recognizing trauma to the bony skeleton ch24

Question 1

what is a complete fracture

Answer 1

if the cortex is brokend through and through, the fracture is called complete

Question 2

what is incomplete fracture

Answer 2

if only a part of the cortex is fractured, it is called incomplete

Question 3

what are examples of incomplete fractures in children

Answer 3

greenstick fracture (involves only one part of, but not entire cortex)
torus fracture (buckle fracture) = compression of cortex

Question 4

what are radiologic features of acute fracture

Answer 4

• fracture lines, when viewed in the optimum orientation, tend to be “blacker” than other lines normally found in bones such as nutrient canals
• there may be an abrupt discontinuity of the cortex, sometimes associated with acute angulation of the normally smooth contour of bone
• fracture lines tend to be straighter in their course yet more acute in ther angulation than any naturally occuring lines
• edges of fracture mayb be jagged or irregular

Question 5

characteristics of acute fracture (5)

Answer 5

1. abrupt disruption of all part of the cortex
2. acute changes in the smooth contour of a normal bone
3. fracture lines are black and linear
4. where fracture lines change their course, they tend to be sharply angulated
5. fracture fragments are jagged and not smoothly corticated

Question 6

What is subluxation

Answer 6

In a subluxation, the bones that originally formed the two components of a joint are in partial contact with each other. occurs only at joints

Question 7

The fractures are usually described using four major parameters:

Answer 7

1. number of fragments
2. direction of the fracture line
3. relationship of the fragments to each other
4. whether the fracture communicates with the outside of atmosphere

Question 8

If the fracture produces two fragments, it is called a ___ fracture

Answer 8

simple fracture

Question 9

If the fracture produces more than two fragments, it is called a ___ fracture

Answer 9

comminuted

• segmental fracture: a portion of the shaft exists as an isolated fragment
• butterfly fragment - central fragment has a triangular shape

Question 10

describe transverse fracture

Answer 10

• the fracture line is perpendicular to the long axis of the bone; these are caused by a force directed perpendicular to the shaft

Question 11

describe diagonal or oblique fracture

Answer 11

• the fracture line is diagonal in orientation; caused by force usually applied along the same direction as the long axis

Question 12

describe spiral fracture

Answer 12

twisting force or torque produces afracture like those that might be caused by planting the foot in a hole while running
- these fractures are usually unstable and often associated with soft-tissue injuries such as tears in ligaments or tendons

Question 13

There are four major parameters most commonly used to describe the relationship of fracture fragments (relative to the proximal fragment):

Answer 13

1. displacement
2. angulation
3. shortening
4. rotation

Question 14

What is avulsion

Answer 14

• common mechanism of fracture production in which the fracture fragment is pulled from its parent bone b the pull of a tendon

Question 15

what are indirect signs of possible fracture

Answer 15

1. soft-tissue swelling
2. disappereance of normal fat stripes
3. joint effusion
4. periosteal reaction

Question 16

Factors that accelerate fracture healing

Answer 16

youth
early immobilization
adequate duration of immobilization
good blood supply
physical activity after adequate immobilization
adequate mineralization

Question 17

factors that delay fracture healing

Answer 17

old age
delayed immobilization
too short a duration of immobilization
poor blood supply
steroids
osteoporosis, osteomalacia

Question 18

spinal fracture is imaged with

Answer 18

CT

Question 19

What are some of the more common spinal fractures

Answer 19

compression fractures
jefferson fractures
hangman fractures
burst fracture
chance fracture

Question 20

what are the three cervical lines

Answer 20

Three parallel arcuate lines should smoothly join all of the spinolaminar white lines that occur :
first at the junctions between the laminae and the spinous processes
secon line should join all of the posterior aspects of the vertebral bodies
and third line should join all of the anterior aspects of the vertebral bodies

Question 21

what is a jefferson fracture

Answer 21

fracture of C1 usually involving both the anterior and posterior arches. caused by an axial loading injury (e.g. diving into a swimming pool and hitting ones head on the bottom)

Question 22

what is hangmans fracture

Answer 22

fracture of posterior elements of C”
results from hyperextension-compression injury typicall occuring in an unrestrained occupan in a motor cehicle accident who strikes his or her forehead on the windshield with the nek extended

Question 23

what is burst fraction

Answer 23

common in the cervical spine, thoracic spine, upper lumbar spine

• high-energy axial-loading injuries
• comminuted compression fracture of the vertebral body

Question 24

what is chance fracture

Answer 24

transverse fractures through the entire vertebral body, pedicles, and spinous process,

Question 25

what is locked facets

Answer 25

bilateral locking of the facets in the cervical spine can occur as a result of a hyperflexion injury in which the inferior facets of one vertebral body slide over and in front of the superior facets of the body below
- alwaays results in neurological impairment

Question 26

what are pathological fractures

Answer 26

those that occur with minimal or no trauma in bones that had a preexisting abnormality