Radiology - Fractures and Dislocation Flashcards
Rules of recognising fractures
Take minimum of 2 views, 90 degrees to each other
Elevated view of any anterior/ posterior fat pad or elbow effusion
A rigid ring must break in at least 2 places
X-ray the joint above and below when the paired bones are injured
Bony rings
Pelvis - obturator foramina Paired long bones, forearm and leg Mandible Zygomatic arch Vertebra
Describing fractures using position
Angulation Displacement Distraction Impaction Foreshortening
Paths of fracture line
Transverse - looks horizontal
Oblique
Spiral
Longitudinal - looks vertical
Fractures in children
Plastic
Torus
Greenstick
Non-accidental injury
Salter - Harris classification
Used for growth plate injuries
Slipped (horizontal) Above Lower Through Ruined
Special fractures
Fatigue fractures
Insufficency fractures
Pathological fractures
Transverse fractures
Fracturing force impacts directly on the bone
Stable but the area of bone in contact for healing is small, so union takes 2x as long in spiral fractures
Spiral fractures
Low velocity fractures
Distal part of the limb is stationary and the heavy body twists around it
Why is fracture healing more rapid in spiral fractures
Because of the large areas in contact
Butterfly fracture
Caused by a direct blow combined with evolving spiral fracture
Healing is often slow
Comminuted fractures
Unstable fractures
Usually the result of great force
More than two bony fragments to the fracture configuration
Why is bone healing is comminuted fractures usually delayed
Blood supply is compromised despite large contact area
Insufficiency fractures
Typically seen in osteoporotic patients
Includes NOF and pubic ramus fractures
Payments w/ these should have metabolic bone disease workup
Aim of comminuted fragment treatment
Early stabilisation and internal fixation to allow early mobilisation
