Musculoskeletal: General Flashcards
What is this showing?
Lipohaemarthrosis (joint effusion containing fat and blood) that has leaked from bone following trauma
(fat will float to the top.)
Note the visible fracture line, this is a tibeal plateau fracture
Types of long bone fractures
- transverse
- Oblique
- Spiral: twisting injury
What does ‘comminuted’ fractures mean?
Boney injury that results in more than 2 seperate bone components
eg; butterfly fragment or segmental fragment
How do you define fracture displacement?
in terms of the abnormal position of the distal fracture fragment in relation to the proximal bone.
Eg; angulation, rotation, change of bone length, loss of alignment
Describe ‘loss of alignment’ or ‘displacement’
usually along the long axis.
Usually accompanied by some degree of angulation, rotation or change in bone length.
What type of fracture is most likely to shorten?
An oblique fracture
A transverse fracture would need to be fully ‘off-end’ to shorten
Angulation can be _____ or ______
Rotation of a long bone can be _______ or ________
Angulation can be varus or valgus
Rotation of a long bone can be internal or external
What do the terms of distraction and impaction mean?
Distraction: a fracture that results in increased overall bone length due to widening/distraction of the components
Impaction: a fracture that results in shortening of bone without loss of alignment. (each component is driven into the other)
What is a ‘pathological fracture’ and what is the commonest cause?
A fracture that arises in abnormal bone (that usually wouldn’t occur in healthy bone)
Osteoporosis is the commonest cause!
Also; benign, malignant, primary or secondary bone tumours
This patient has multiple myeloma.
What can you see on xray?
This is an example of a pathological fracture of the humerus with anterior displacement and angulation.
The bone appears ‘moth eaten’
What is an avulsion injury?
Where a bone fragment is pulled away by a tendon or ligament
image; a bone fragment has been avulsed from the distal phalanx due to hyperflexion at the DIPJ
**Usually by excessive movement at the joint!**
A stress fracture is the result of?….
What can you see on xray of these?
Repeated low impact trauma to normal bone
Often no visible fracture line visible.
- *‘Periosteal reaction’ may be the only visible abnormality**
- (subtle calcification of the periosteam)*
What is this fracture called?
A periprosthetic fracture
You can see the loosening lucent (black) areas around the prosthesis.
The weakened bone has fractured.
What is a Colle’s fracture
Very common extra-articular fractures of the distal radius that occur as the result of a fall onto an outstretched hand.
They consist of a fracture of the distal radial metaphyseal region with dorsal angulation and impaction, but without the involvement of the articular surface
How do we describe dislocations
in terms of the position of the distal bone in relation to the proximal bone (NOT vice-versa)
(**dislocation: loss of anatomical congruence of bones at a joint)
Diastasis is?
Seperaton of 2 normally adjacent parts, either at a ligamentous joint, or at a growth plate.
What are these?
Kirschner wires or ‘K’ wires
used to position/immobilise fractures
Placed through skin under anesthetic
Malunion versus non-union
Malunion: complication that arises is a fracture is allowed to heal in an abnormal position.
Non-union: failure of bone to heal following a fracture
Occasionally a bone will not heal because its internal blood supply is compromised. This may result in…..
Avascular Necrosis (AVN) death of bone cells through a lack of blood supply
List some fracture mimics
- Unfused Growth Plates: young patients
- Unfused apophysis: of 5th metatarsal
- Accessory Ossicle: not present in all people (clue; will have a corticated edge!!)
- Vascular/nutrient lines: pass obliquely through cortex
- Harris Lines: thin sclerotic lines passing transversely throguh long bone shaft
