radiology 2- fractures and dislocations

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CircadianHomunculus
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228609
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radiology 2- fractures and dislocations
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2013-07-31 01:10:05
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radiology fractures dislocations
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radiology 2 fractures and dislocations
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  1. Label the structures on the radiograph.
  2. Label the structures on the radiograph.
  3. Label the structures on the radiograph.
  4. Label the structures in the radiograph.
  5. Label the structures in the radiograph.
  6. Label the structures in the radiograph.
  7. Label the structures in the radiograph.
  8. Label the structures in the radiograph.
  9. Label the structures in the radiograph.
  10. Label the structures in the radiograph.
  11. *Disruption in the continuity of all or aprt of the cortex of a bone.
    *Cortex is broken through and through.
    *Only part of the cortex is broken.
    • Fracture
    • Complete fracture
    • Incomplete fracture
  12. What are the radiologic features of acute FX's?
    • Abrupt discontinuity of the cortex
    • FX lines ("blacker" more lucent area)
    • FX lines are more linear
    • Edges are jagged and rough
  13. What bones present pitfalls to identifying fractures?
    • Sesamoids: (bones that form in a tendon as it passes over a joint)
    • Accessory ossicles: (accessory epiphyseal or apophyseal ossification centers that do not fuse with the parent bone)
  14. *Complete loss of opposition in a joint.
    *Partial bony contact in a joint.
    • Dislocation
    • Subluxation
  15. What criteria should be met when taking radiographs?
    • Should include the joint above and below fracture (r/o dislocation)
    • Comparison views may be useful when evaluation the pt (esp pediatric)
  16. What are the indications for obtaining a bone radiograph?
    • Deformity of a bone or joint
    • Inability to use a limb or joint
    • Unexplained pain in a bone or joint
  17. What is the 10 step process used to describe a fracture?
    • 1. General: pt ID, age, HPI confirmed w/ radiograph (correct study, extremity? adequate, good quality?), check date & time stamp for multiple studies of the same view
    • 2. Open or closed fx
    • 3. Direction/type of fx: transverse, oblique, spiral, segmental, etc
    • 4. Anatomic location: femur, humerus, scaphoid, etc
    • 5. Geographic/regional location of fx: intra vs extra-articular, proximal vs distal
    • 6. Position and alignment: long axis of fragment (alignment), relationship of fx fragments to their normal anatomic location (position)
    • 7. Angulation: varus/medial angulation of distal end (toward midline), valgus/lateral angulation of distal end (away from midline), anterior/posterior, volar/dorsal
    • 8. Apparent roation/malrotation
    • 9. Functional assessment: active ROM proximal & distal to fx and muscle strength/function
    • 10. Neurovascular status: esp distal to fx site, vascular (pulse, cap refill), neuro (lt touch, sharp/dull & 2 pt discrimination)
  18. What type of fractures are considered a surgical emergency?
    Open fractures
  19. What type of fracture is this?
    intra-articular olecranon fx
  20. What type of fracture is this?
    transverse fx (great toe, distal phalanx)
  21. What type of fracture is this?
    intra-articular talus neck fx
  22. What type of fracture is this?
    transverse patella fx
  23. What type of fracture is this?
    oblique fx of the tibia and fibula
  24. What type of fracture is this?
    oblique fx of the tibia and transverse fx of the fibula
  25. What type of fracture is this?
    spiral fx of the tibia and fibula
  26. What type of fracture is this?
    greenstick fx of the distal radius
  27. What type of fracture is this?
    torus fx of the distal radius and ulna (buckle across both bones)
  28. What type of fracture is this?
    comminuted distal femur fx
  29. What type of fracture is this?
    pathologic fx of the proximal humerus
  30. What type of fracture is this?
    segmental fx with butterfly fragment mid-shaft humerus
  31. What type of fracture is this?
    segmental fx with butterfly fragment right humerus
  32. What type of fracture is this?
    avulsion fx at the base of the proximal phalanx
  33. What type of fracture is this?
    stress fx (notice "fuzziness" on third metatarsal)
  34. What type of fracture is this?
    compression fx (spine)
  35. Name the bone that is fractured.
    C1 fx
  36. Name the regional locations of the long bones.
  37. Which regional location is between the metaphyses of a long bone (shaft of a long bone)? What are the three sub areas within this location?
    • Diaphysis
    • Proximal third, middle third, distal third
  38. Which regional location is between the epiphysis and diaphysis (widened end of a tubular bone)?
    Metaphysis
  39. What regional location is between the joint and the epiphyseal plate (physis) in children or the epiphyseal scar in adults?
    Epiphysis
  40. Known as the growth plate (only in children) and is responsible for longitudinal growth of the long bones.
    • Physis
    • **also called pressure epiphyses which occurs at the end of long bones**
  41. Growth plate fx's are described using the Salter-Harris classifcation. What are the types and what does the mneumonic stand for?
  42. What Salter-Harris class fracture is this?
    Salter-Harris I (straight)
  43. What Salter-Harris class fracture is this?
    Salter-Harris II (above)
  44. What Salter-Harris class fracture is this?
    Salter-Harris III (beLow)
  45. What Salter-Harris class fracture is this?
    Salter-Harris IV (through)
  46. What Salter-Harris class fracture is this?
    Salter-Harris V (cRushed)
  47. Also called traction epiphysis, such as the iliac crest and trochanters of the hip, contribute primarily to the contour of bone and little to actual longitudinal growth.
    Apophysis (are present at the origin of major muscles and respond to traction rather than pressure)
  48. What is the regional location of the fracture?
    Mid-shaft (femur fx)
  49. What is the regional location of the fx?
    epiphysis fx (salter-harris III)
  50. What is the regional location of the fracture?
    metaphyseal fx of distal radius- COLLES fx (dorsal angulation)
  51. What is the regional location of the fracture?
    humerus avulsion fx of greater tuberosity (apophysis fx)
  52. What are the different ways in which a fracture fragment becomes displaced?
    • Over-riding (shortened, bayoneted)
    • Distracted
    • Apposition
  53. The angulation describes the ______ in which the apex of the angulated fracture points.
    direction (anterior, posterior, medial, lateral)
  54. Term that describes angulation whereby the apex points AWAY from the midline.
    Varus
  55. Term that describes angulation whereby the apex points TOWARD the midline.
    Valgus
  56. Describes a state in which the ends of the fracture fragments overlap, measured in millimeters (or centimeters).
    Shortening (bayonetted)
  57. Describes a state in which the ends of the fracture fragments are separated, measured in millimeters (or centimeters).
    Distraction
  58. Term used to describe the turning of fracture fragments along the long axis of a bone, generally measured by physical examination.
    Rotation (internal/external)
  59. Is this a dislocation or subluxation? What is the treatment?
    • Dislocation
    • Urgent reduction if there is soft tissue or neuro-vascular compromise (NV exam before and after reduction, x-ray after reduction)
  60. What is this??
    Hill-Sachs (indicates previous anterior dislocation)
  61. Is this an anterior or posterior dislocation?
    Anterior shoulder dislocation (head of humerus larger, coming at us)
  62. What type of a dislocation is this?
    Dislocation of talus (subtalar joint)
  63. What does the functional assessment check for?
    Active ROM proximal & distal to fx (can't they actually move it? what is their muscle function?)
  64. How would you check for neurovascular status, especially distal to the fracture fragment?
    • pulses, capillary refill
    • light touch & sharp/dull
    • 2 point discrimination
  65. What are the stages of bone repair from a fracture?
    • fracture hematoma
    • fibrocartilaginous callus formation
    • bony callus formation
    • bone remodeling
  66. What are the complications that can arise from healing fractures?
    • Delayed union: eventually heals
    • Malunion: mechanically/cosmetically unacceptable position
    • Nonunion: healing will never occur
    • Pseudoarthrosis: complete with synovial lining, may form at the fracture site
  67. What is this?
    malunion
  68. What is this?
    nonunion
  69. What is this?
    pseudoarthrosis

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