Introduction to Trauma

Question 1

What is a complete or incomplete disruption in continuity and structure of the bone and/or cartilage?

Answer 1

Fracture

Question 2

What type of force is cortical bone the strongest with?

Answer 2

Compression

Question 3

What type of force is cortical bone most vulnerable to?

Answer 3

Shearing forces

Question 4

What type of force is cortical bone less resilient to?

Answer 4

Distraction

Question 5

T/F: Fracture usually occurs as a combination of all 3-forces with one force being potentially more dominant than the others

Answer 5

True

Question 6

Will fractures always involve significant soft tissue damage?

Answer 6

Yes

Question 7

What type of fracture is caused by a bone weakened by local or systemic pathology?

Answer 7

Pathological fracture

Question 8

What is it called when Surgical pin holes or a site of bone resection weakens the bone?

Answer 8

stress raiser

Question 9

What type of incomplete fracture involves cortical buckling on compression?

Answer 9

Torus fracture

Question 10

What type of incomplete fracture involves incomplete fracture on tension?

Answer 10

Green-stick fracture

Question 11

What type of incomplete fracture involves bending of the bone without angular break and remodeling?

Answer 11

Plastic deformity

Question 12

What type of fracture involves a fragment of bone being detached by the tension from muscles or ligaments?

Answer 12

Avulsion fracture

Question 13

What type of fracture is a typically corner fracture that is chipped rather than avulsed?

Answer 13

Chipped fracture

Question 14

What type of fracture results in telescoping of osseous trabeculae. No typical radiolucent line is seen on radiographs and instead a zone of sclerosis or condensation may be present?

Answer 14

Impaction (compressed) fracture

Question 15

What type of fracture is typically in the calvaria (cranial vault) and occasionally in Tibial plateau?

Answer 15

Depression fracture

Question 16

What type of fracture involves repeated stress applied to normal bone leading to bone marrow hyperemia and bone resorption?

Answer 16

Stress (fatigue) fracture

Question 17

What type of fracture involves normal stresses i.e. normal weight bearing, walking applied to osteoporotic (involuted/insufficient) bone?

Answer 17

Insufficiency fracture

Question 18

What type of fracture results from a bone weakened by pathology such as neoplasms, infection, congenital defect of collagen etc.?

Answer 18

Pathological fracture

Question 19

What type of fracture involves 2 or more segments?

Answer 19

Comminuted fracture

Question 20

What type of Comminuted fracture creates 2 separate fracture lines producing an isolated segment of bone?

Answer 20

Segmental fracture

Question 21

What type of Comminuted fracture has a wedge-shaped fragment produced at the apex of the maximum force?

Answer 21

Butterfly fragment

Question 22

What type of fracture is when the skin is intact and no communication with the outside air present?

Answer 22

Closed fracture

Question 23

What type of fracture is when the skin is not intact and there is communication with the outside air present?

Answer 23

Open fracture

Question 24

What type of apposition involves overlap of one fragment over another?

Answer 24

Bayonet apposition

Question 25

What type of apposition involves complete loss of apposition d/t forced traction?

Answer 25

Distraction

Question 26

What type of alignment is away from midline in relation to the distal fragment?

Answer 26

Valgus

Question 27

What type of alignment is towards midline in relation to the distal fragment?

Answer 27

Varus

Question 28

What are the most vulnerable regions in the pediatric skeleton?

Answer 28

epiphyseal growth plate and growth apophysis

Question 29

What helps with the diagnosis, prognosis and treatment of growth plate injury?

Answer 29

Salter-Harris

Question 30

How many Salter-Harris types are there?

Answer 30

9 (but we only discuss 5 of them)

Question 31

What type of Salter-Harris fracture is through growth plate itself often unrecognized because of minimal displacement?

Answer 31

Salter-Harris 1

Question 32

What type of Salter-Harris fracture is the most common (>75%), fracture through physis and a part of metaphysis forming a Thurston-Holland fragment. Good healing prospects?

Answer 32

Salter-Harris 2

Question 33

What type of Salter-Harris is through the plate and into epiphysis?

Answer 33

Salter-Harris 3

Question 34

What type of Salter-Harris fracture traverses metaphysis, physis and into epiphysis?

Answer 34

Salter-Harris 4

Question 35

What type of Salter-Harris fracture is a crush injury to the growth plate, often unrecognized or confused with type 1 but essentially damages physeal blood supply?

Answer 35

Salter-Harris 5

Question 36

What Salter-Harris types show highest complications leading to premature plate closure, limb deformities, shortening and other sequela?

Answer 36

4 and 5

Question 37

What is a form of insufficiency fracture that develops | in bones with insufficient osteoid?

Answer 37

Pseudo-fracture

Question 38

What conditions is a Pseudo-fracture most commonly seen in?

Answer 38

Rickets and Osteomalacia

Question 39

How are the widened transverse radiolucent lines oriented in Pseudo-fractures?

Answer 39

Right angle to the medial cortex of long bones

Question 40

During injuries, what does cell damage create?

Answer 40

Bone Bruise (intra-osseous edema)

Question 41

What kind of fracture appears when injury and intra-osseous edema have occurred?

Answer 41

occult fracture

Question 42

What kind of fractures are due to a mismatch of bone strength and chronic mechanical stress placed upon the bone?

Answer 42

Stress fractures

Question 43

What kind of stress fracture is due to abnormal stresses on normal bone?

Answer 43

fatigue fracture

Question 44

What kind of stress fracture is due to normal stresses on abnormal bone?

Answer 44

insufficiency fracture

Question 45

What is a complete loss of articular contact/alignment with resultant injury to periarticular restraints?

Answer 45

Dislocation

Question 46

What is a partial loss of articular alignment?

Answer 46

Subluxation

Question 47

What is a separation of fibrous joints or fibrocartilagenous joints often seen at the sutures in the scull and symphysis pubis?

Answer 47

Diastasis

Question 48

What develops prior to closure of skull sutures (<3 y.o) as a result of tear in the dura followed by leptomeningeal and brain herniation with CSF pulsations?

Answer 48

leptomeningeal cyst (growing skull fracture)

Question 49

Is a leptomeningeal cyst a true cyst?

Answer 49

No

Question 50

What is the result from a traumatic disruption of bone and periosteum causing significant hemorrhage?

Answer 50

Fracture healing

Question 51

What are the three main stages of fracture healing?

Answer 51

Inflammatory (48 hours) Repair (7-14 days) Remodeling (9-24 months)

Question 52

Which phase is the shortest phase and causes hematoma and inflammatory mediators within first 48-hours initiate chemotaxis with phagocytes and repair cells being drawn to fracture site?

Answer 52

Inflammation

Question 53

Which phase has cells involved during initial inflammation will gradually begin to form granulation tissue and remove unwanted material and damaged cell. During this phase within 7-14 days hematoma becomes vascularised and may appear more translucent on x-rays?

Answer 53

Repair

Question 54

Which phase is when population of cells will sufficiently evolve into fibroblasts, chondrocytes and osteoblasts the osteoid and bone mineralization will continue for about 9-24 months?

Answer 54

Remodeling

Question 55

T/F: Fracture callus still remains very vulnerable to shearing forces but may be better stimulated if limited axial forces are applied

Answer 55

True

Question 56

T/F: pediatric fractures heal quicker

Answer 56

True