PCE axial workshop these cards are to be viewed alongside powerpoint

Question 1

Fall onto chin. ?Fracture slide 3

Answer 1

There are minimally displaced open fractures involving the right parasymphyseal region and left angle of the mandible. The fractures extend to communicate with the neighbouring dentition.

Question 2

Punch to left side of face. ST swelling. ?Fracture slide 4

Answer 2

There is a fracture of the left infraorbital margin, lateral wall of the left maxillary sinus and widening of the left zygomaticofrontal suture. Features in keeping with a left sided tripod fracture. Air-fluid level noted in the right maxillary antrum raising the suspicion of a further injury.

Question 3

Patient a/w mouth fixed open. ?Cause. slide 5

Answer 3

Bilateral anterior dislocation of the temporomandibular joints.

Question 4

RTA. Right hip pain. ?NOF # slide 6

Answer 4

There is a comminuted intra-articular fracture involving both columns of the right acetabulum.

Question 5

Fall down flight of stairs. Facial swelling and bruising. ?# slide 7 and 8

Answer 5

There is depression of the left orbital floor, with an associated fracture of the left zygomatic arch and widening of the left zygomaticofrontal suture. Features in keeping with a left sided tripod fracture. In addition, there is a fracture of the right zygomatic arch and left parasymphyseal region of the mandible.

Question 6

Alleged assault. Left sided swelling. Diplopia. slide 9

Answer 6

There is left supraorbital emphysema (black eyebrow sign) in keeping with a fracture communicating with an adjacent air filled chamber (a sinus).

Question 7

RTC. Bullseye. C Spine tenderness. ?# slide 10

Answer 7

There is subtle anterolithesis of c2 on c3 with a fracture extending through the posterior elements (Hangman’s fracture)

Question 8

RTC. Car v’s Pedestrian. Trauma series for #. slide 11 and 12

Answer 8

There is a transverse fracture through the base of the odontoid peg. Subtle overhang of the right lateral mass of C1 on C2 raises the suspicion of a further fracture involving C1.

Question 9

Fall from height. Tenderness at L2. slide 13

Answer 9

There is loss of anterior vertebral body height by approximately 25% at L1. Features in keeping with a anterior wedge compression fracture.

Question 10

Fall from roof. Police with patient. Incontinent of urine. ?# slide 14

Answer 10

There is a marked loss of vertebral body height at L2 with loss of posterior alignment (Concavity) suggesting retropulsion. Features in keeping with a burst fracture.

Question 11

Motorcyclist RTC. R/O NOF # slide 14

Answer 11

There is marked diastasis of the symphysis pubis and widening of the right SIJ. Features in keeping with an ”open-book” fracture.

Question 12

Football injury. Pain in left hip rrom. ?# slide 16

Answer 12

There is a minimally displaced avulsion fracture involving the left ASIS (at the insertion of the Sartorius muscle). The bracketed information is just for your background knowledge.

Question 13

Fall down stairs. Long lie. ?# slide 17

Answer 13

There is a fracture through the base of the odontoid peg with posterior displacement and angulation of the peg. There is an associated fracture involving the posterior arch of C1.