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Radiology Trauma > Pelvis and Hip Trauma > Flashcards

Pelvis and Hip Trauma Flashcards

1
Q

pelvic fractures can be classified as what

give explanation

A

stable or unstable

stable - single break - MC 2/3 of fractures
unstable - break in 2 or more places

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2
Q

xray trauma evaluation of pelvis requires which lines to be intact

A 
iliopectineal (iliopubic) 
ilioischial 
teardrop 
symphysis pubis 
sacrum 
acetabulum 
shentons line
arcuate lines of sacrum
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3
Q

anatomic pelvis is composed of 2 arches.. what are they

A

anterior and posterior

anterior - smaller arch, pubic and ischium along with pubic ligaments and pubic symphysis

posterior - larger arch, iliac wings and sarcum suspended by sacroiliac ligaments in the body

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4
Q

pelvic fracture evaluation requires to establish continuity using what 3 pelvic bony ring lines

A

pelvic inlet
pelvic outlet
obturator foramen

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5
Q

stability of pelvic fractures depends on where the fracture or dislocation disrupts what structures

A

pubic symphysis

sacroiliac joints

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6
Q

Most pelvic fractures result from what

A

MVA 50%
MV and person collision 30%
fall from height 10%
motorbike 4%

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7
Q

what types of pelvic fractures are common in elderly

A

insufficiency pelvic fractures

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8
Q

what is a stable pelvic fracture

what is a unstable pelvic fracture

A

stable - single break (MC)

unstable - break in 2 or more places

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9
Q

give an example of stable pelvic fractrue

A

avulsion fractures, iliac wing fracture, sacrum fracture, ischiopubic fracture

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10
Q

what hip fractures are most common among active adolescents and young adults

A

apophyseal fractures

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11
Q

pelvic and hip avulsion fractures usually occur in the age range of __ to __

what is mechanism of injury

A

14-25

kicking and gymnastics
sudden detachment of tendon

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12
Q

avulsion fracture of the hip may be mistaken for what

A

osteosarcoma

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13
Q

what is a stable* iliac wing* fracture resulting from direct blow that is usually treated conservatively unless it is comminuted

A

duverney fracture

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14
Q

what is an unstable* fracture of the hip that involves vertical shearing force* that causes an ipsilateral hemipelvic fracture* through ipsilateral rami and SI joint and ala

A

Malgaigne fracture

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15
Q

patient presents with short limb on one side of fracture, what is the fracture

A

malgaigne fracture

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16
Q

what unstable fracture results from lateral compression force such as car accidents

A

bucket handle fracture

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17
Q

what are vertically oriented fractures through the superior and inferior pubic rami on one side as well as contralateral SI joint disruption

A

bucket handle fracture

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18
Q

what unstable fractures the superior pubic ramus and ischiopubic junction bilaterally that causes bladder and urethral injury

A

straddle pelvic fracture

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19
Q

what pelvic fracture is often referred to as open book fracture

A

sprung pelvis fracture dislocation

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20
Q

what fracture is due to forced separation of the posterior ring through one or both SI joints with disruption of pubic symphysis and anterior ring diastasis

A

sprung pelvis fracture dislocation

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21
Q

what fracture causes the iliac wings to look asymmetrical

A

sprung pelvis fracture dislocation

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22
Q

proximal femur fractures tend to occur in what patients

A

elderly - especially with osteoporosis

23
Q

proximal femur fractures is the result of high or low impact trauma in elderly

A

low

24
Q

proximal femur fracture is the result of high or low impact in younger patients

A

high

25
Q

why is femoral neck fractures dangerous

A

disrupts blood supply resulting in ischemic osteonecrosis/AVN of femoral head

26
Q

intracapsular vs extracapsular prognosis

A

intracapsular worse cause affects blood supply

extracapsular does not affect blood supply

27
Q

what are examples of intracapsular and extracapsular fractures of the femur head

A

intracapsular - supcapital, midcervical, basicervical

extracapsular - trochanteric and subtrochanteric

28
Q

what classification method is used to determine and predict stability of injury

A

garden classification

29
Q

many define basicervical fracture as what fracture

A

intertrochanteric

30
Q

garden classication of femoral neck fractures

A

graden 1 - incomplete
garden 2 - complete but non displaced
garden 3 - complete and partially displaced
garden 4- complete and displaced entirely (fragments are not together)

31
Q

what femoral neck fractures are diffucult to diagnose

A

undisplaced subcapital fracture - seen as line of sclerosis either complete or incomplete caused by impaction

32
Q

patient presents with inability to walk or stand and their limb appears shortened and externally rotated

A

dispaced femoral neck fractures

33
Q

intertrochanteric femoral fractures are result of what

A

violence, falls, car and pedestrian

34
Q

what fractures of the femoral neck are more common in younger patients

A

interchocanteric and subtrochanteric fractures

35
Q

extracapsular fractures such as intertrochanteric and subtrochanteric fractures often occur with significant force that results in what type of fracture

A

comminuted

36
Q

what are complications of extracapsular fractures

A

fat pulmonary embolisms

37
Q

subtrochanteric fractures occur 2 cm inferior to the ____

A

lesser trochanter

38
Q

what population is more susceptible to hip dislocations

A

people with prosthesis his dislocated more readily and with less force

39
Q

what is the most common hip dislocation

A

posterior

40
Q

which hip dislocation is associated with acetabular fracture

A

central hip dislocation - protrusio

41
Q

what is a complication of posterior hip location

A

damage sciatic nerve

posterior hip capsule damage

42
Q

what is mechanism of posterior hip dislocation

A

MVA and dashborad injury

43
Q

posterior dislocation causes damage to sciatic nerve which presents as what

A

unable to walk with general paresthesia in limb

44
Q

in posterior hip location the femoral heads is displaced where? how is leg positioned

A

posterior, superior, and lateral

internally rotated - can barely seen less trochanter on xray

femoral head will also appear smaller on that side compared to other

45
Q

what modality is needed for evaulation of posterior dislocation

A

CT

46
Q

what sacral fractures are infrequet

A

isolated sacral fracture

47
Q

isolated sacral fractures are often __ oriented and due to direct blow

A

transverse

48
Q

when sacral fractures are part of complex injury they are usually ___ oriented and fracture through sacral foramen

A

vertical

49
Q

sacral fractures that develop due to insufficiency and stress fractures that are ___ to SI joints

A

parallel

50
Q

what do you look at on the sacrum to look for fractures

A

arcuate lines and sacral foramina

51
Q

what classification is used to classify sacral fractures

A

Denis classification

zone 1
zone 2 - through sacral foramina
zone 3 - transverse down the middle
zone 4 - transverse - looks like a U - down sacral foramen then across then up sacral foramen

52
Q

what other fractures in the vertebral column would indicate suspicion of sacral fracture

A

fracture of L4-L5 TP

53
Q

what is another way besides CT and xray to view sacral fractures? what specific fracture

A

radionuclide bone scans - HONDA sign

insufficiency fracture

54
Q

coccyx fractures result from what

A

falls on buttock and direct impact

Radiology Trauma (6 decks)

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