Unit 3 - Radiology, Fractures, Fixation

Question 1

radiographic signs of OA

Answer 1

non-uniform joint space narrowing, osteophytes, subchondral sclerosis and subchondral cysts

Question 2

osteoporosis on radiograph

Answer 2

need >30% bone loss to see on xray

Question 3

radiographic sign of osteonecrosis/avascular necrosis

Answer 3

hollowed out area on femoral head/other places, MRI more sensitive early in degen, if you can see it on radiograph, pretty far gone

Question 4

primary bone healing

Answer 4

occurs in surgically compressed or fixated fractures, no visible callus formation, Haversian remodeling

Question 5

secondary bone healing

Answer 5

inflammatory phase (bleeding, bone necrosis at fx end, fibroblasts replace collagen), callous formation (pain and swelling, soft callous forms making ends sticky, 4-12 days , then callous converts to woven bone 4 weeks), Remodeling phase (6 weeks-months, convert woven bone to lamellar bone according to Wolff’s Law and piezoelectric effect, callous reabsorbed)

Question 6

types of fractures (loading)

Answer 6

transverse (bending), spiral (torsional), compression/impacted (axial), avulsion (tensile), oblique (combined load)

Question 7

comminuted fracture

Answer 7

lots of pieces, common with axial loads or large energy impacts

Question 8

stress fracture

Answer 8

repetitive loading, often on the tension side of bone

Question 9

greenstick fracture

Answer 9

incomplete - pediatric - occurs on tensile side of bone

Question 10

torus fracture

Answer 10

incomplete - pediatric - buckle, compression side of bone

Question 11

physeal fracture

Answer 11

weak link in pediatric joint, often injured before ligaments

Question 12

intraarticular fracture

Answer 12

may have negative impact on ROM

Question 13

open fracture types

Answer 13

I - wound 1cm, no extensive soft tissue damage, flap, or avulsion
III - extensive damage, high risk of infection, usually high velocity trauma

Question 14

fractures that are surgical emergencies

Answer 14

open, risk of infection increased after 6 hours
fracture with associated vascular injury
acute compartment syndrome

Question 15

signs and symptoms of possible fracture

Answer 15

history of trauma
localized pain, worse with movement
muscle guarding with passive movement
decreased functional use
swelling, deformity
sharp, local tenderness

Question 16

fracture complications

Answer 16

DVT/PE
fat emboli from marrow, especially long bone fractures
neurovascular compromise
infections
AVN