Flashcards in Ortho Deck (59)
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1
chondral fracture
articular cartilage
2
transchondral fracture
bone and transverse the articular cartilage
3
osteochondral fracture
both the bone and articular cartilage
4
3 aspects of displacement
Translation
Angulation
Rotation
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Translation
draw line down center of bone - not continuous at the fracture site
direction of translation of distal fragment compared to proximal
described as %
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Angulation
line drawn down center of bone angled at fracture
direction of angulation of distal fragment compared to proximal
described in degrees
7
Rotation
turning of the distal fracture fragment in relation to proximal portion
orientation of joints above and below fracture
8
Distraction
fractures seperated by a gap with no overlap
common in transverse fractures from a tension force- pulls or stretches two objects apart
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Dislocation
joint out of articular capsule
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Subluxation
joint goes out of capsule but comes back in
11
Impaction
wedged into each other
stable fracture
12
Avulsion
Caused by abnormal tensile stress on ligaments or tendons
Typical locations - hands, feet, pelvis
13
Transverse Fracture
perpendicular to the long axis of the bone
commonly from direct force, or tension force
common in forearm/leg - often stable
14
Oblique Fracture
Commonly Indirect force
compression + angulation = shear force
Inherently unstable, repaired in OR
15
Spiral Fracture
twisting movement through the long bone axis
rotations/shear force
inherently unstable, repaired in OR
very uncommon
16
Comminuted Fracture
> 2 fracture fragments
unstable, repaired in OR
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Minimal Comminuted Fracture
small fx fragments next to larger fx line
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Moderate to Severe Comminuted Fracture
several large fx fragments
19
Butterfly Fragment
indirect force
bending of the bone with tension vector on the convex side and compression vector on the concave side
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Butterfly Fragment location on bone
produced along the concave, compression side
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Butterfly Fragment is subtype of which fracture
Comminuted fracture
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Greenstick Fracture
Incomplete fracture of long bone
bending force applied perpendicular to shaft
Incomplete fracture on convex cortex, concave cortex becomes bent, but without visible crack
23
Buckle Fracture =
Torus Fracture
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Buckle Fracture
incomplete fracture
metaphyseal diaphyseal junction after FOOSH
Very stable
25
AC joint
AP w/ weights
AP w/o weights
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Chest
PA
Lateral (full inspiration)
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Clavicle
AP
Axial (20 degree cephalad AKA tube tilted 20 degrees towards head)
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Humerus
AP
Lateral
Possibly Grashey
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Ribs
AP
Oblique
- upper ribs: inspiration
- lower ribs: expiration
30
SC Joint
AP
Oblique (bilateral)
31
Proximal Humerus Fracture
Unstable
ORIF
Anterior dislocation is most common
32
Elbow
AP
External
Oblique
Lateral
33
Fingers
AP
Oblique of hand
Lateral of effected finger
34
Hand
AP
Oblique
Lateral
35
Thumb
AP
Oblique
lateral
36
Wrist
AP
Oblique
37
Forearm
AP
Lateral
38
Radial Head Fracture
Note anterior fat pad sign
39
Nightstick Fracture
direct force of forearm
protective injury
40
Colles Fracture
Common of distal radius
Result of FOOSH
Extra-articular
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Metacarpal Fracuter
10% of all fractures, 40% of had fractures
5th metacarpal - 25% of all metacarpal fxs
usu direct trauma, can be indirect
42
Hip
AP pelvis
Frog lateral (legs in diamond while laying down)
43
Ankle
Ap
Mortise (internal rotation of leg 15/20 degree, intermalleolar line parallel to detector
Lateral
44
Femur
AP
Lateral
45
Foot
AP
Oblique
Lateral
46
Knee
< 40 y/o
-AP
-Lateral
-Tunnel
- Sunrise
> 40 y/o
- PA, bilateral, weight bearing (AKA30 degree PA flexed view)
- Bilateral tunnel
-Bilateral sunrise
- lateral affected knee
47
Tib-Fib
AP
Lateral
48
Heel
Axial
Lateral Calcaneus
49
CT > X-ray
subtle fractures
articular extension of fracture
presence of articular step-off/gap
50
MRI
soft tissue eval
Diagnosis of occult fractures
Associated ligament or articular cartilage injury
Modality of choice:
- disc herniation
- internal derangement of joints
51
Ultrasound
trauma - assess soft tissue injury
52
Bone Scan
metastases
Stress fractures
insufficiency fractures
53
Four rotator cuff muscles
Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
54
Suprspinatus
initiates and acts throughout abduction cycle
most commonly torn
55
Infraspinatus
ER with arm in neutral
56
Teres minor
ER in 90 degrees of abduction
57
Subscapularis
main internal rotator of the shoulder
58
Proximal Humerus Blood Supply
2 branches of the axillary artery
- anterior humeral circumflex artery
- posterior humeral circumflex artery
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