pad is seen as a lucency and posterior fat pad lies within the olecranon fossa and would not be visible on a lateral view of a normal elbow.

48
Q

Why will the fat pads be displaced in a fracture of the elbow?

A

Any process that produces fluid within the joint space will displace the fat pads.

*posterior fat pad seen as crescent shaped lucency behind lower end of the humerus.

49
Q

What happens when there is no radiograpic evidence of a fracture in the presenceof the posterior fat pad (elbow)?

A

Oblique views are necessary and if there is still no evidence of fracture, the arm will be immoblized and reevaluated in 2 weeks for signs of healing (line of sclerosis) or the patient is sent to CT.

50
Q

What is typical with fractures of the forearm and what must we do when radiographing them?

A

Most fractures involve both bones of the forearm. When only 1 fracture is seen, both joints must be demonstrated to rule out another fracture or dislocation at eitehr hte proximal or distal end.

51
Q

What is a Monteggia fracture?

A

Fracture of the shaft of the ulna with an anterior dislocation of the radial head (may be lateral as well).

52
Q

What is a Galeazzi fracture?

A

Fracture of the shaft of the radius with a posterior dislocation of the ulna at the wrist.

53
Q

What is a Pott’s fracture?

A

Fractures of both malleoli and dislocation of the ankle.

54
Q

What is a bimalleolar fracture?

A

Occurs when one fracture is transverse and one fracture is spiral or oblique.

55
Q

What is a trimalleolar fracture?

A

Involves medial, lateral and posterior malleoli. Usually contains a dislocation as well as fractures.

56
Q

What is the most common foot fracture?

A

Jones fracture

57
Q

What is a Jones fracture? How is it typically done?

A

Transverse fracture at the base of the 5th metatarsal. Avulsion type fracture that results from an inversion of the foot with plantar flexion such as would occur in stepping off a curb.

58
Q

What is the most commonly dislocated joint in the body?

A

The shoulder

59
Q

What type of dislocations are the majority of shoulder dislocations?

A

Anterior dislocations (95%) and the result of external rotation and abduction of the arm.

60
Q

What is often associated with cases of shoulder dislocations?

A

Fractures of the head of the humerus and/or a fracture of the glenoid rim.

61
Q

Most hip dislocations are ___________ and are caused by what?

A

posterior; motor vehicle accidents or falls from great heights.

*there may or may not be associated fractures with hip dislocations.

62
Q
A

Radiologic Pathologies 3461 (28 decks)

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