Radiographs - need to re-format since import from StudyBlue Flashcards Preview

risk of complication from infection

a fracture as a result of compression. Often found in the vertebral bodies

Impacted fracture in which the periosteum is bulging; also known as a buckle fracture

Separation of a bone fragment from its cortex at an attachment of a ligament or tendon

involves the joint surface of a bone

Fracture involving the epiphyseal plate

1. Transverse 2. Oblique 3. Spiral 4. Compression 5. torus 6. Comminuted 7. Avulsion 8. Intra-articular 9. Epiphyseal

1. Translated 2. Angulated 3. Rotated 4. Distracted 5. Overriding 6. Impacted

1. twisting 2. Tortional 3. rotational

1. Impacted 2. Crush

Buckle fracture

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Type I: straight across through physis Type II: above (through metaphysis) Type III: lower (through epiphysis and into joint) IV: through all (metaphysis, physis, and epiphysis) V: erasure of growth plate (crush injury)

Type 1: through physeal place Type II: Physeal fracture that extends through metaphysis Type III: Physeal frature that extends through epiphysis Type IV: physeal plate plus epiphysis and metaphysis Type V: compression fracture of growth plate

"Prison Makes Every Boy Cry" - ALL of these somehow penetrate through to the articular space, i.e., there is joint involvement.  III-V threat to growth I: Physis II: Metaphysis III: Epiphysis IV: Both V: Crush

1. Angulation 2. Displacement or Dislocated (displaced/non-displaced) 3. Shortened 4. Rotation

1. 1. naming of fractures is almost always a combination of terms 2. Many typical fractures are named for people 3. Radiographs don't lie! 4. one view is no view! 5. know when to seek assistance!

1. Normal - early (

outer, hard, compact bone, cortical outline

1. In radiology, a region in an image caused by an absorber of lower x-ray attenuation than its surrounding tissues; in general, the opposite of opacity.

1. first, do no harm 2. base treatment on accurate diagnosis & prognosis 3. Select treatments with specific aims 4. Cooperate with the "laws of nature" 5. make treatments realistic and practical 6. select treatment for the individual patient

1. relieve pain 2. obtain and maintain satisfactory position of the fragments 3. allow, and if necessary, encourage bony union to restore optimum function

1. Protection alone (no reduction or immobilization) 2. Immobilization alone, external splint (w/o reduction) 3. Closed reduction by manipulation --> immobilization 4. Closed reduction by continuous traction  --> immob. 5. Closed reduction --> functional bracing 6. Closed reduction by manip --> external skel. fixation 7. Closed reduction by manip --> internal skel. fixation 8. Open reduction --> internal skeletal fixation

return of a fractured bone to a normal position; may be closed (not requiring surgery) or open (requiring surgery)

1. Fracture hematoma 2. Osteogenic cells form external callus 3. Endosteum forms internal callus 4. Fracture callus - clinical union - biological glue 5. Radiographic union 6. Wolff's law

when the cartilaginous callus is replaced by woven bone(hard callus) via endochondral ossification

A law of bone states that the architecture of bone is determined by mechanical stresses placed on it and the bone's adaptation to withstand those stresses.

1. skin injuries 2. neuro-vascular triad injuries 3. muscular injuries 4. other injuries from trauma 5. remote injuries 6. hemorrhagic shock

* Stress fracture of the anterior tibia. * most be non-weight bearing to heal * DON'T ever miss it * Can lead to major fracture of Tibia

CT scan (Computed Tomography)

Injury on the opposite side of where there is an obvious injury. IMPORTANT

Kids who have ophen physis

Type I: transverse fracture through physis * Looks normal but there is swelling and pain * Palpate right over physis & it is extremely painful there * make assumption that they have type I * Will not show on radiograph

Type II: Same as type I but also up into the metaphysis (the bone) * Will show on radiograph

Type III: Intra physis goes into epiphysis, * Bad news * Effects chrondral surfaces * Chrondral surfaces do not heal and this is almost always the first step to OA * Can cause deformities when half of the physis grows and the other doesn't

Type III salter-harris fracture. intra physis fracture goes into epiphysis

Type IV: Metaphisis, physis, & metaphysis * Big issues

Type V: Compaction * Compresses that area * Commonly leads to cessation of the growth plate on injured limb * Compression/crush injury

1. skin necrosis 2. compartment syndrome 3. joint infections 4. osteomyelitis 5. avascular necrosis

1. Fat embolism 2. Pulmonary embolism 3. pneumonia 4. tetanus

bone marrow and other fatty intraosseous tissue enter the circulation as a result from severe fractures

1. Joint stiffness 2. post-traumatic DJD 3. Abnormal fracture healing 4. Growth disturbances 5. Chronic osteomyelitis 6. Post-traumatic osteoporosis (related to Wolff's law) 7. Post-traumatic myositis ossificans 8. Tendon ruptures 9. RSD/CRPS (complex regional pain syndrome)

Reflex Sympathetic Dystrophy, or Complex Regional Pain Syndrome sympathetic nervous system is in "overdrive", sustains neuropathic pain

1. Mal-union 2. Delayed union 3. Fibrous union (pseudoarthrosis) 4. Non-union

bone formation within muscle

- Direct bone infection - Often through blood, injury, or adjacent soft tissue infection - Staph, - Salmonella (increased risk with sickle cell disease), - Tuberculosis (in spine first) - Syphilis can cause (rarely)

Unsatisfactory position with residual bony deformity

fracture may eventually heal but takes longer than normally expected time frame

also called pseudoarthrosis soft tissue healing

fracture may fail to completely heal by bony union

1. Radiographs 2. Fluroscopy 3. Video Fluroscopy 4. Bone Scans (scintigraphy) 5. Ultrasonography 6. Computed Tomography (CTs) 7. Magnetic Resonance Imaging (MRIs/MRAs)

* x-ray in real time

1. Fracture fixation 2. arthrography 3. myelography 4. discography 5. biopsy 6. gastrointestial evaluation

-immobilization to maintain realignment of the fracture site... -traction, fixation (pinning/immobilizer), casts

study of the spinal column after injecting opaque contrast material

Special x-ray technique for examining a body part by immediate projection onto a fluorescent screen in real time. Can be called video fluroscopy

scintigraphy

* Nuclear imaging test that Helps to diagnose and track bone disease * Diagnose unexplained skeletal pain that's undetectable on an X-ray by showing increased blood flow. very useful in Dx of sublte fractures * MOSTLY REPLACED by MRI * Very sensitive, but NOT specific * can't figure out what is going on there. * called stress reaction

- used in both PT research AND treatment - assesses muscle behavior and - treats pts (muscluloskeletal imaging --> biofeedback) Advantages: ease of access, portability, pt tolerance, real-time imaging Good validity & riliability Disadvantage : hard to interpret!!

Axial imaging with ability to reformat to any plane GOLD STANDARD for BONE IMAGING (do radiograph first, then gold standard CT if indicated)

inject dye into joint capsule and to CT to see if it leaks

* Gold Standard for Soft Tissue imaging * Expensive (MRAs most expensive) * Two Types * Type T1: Weighted (bright) image is fat, water dark * Type T2 Weighted image (bright) is water

* Type T1: Weighted (bright) image is fat, water dark * Best for anatomic structure Type T2 Weighted image (bright) is water * Best for contrasting normal and abnormal tissue.

magnetic resonance angiography (shows vessels) Increases sensitivity and specificity of the imagaing technique Use contrast dye

Water CSF Acute Hemorrhage (blood) soft tissue tumors (blood)

1. Expensive 2. subject to artifact from metal 3. can cause shifting of metal/foreign objects in eyes/brain 4. can interfere with pacemakers 5. clausterphobia (10% pts can't tolerate)