Osseous conditions Flashcards
osteochondritis dissecans
associated with repetitive overhead or upper extremity weight bearing activities
gymnastics and throwing
repetitive trauma and or vascular insufficiency
20-25 yr
males> females
osteochondritis dissecans presentation
complain of elbow pain
insidious, activity related onset that consists of pain, stiffness, possible effusion in lateral aspect of dominant UE
early on loss of extension
eventual catching, locking, grinding
treatment for osteochondritis dissecans
relative rest and possible immobilization with gradual return
may require surgery for microfracture or drilling, fixation of lesion, debridement, OATS
forearm fx types
nightstick
greenstick
monteggia
galeazzi
torus
nightstick fx
midportion fx in ulna without other fx being present
often occurs from a direct blow to the ulna
greenstick fx
incomplete fracture of one of the forearm bones due to flexibility of pediatric bones
Fracture occurs on the traction side of the injury
Often occurs during fall onto hand in children
torus fx
buckle fracture that occurs when the bony cortex is compressed and fails, but does not extend into the traction side of the bone
Often occurs during fall onto hand in children
monteggia fx
proximal ulna fracture with dislocation of radial head
Typically occurs when falling onto outstretched hand with elbow extended, and forearm pronated
HU jt- closed packed
HR jt- open packed
galeazzi fx
distal or middle radius fracture with dislocation of the distal ulna at the wrist
typically occurs when falling onto hand with forearm pronated
Unable to be reproduced in laboratory setting
colles fx
most common fracture of the wrist
Fracture occurs in distal radius
dorsal angulation of the distal fragment
we also include fracture of ulnar styloid
MOI- fall onto outstretched hand with wrist in extended position
consider median nerve
smiths fx
fracture occurs in distal radius
palmar angulation of the distal fragment
MOI- Fall onto outstretched hand with wrist in flexed position
consider median nerve
Frykmans classification tip
odd numbers- types of radius fx
even numbers- same radius fx but with ulnar styloid fx
frykmans type 1 and type 2
1- Extra articular distal radius fracture
2- extra articular distal radius fx with ulnar styloid fx
frykmans type 3 and 4
3- intra articular fx of distal radius extending into radiocarpal jt
4- same but add in ulnar styloid fx
frykmans type 5 and 6
5- intra-articular radius fx that extends into the distal radio ulnar joint
6- same but with ulnar styloid fx
frykmans type 7 and 8
7- distal radius intra articular fracture that extends into both the radiocarpal and distal radio ulnar joints
8- same but with fx in u styloid
scaphoid fx
most common carpal fx
Typically occurs due to fall on outstretched hand
Three possible fracture locations
Poor blood supply in proximal pole as it relies on retrograde blood flow from radial artery
Increases risk for avascular necrosis
scaphoid fractures implications and examination
Of the difficult to see on x-rays
Recommended to treat as a fracture until proven otherwise
Immobilize one to two weeks with repeated imaging and clinical examination
anatomic snuffbox pain felt with ulnar deviation within 72 hours
scaphoid tubercle tenderness at two weeks
boxers fracture
Fracture of the fifth metacarpal (4th uncommon)
can be present anywhere along the shaft
Usually involves displacement
Occurs as a result of hitting an object with a closed fist
bennet fx
fracture of the base of the first metacarpal
Partial intra-articular
Typically a result of trauma involving axial loading through the thumb
rolando fx
fracture of the base of the first metacarpal that results in three fragments of bone
Fully intra-articular
Typically a result of trauma involving axial loading through the thumb
