Part 5 Flashcards
fractures of the distal humerus
transcondylar lateral condyle medial condyle T shaped intercondylar Y shaped intercondylar modified T or Y shaped
what is the most common elbow fracture in children?
supracondylar
what is the most common elbow fracture in adults?
radial head or neck
what are some things to look out for when evaulating the elbow?
positive fat pad sign
radio-capitellar line
anterior humeral line
hockey stick appearance
what are the routine radiographs for the elbow?
AP
lateral
positive fat pad sign
anterior fat pad “sail sign”
see posterior fat pad
what line is helpful in determining supracondylar fractures?
anterior humeral line
what line is helpful in determining radial subluxations?
radiocapitellar line
where does the anterior humeral line usually fall?
middle 1/3 of the capitellum
ossification of capitellum
3-6 months
ossification of radial head
4-5 years
ossification of internal/medial epicondyle
5-7 years
ossification of trochlea
8-9 years
ossification of olecranon
8-10 years
ossification of external/lateral epicondyle
11-12 years
what is the helpful mnemonic for the ossification centers of the elbow?
CRITOE
is it a problem if one of the ossification centers occifies out of order?
yes, needs further examination
nursemaid’s elbow results from?
sudden jerk or pull on the hand resulting in entrapment of the annular ligament of the radial head
how does the child hold their arm if they have nursemaid’s elbow?
pronation
reduction of nursemaid’s elbow is by?
supinating the forearm
how common is dislocating the elbow?
adults: 3rd most common
children: most common
what is the most common classification of elbow dislocation?
posterior/posterolateral
what is the most common injury to the forearm?
both bones fractured
galeezzi’s fracture
oblique spiral like fracture of the distal radius
slight dislocation of the distal radial ulnar articulation
both bones fracture
transverse fractures of both bones of the distal forearm with posterior and lateral displacment and over riding deformity
nightstick fracture
usually due to direct trauma to the forearm, which is raised to protect the head during an assault with a club or hard object
minimally displaced oblique fracture of the distal ulnar shaft
monteggia fracture
oblique fracture to the shaft of the ulna
radial head dislocated anteriorly
greenstick fracture
partial disruption of the cortex with angular change at the fracture site
tendancy for re-angulation following initial reduction
what bones does a greenstick fracture involve?
radius, ulna (maybe even both)
torus fracture
most common fracture of a child
FOOSH injury
outward bulging of the cortex often at the posterior radial surface
which view is a torus fracture seen best?
lateral
routine views of the wrist
PA
oblique
lateral
colles’ fracture
fracture of the radius about 1 1/2 inches above the carpals with posterior displacement of the distal fragment
colles’ fracture usually occurs in what age group?
elderly
what is the mechanism of injury for colles’?
FOOSH
colles’ fractures are often associated with?
ulnar styloid fractures
what is the deformity associated with colles’ fracture?
dinner fork deformity
what are some radiographic indicators of colles’ fracture?
pronator quadratus fascial line should be less than 3mm of the radius to be normal
smith’s fracture
fracture of the radius 1 1/2 inches from the carpals withe anterior angulation of the distal fragment
smith’s fracture results from?
fall on back of the hand
what is a smith’s fracture also known as?
reverse colles’ fracture
barton’s fracture
fracture of the posterior rim of the radius with accompanying carpal dislocation
what causes a barton’s fracture?
FOOSH
hutchinson’s/chauffeur’s fracture
radial styloid process
may be avulsion or direct trauma
what view is hutchinson’s fracture best seen?
P-A view
what is the most common carpal injury?
scaphoid
who most commonly gets carpal injuries?
15-40 year olds
what part of the scaphoid is most commonly involved?
waist
what is the most common site for an occult (cannot see on radiograph) fracture?
scaphoid
which view can you most commonly see scaphoid fracturess?
ulnar flexion
what are the complications for scaphoid fractures?
often occult
delayed union
nonunion
avascular necrosis
