Radiologic "Clinical Decision Rules" and Evaluation of Fractures Flashcards
What are CDRs?
decision making guides
How are CDRs used?
questions asked and/or findings noted that help decide whether imaging is necessary or appropriate in trauma injury AND/OR
which imaging modality to use/choose
What can CDRs help avoid?
time
expense/cost
radiation exposure
What are some examples of CDR’s?
Pittsburgh Decision Rules Ottawa Knee Rules Ottawa Ankle and Foot rules Canadian C-spine rules NEXUS criteria
Are PT’s suppose to diagnose fracture?
no
What do PT’s need to understand about fracture?
terms, concepts and principles to begin to consider implications of trauma, fracture, healing and hardware on patient prognosis/recovery
This term is defined as a break in the structural continuity of bone or cartilage
fracture
What are the two categories of fractures?
closed
open
This type of fracture is where the skin has not been broken (tenting of skin is still closed)
closed
This type of fracture is where the skin has been broken no matter how small an opening
open
How are fractures described on film/reports?
site and extent type alignment direction of fracture line special features associated abnormalities abnormal stress/pathological process special considerations in children
This site of fracture is described as a fracture inside the joint capsule
a. intra articular
b. extra articular
c. proximal end
d. distal end
intra articular
This site of fracture is described as a fracture outside the joint capsule
a. intra articular
b. extra articular
c. proximal end
d. distal end
extra articular
What are two types of fractures?
complete
incomplete
This type of fracture is when there are 3 or more fragment pieces
a. complete
b. comminuted
c. incomplete
d. open
comminuted
This type of fracture is when the fracture doesn’t extend all the way through
a. complete
b. comminuted
c. incomplete
d. open
incomplete
This type of fracture is when the fracture extends through both sides of cortical bone
a. complete
b. comminuted
c. incomplete
d. open
complete
What terms define the alignment of fracture?
defined
position
displacement
angulation
This term describes the relationship of longitudinal axis of one fragment to the other, in tandem or parallel
a. defined
b. position
c. displacement
d. angulation
defined
This term describes the relation of fragments to normal anatomic structure
a. defined
b. position
c. displacement
d. angulation
position
This term describes the loss of position
a. defined
b. position
c. displacement
d. angulation
displacement
Angulation is a _ from alignment
deviation
The distal fragment in relation to proximal fragment and normal anatomic position
position description
What are two special features?
impaction
avulsion
This special feature of a fracture is defined as the bone collapsing in on itself
a. impaction
b. avulsion
c. displacement
d. distraction
impaction
This special feature of a fracture is defined as when a fractured off chunk of bone may pull away
a. impaction
b. avulsion
c. displacement
d. distraction
avulsion
What are two associated abnormalities?
subluxation
dislocation
This type of abnormality is described as the joint partly dislocated and potentially reduced itself
a. subluxation
b. dislocation
c. impaction
d. avulsion
subluxation
This type of abnormality is described as the joint not aligned anymore, the two bones separated
a. subluxation
b. dislocation
c. impaction
d. avulsion
dislocation
Abnormal stress and pathologic process will show
increase radiodensity (radiopaque)
What are two special considerations in children?
location
difficulties in assess
What are three incomplete fractures common in children?
greenstick fracture
plastic bowing
torus (buckle) fracture
How are fractures corrected and stabilized?
reduction
fixation
This type of fracture correction is a restoration of fragments to normal anatomic position
a. reduction
b. fixation
reduction
This type of surgery to correct a fracture is completed in order to straighten things out
a. open reduction
b. closed reduction
c. external fixation
d. internal fixation
open reduction
This correction of a fracture is when the fragments are straightened without surgery
a. open reduction
b. closed reduction
c. external fixation
d. internal fixation
closed reduction
This type of fracture stabilization is when fragments are maintained in position
a. reduction
b. fixation
fixation
Rods outside the limb going into the body maintain fragments in position
a. open reduction
b. closed reduction
c. external fixation
d. internal fixation
external fixation
Nails, screws, plates, rods, wires are used to maintain fragments in position
a. open reduction
b. closed reduction
c. external fixation
d. internal fixation
internal fixation
What are 4 potential complications of fragments/fracture union?
delayed union
slow union
nonunion
malunion
This complication at a fracture site is defined as when the bone doesn’t unite in the usual time frame
a. delayed union
b. slow union
c. nonunion
d. malunion
delayed union
This complication at a fracture site is when the union is slow
a. delayed union
b. slow union
c. nonunion
d. malunion
slow union
This complication at a fracture site is when the fracture fails to unite and the two boney ends round off
a. delayed union
b. slow union
c. nonunion
d. malunion
nonunion
This complication at a fracture site is when the fracture heals but with some deformity (angulation or rotation)
a. delayed union
b. slow union
c. nonunion
d. malunion
malunion
This complication at a fracture site is defined as a false joint
a. fragment/fracture union
b. pseudoarthrosis
c. osteomyelitis
d. avascular necrosis
pseudoarthrosis
This complication at a fracture site is defined as a bone infection
a. fragment/fracture union
b. pseudoarthrosis
c. osteomyelitis
d. avascular necrosis
osteomyelitis
This complication at a fracture site is a loss of blood supply to the bone
a. fragment/fracture union
b. pseudoarthrosis
c. osteomyelitis
d. avascular necrosis
avascular necrosis
What are other associated complications in soft tissues?
arterial injury
nerve injury
compartment syndrome
