MSK - Trauma Flashcards
Tillaux fracture
Salter Harris III fracture of the lateral tibial epiphysis, avulsion of the anterior inferior tib-fib ligament; occurs because physis fuses medial to lateral (so lateral weaker)
Triplane fracture
Vertical epiphyseal fracture, horizontal physical fracture, oblique metaphyseal fracture
Wagstaffe-Lefort fracture
Avulsion of ant distal fibular at site of insertion of ATFL (from the fibular attachment); Tillaux-Chaput involves the tibial insertion
Maisonneuve fracture
High fibular fracture with interosseous membrane tear or medial malleolar fracture; look for subtle medial joint space widening on the AP radiograph
Pilon fracture
Comminuted vertically oriented fracture of distal tibia involving the tibial plafond
Segond fracture is associated with
Avulsion fracture at insertion of lateral capsular ligament
ACL injury and IT band injury
NB: IT band inserts on Gerdy’s tubercle of the tibia
Imaging findings Tennis leg
Tear at medial gastroc myotendinous junction
Rupture of plantaris tendon
Avulsion sites in pelvis
ASIS - sartorius AIIS - rectus femoris Greater trochanter - gluteus medius/minimus Lesser trochanter - iliopsoas Ischial tuberosity - hamstrings
Fracture classification for acetabular #
Judet-Letournel
Fracture classification system for femoral head?
Femoral neck?
Pipkin - femoral head
Garden - sub capital femoral neck (based on degree of valgus displacement)
Classic location of stress fracture in femur
Inferomedial femoral neck, less commonly in superior femoral head
Classification system for AC joint injury
Rockwood
What is laxation erecta
Inferior shoulder dislocation
Often association with cuff tear and GT fracture
Injury to axillary nerve or artery
List the anterior-inferior instability lesions of the shoulder
- HAGL - humeral avulsion of the glenohumeral ligament ( presents with fluid/edema in axillary recess, avulsion of ligament from surgical neck)
- BHAGL - same as above but have bony avulsion
- Bankart
- ALPSA - labral tear still attached to periosteum
- Perthes - same as above, but flipped under and heals with bulky appearance
- Floating AIGHL
*Note - GLAD lesions do not tend to be associated with instability
List the posterior inability lesions of the shoulder
- PHAGL
- Reverse bankart
- Congenital hypoplastic posterior glenoid
What is the Bennett lesion? (seen in baseball players)
Ossification posterior band IGHL - associated with posterior labral injury, and tears of infraspinatus and teres minor
What is Essex-Lopresti fracture?
Radial head # + ulnar dislocation at DRUJ
Monteggia versus Galeazzi
“GRUM” (which bone is fractured)
Monteggia - ulnar shaft fracture, prox radial head dislocation
Galeazzi - radial shaft fracture, distal ulna dislocation
Types of distal radial fractures
Colles Smith Barton Reverse Barton Chauffeur (intra-articular involving the radial styloid)
Kienbock disease
NEGATIVE ulnar variance predisposing factor
Usually involves the whole lunate (edema –> sclerosis)
DDx: ulnar impaction syndrome - POSITIVE ulnar variance (changes seen along proximal aspect of lunate)
What is a Stener lesion
Complication of UCL injury, complete disruption with interposition of adductor aponeurosis
Results in mass like area proximal to joint line, adjacent to metacarpal head which (ball on yo-yo sign)
Which muscle is involved in ischiofemoral syndrome?
Quadratus femoris
What is distal intersection syndrome? proximal intersection syndrome?
Distal: When the tendons in the 2nd and 3rd compartment “cross over”, EPL tendon (3rd compart) crosses over ECRB/ECRL (2nd compart), usually happens at the joint, Listers tubercle plays a role
Proximal: Proximal to distal radius, when APL& EPB (1st compart) crosses over tendons in second compart approx. 5 cm proximal to joint
Difference in sublabral foramen versus recess in shoulder (SLAP tear mimics)
- Foramen: in the FRONT, from 1-3 o’clock
- Recess: in the ROOF, from 11-1 o’clock (at biceps insertion)
What is a Bennett lesion in the shoulder?
Traction injury, usually in throwing athletes (thrower’s exostosis) - curvilinear band of calcification/ossification along posterior IGHL
Imaging findings in posterior interosseous nerve syndrome
- Entrapment neuropathy, branch of radial nerve i.e. PIN
- Cause: Multiple sites of compression (orthobullets); Arcade of Frohse, b/w brachialis and brachioradialis
- Can also occur post trauma to radial head
- Involves supinator and proximal forearm extensor muscles - edema or atrophy depending on acuity
Impingement syndromes around the knee
- Suprapatellar: inflamed quadriceps FP
- Infrapatellar: Hoffa’s disease (diffuse involvement) and patellar maltracking /PT-LFCFS (superolateral FP)
