Radiologic "Clinical Decision Rules" and Evaluation of Fractures

Question 1

What are CDRs?

Answer 1

decision making guides

Question 2

How are CDRs used?

Answer 2

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

Question 3

What can CDRs help avoid?

Answer 3

time
expense/cost
radiation exposure

Question 4

What are some examples of CDR’s?

Answer 4

Pittsburgh Decision Rules 
Ottawa Knee Rules
Ottawa Ankle and Foot rules 
Canadian C-spine rules 
NEXUS criteria

Question 5

Are PT’s suppose to diagnose fracture?

Answer 5

no

Question 6

What do PT’s need to understand about fracture?

Answer 6

terms, concepts and principles to begin to consider implications of trauma, fracture, healing and hardware on patient prognosis/recovery

Question 7

This term is defined as a break in the structural continuity of bone or cartilage

Answer 7

fracture

Question 8

What are the two categories of fractures?

Answer 8

closed

open

Question 9

This type of fracture is where the skin has not been broken (tenting of skin is still closed)

Answer 9

closed

Question 10

This type of fracture is where the skin has been broken no matter how small an opening

Answer 10

open

Question 11

How are fractures described on film/reports?

Answer 11

site and extent 
type 
alignment
direction of fracture line 
special features
associated abnormalities 
abnormal stress/pathological process 
special considerations in children

Question 12

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

Answer 12

intra articular

Question 13

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

Answer 13

extra articular

Question 14

What are two types of fractures?

Answer 14

complete

incomplete

Question 15

This type of fracture is when there are 3 or more fragment pieces

a. complete
b. comminuted
c. incomplete
d. open

Answer 15

comminuted

Question 16

This type of fracture is when the fracture doesn’t extend all the way through

a. complete
b. comminuted
c. incomplete
d. open

Answer 16

incomplete

Question 17

This type of fracture is when the fracture extends through both sides of cortical bone

a. complete
b. comminuted
c. incomplete
d. open

Answer 17

complete

Question 18

What terms define the alignment of fracture?

Answer 18

defined
position
displacement
angulation

Question 19

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

Answer 19

defined

Question 20

This term describes the relation of fragments to normal anatomic structure

a. defined
b. position
c. displacement
d. angulation

Answer 20

position

Question 21

This term describes the loss of position

a. defined
b. position
c. displacement
d. angulation

Answer 21

displacement

Question 22

Angulation is a _ from alignment

Answer 22

deviation

Question 23

The distal fragment in relation to proximal fragment and normal anatomic position

Answer 23

position description

Question 24

What are two special features?

Answer 24

impaction

avulsion

Question 25

This special feature of a fracture is defined as the bone collapsing in on itself a. impaction b. avulsion c. displacement d. distraction

Answer 25

impaction

Question 26

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

Answer 26

avulsion

Question 27

What are two associated abnormalities?

Answer 27

subluxation | dislocation

Question 28

This type of abnormality is described as the joint partly dislocated and potentially reduced itself a. subluxation b. dislocation c. impaction d. avulsion

Answer 28

subluxation

Question 29

This type of abnormality is described as the joint not aligned anymore, the two bones separated a. subluxation b. dislocation c. impaction d. avulsion

Answer 29

dislocation

Question 30

Abnormal stress and pathologic process will show

Answer 30

increase radiodensity (radiopaque)

Question 31

What are two special considerations in children?

Answer 31

location | difficulties in assess

Question 32

What are three incomplete fractures common in children?

Answer 32

greenstick fracture plastic bowing torus (buckle) fracture

Question 33

How are fractures corrected and stabilized?

Answer 33

reduction | fixation

Question 34

This type of fracture correction is a restoration of fragments to normal anatomic position a. reduction b. fixation

Answer 34

reduction

Question 35

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

Answer 35

open reduction

Question 36

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

Answer 36

closed reduction

Question 37

This type of fracture stabilization is when fragments are maintained in position a. reduction b. fixation

Answer 37

fixation

Question 38

Rods outside the limb going into the body maintain fragments in position a. open reduction b. closed reduction c. external fixation d. internal fixation

Answer 38

external fixation

Question 39

Nails, screws, plates, rods, wires are used to maintain fragments in position a. open reduction b. closed reduction c. external fixation d. internal fixation

Answer 39

internal fixation

Question 40

What are 4 potential complications of fragments/fracture union?

Answer 40

delayed union slow union nonunion malunion

Question 41

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

Answer 41

delayed union

Question 42

This complication at a fracture site is when the union is slow a. delayed union b. slow union c. nonunion d. malunion

Answer 42

slow union

Question 43

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

Answer 43

nonunion

Question 44

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

Answer 44

malunion

Question 45

This complication at a fracture site is defined as a false joint a. fragment/fracture union b. pseudoarthrosis c. osteomyelitis d. avascular necrosis

Answer 45

pseudoarthrosis

Question 46

This complication at a fracture site is defined as a bone infection a. fragment/fracture union b. pseudoarthrosis c. osteomyelitis d. avascular necrosis

Answer 46

osteomyelitis

Question 47

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

Answer 47

avascular necrosis

Question 48

What are other associated complications in soft tissues?

Answer 48

arterial injury nerve injury compartment syndrome