Describing fractures Flashcards

Question

Answer 1

Sail sign Elevation of the anterior fat pad on lateral elbow radiograph to create a silhouette similar to the sail of a boat Anterior fat pad is often normal It indicates: Presence of an elbow joint effusion Presence of an intra-articular fracture Radial head fracture in adults Supracondylar fracture in children **Posterior fat pad on a lateral x-ray of the elbow is always abnormal** Where a fat pad is raised and no fracture is demonstrated, an occult fracture should be suspected

Answer 2

Elbows Most commonly dislocate posteriorly, particularly with fractures of the radial head, olecranon, or coronoid process Shoulders Dislocate anteriorly in 95% of cases Hips Dislocate posteriorly in 90% of cases Patella Tends to dislocate laterally Note whether any dislocations are associated with a fracture, as this would be referred to as a **complex dislocation or fracture-dislocation**

Answer 3

Dislocation Complete (100%) loss of articular congruity; no part of the articular surfaces of the bones contributing to the joint are touching each other Subluxation Partial (< 100%) loss of articular congruity; some part of the articular surfaces of the bones contributing to the joint are touching each other

Answer 4

subluxation on left dislocation on right

Answer 5

Look for air within the soft tissues, especially around the site of a fracture **Presence of air is indicative of a compound fracture**

Answer 6

Look for foreign bodies within the soft tissues - particularly shrapnel which may have been deposited during penetrating injury

Answer 7

Fractured ends are manipulated back into position and immobilized using a splint or a cast Should be achieved within a few hours after the injury Reduction is either the definitive management or temporary until surgery can be performed An x-ray must be obtained after immobilization to ensure adequate reduction

Answer 8

Results from the spread of microorganisms from wounds associated with an open fracture Most commonly caused by **Staphylococcus aureus**

Answer 9

Due to cartilage destruction and changes of the subchondral bone Increased risk with: Older age Obesity Repetitive joint use Trauma

Answer 10

Characterized by chronic pain, often of the distal limbs Can occur after a fracture or surgery and is difficult to manage

Answer 11

Reduced joint space Generally asymmetric Subchondral sclerosis Increased bone deposition surrounding the joint Subchondral cysts Cystic formations around the joint Osteophytes Bony projections along the joint line

Answer 12

(1) Joint space narrowing (2) Osteophytes (3) joint destruction (4) Involvement of the carpometacarpal (CMC) joint which is very common

Answer 13

OA Anteroposterior and lateral views showing (1) Joint space narrowing (2) Osteophyte formation

Answer 14

Key findings on x-ray: Reduced joint space Generally symmetric Articular surface erosions Discontinuities in the bone plate Periarticular osteopenia Hypodensity of bone surrounding the joint Soft tissue swelling

Answer 15

Key findings on x-ray: Well-defined erosions with overhanging edges Normal bone mineralization Relative sparing of the joint space Tophi Appear as soft tissue masses with higher density than surrounding soft tissue Occasionally they are calcified

Answer 16

Open fractures Neurovascular injury with fracture Extreme swelling/compartment syndrome Unable to achieve or maintain reduction (including if ED is not experienced in fracture reduction, splinting or casting) Forearm fractures with elbow or wrist dislocation

Answer 17

communited

Answer 18

Describe the fracture. Which bone? Left humerus Which part of the bone? Middle/Midshaft or Diaphysis Which type of fracture? Spiral Midshaft spiral fracture of the left humerus

Answer 19

Describe the fracture. Which bone? Right radius Which part of the bone? Distal or metaphysis Which type of fracture? Transverse **Distal transverse fracture of the right radius**