Trauma Imaging Flashcards
What is a flail segment?
Flail chest or flail thoracic segment occurs when three or more contiguous ribs are fractured in two or more places
What is the most commonly injured solid organ in the body?
the spleen
How can you treat splenic laceration without doing splenectomy?
can do embolisation of the splenic artery due to the fact that the spleen has a dual blood supply coming from short gastric arteries too
What is the second most commonly injured solid organ in trauma?
the liver
What is the main treatment for liver trauma?
bed rest
What is third most injured solid organ in trauma?
the kidney
Why are you more worried about kidney trauma vs liver and spleen?
kidney has end organ blood supply so much more worried about infarction
Name 5 types of fracture and the force that causes them?
transverse (bending force) oblique (shearing force) spiral (torsional force) comminuted (high energy fracture) segmental (break in two places)
What is the fat pad sign?
on elbow XR should only see an anterior fat pad normally but in joint effusion there will also be a posterior one, this could be a sign that there is a fracture
What is a Colles fracture?
this is an extra articular fracture of the distal radius with dorsal displacement or angulation
Colles fractures mechanism?
FOOSH injuries more commonly in those over 60
Characteristic of colles fracture?
dinner fork deformity
Treatment of colles fracture?
depends on the level of displacement can be done with just a sling
What is a smiths fracture?
extra articular fracture of the distal radius with volar displacement or angulation
Mechanism of smiths fracture?
fall onto the back of a flexed wrist
Treatment of smiths fracture?
all need ORIF as highly unstable
Mechanism of scaphoid fracture?
FOOSH injury
Presentation of a scaphoid fracture?
pain and tenderness in the anatomical snuff box and pain on compressing the thumb metacarpal
Describe visualising scaphoid fractures on x ray and treatment?
scaphoid fractures may not be visible on x ray until 2 weeks after fracture so if it is suspected it is important to splint it anyway because of the risk of non-union, AVN and secondary OA.
Supracondylar fracture of the elbow is relatively common in _________
growing children
Mechanism of supracondylar fractures of the elbow?
extension type fractures are more common where there is a fall onto an outstretched hand
Potential complications of supracondylar fracture of the elbow in children?
pressure on the brachial artery and the anterior interosseous branch of the median nerve
Describe intracapsular femoral fracture and treatment?
in these fractures the arterial supply of the femoral head can be disrupted and there is risk of AVN and non-union of the fracture
treatment: need to replace the femoral head, total hip replacement is done in a high functioning person as risk of dislocation and other complications but gives better function, hemi arthroplasty is done in those with restricted mobility as surgery is less complex but doesn’t give as good function
Describe extra capsular proximal femoral fractures and treatment?
these should not cause AVN and have a high union rate
most are fixed with internal fixation keeping the patients own natural hip joint
