The radiological principles behind diagnosing and describing fractures

Question 1

The approach for diagnosing and describing a fracture (who)

Answer 1

1. Describe the radiograph - you need to say what you are looking at and check the 5 Ws (Who, what, where, when and why) on the image to check that the image you are looking at is that of the right patient

Question 2

What is a complete fracture?

Answer 2

-Complete fractures go all the way through the bone. -They can be transverse (straight across the bone), oblique (a diagonal line across the bone), spiral (looks like a corkscrew) and comminuted (more than 2 parts to the fracture)

Question 3

What is an incomplete fracture?

Answer 3

• Incomplete fractures occur when the whole cortex is not broken.
• These can be bowing (the long bone has been bent), buckle (fracture is of concave surface), greenstick (fracture is on convex surface).

Question 4

What is a salter-harris fracture?

Answer 4

-A fracture that involves the growth plate

Question 5

The approach for diagnosing and describing a fracture (what)

Answer 5

• You need to describe the type of fracture you are looking at.
• There are two types of fracture that can occur: complete and incomplete.

Question 6

The approach for diagnosing and describing a fracture (where)

Answer 6

• You need to know where the fracture is.
• This means describing the bone that is involved and what part of the bone is affected.
• You can describe them as a diaphysis (involves shaft of bone), metaphysis (widening portion is adjacent to the growth plate) and epiphysis (end of bone is adjacent to the joint).
• You can also use the anatomical name for the part of the bone for some fractures.

Question 7

The approach for diagnosing and describing a fracture (what it looks like)

Answer 7

• You then need to describe what the fracture looks like.
• The body is usually in anatomical position so the fracture is described in terms of the distal component displacement in relation to the proximal.
• The displacement can include angulation (normal axis of bone is altered), translation (movement of fractured bones away from each other, rotation (on the proximal portion) or a distraction or impaction (bone increasing or decreasing in length).

Question 8

Any other features for fractures

Answer 8

-Finally, see if anything else is involved within the fracture eg. joints, or any other fractures.