S1_L3: Fracture & Elements of Fracture Description

Question 1

Modified TF
A. In a closed fracture, the skin and soft tissue overlying the fracture is intact.
B. In an open fracture, the skin is perforated and the bone is visible.

Answer 1

TT

Note: For open fractures, the fracture must be in proximity with the open injury.

Question 2

Modified TF
A. Subluxations and dislocations are the most common associated injuries with fractures.
B. Pathological Fractures occur in bones strengthened by a pathological process.

Answer 2

TF

B: Pathological Fractures occur in bones weakened by a pathological process.

Question 3

Modified TF
A. Segmental fractures are classified under spiral fractures.
B. Segmental fractures are segmented by more than one fracture line.

Answer 3

FT

A: classified under comminuted fx

Question 4

Modified TF
A. Naming the displacement or angulation of the fracture is based on the position of the proximal fragment.
B. Alignment is the relationship of the longitudinal axis of one fragment to the other.

Answer 4

FT

A: based on the position of the distal fragment

Question 5

Modified TF: Angulation of fx fragments
A. A dorsal or volar apex is seen in the anteroposterior view.
B. A medial or lateral apex is seen in both the lateral and anteroposterior view.

Answer 5

FF

A: seen laterally
B: in AP view only

Question 6

Special features

1. Only one side of the bone is impacted
2. Involves bony prominences serving as attachment of muscles, tendons and ligaments

A. Impaction fracture
B. Depression fracture
C. Compression fracture
D. Avulsion fracture

Answer 6

1. B
2. D

Question 7

Special features

1. Tensile loading of bone
2. Compression and axial loading of bone

A. Impaction fracture
B. Depression fracture
C. Compression fracture
D. Avulsion fracture

Answer 7

1. D
2. A

Question 8

Special features

A spinal fracture where the superior and inferior endplates are driven into the vertebral body. This fracture falls under:

A. Impaction fracture
B. Depression fracture
C. Compression fracture
D. Avulsion fracture

Answer 8

C. Compression fracture

Question 9

Special features

1. Bone has a stable configuration and good healing potential
2. Bone is driven into itself

A. Impaction fracture
B. Depression fracture
C. Compression fracture
D. Avulsion fracture

Answer 9

1. A
2. A

Question 10

Special features

1. Fragments pulled away by contraction of the muscle or passive resistance of ligaments against tensile forces
2. Usually occurs in cancellous bone

A. Impaction fracture
B. Depression fracture
C. Compression fracture
D. Avulsion fracture

Answer 10

1. D
2. A

Question 11

Special features

1. Described by anatomic landmarks
2. Compression on both sides of the bone

A. Impaction fracture
B. Depression fracture
C. Compression fracture
D. Avulsion fracture

Answer 11

1. D
2. C

Question 12

Special features

A skull fracture is assessed and findings show the outer table of the skull is disrupted, but the inner table is intact.

A. Impaction fracture
B. Depression fracture
C. Compression fracture
D. Avulsion fracture

Answer 12

B. Depression fracture

Question 13

Modified TF
A. An incomplete fracture is commonly seen in pediatric patients.
B. A comminuted fracture is an example of a complete fracture.

Answer 13

TT

Question 14

Modified TF
A. Incomplete fractures are relatively stable, and are usually occur in short, irregularly shaped, and flat bones.
B. A complete fracture may be diagnosed using only one view.

Answer 14

TF

B: it may NOT because bones typically have 2 cortices in 1 view. In the AP and Lateral views, all cortices may be evaluated.

Question 15

Modified TF
A. Fracture lines are evident on X-ray as radiolucent.
B. The space between fracture segments depends on the amount of displacement.

Answer 15

TT

Note: More displacement leads to more space.

Question 16

Modified TF
A. Periprosthetic fractures are a special type of fracture associated with orthotic joint replacement.
B. These fractures are usually related to metal implants, such as in THR, due to mismatched hardness or rigidity between the implant and bone, known as the stress riser effect.

Answer 16

TT

Note: if screws are involved, it is termed as peri-implant fracture

Question 17

Modified TF
A. More than 3 fragments are present in comminuted fractures.
B. Comminuted fractures occur due to extremely low energy loads, such as crushing forces in MVA.

Answer 17

FF

A: more than 2 fragments
B: dt extremely high loads

Question 18

Modified TF
A. The more surface area is involved in a fracture, the less its healing potential due to its big surface area.
B. A spiral fracture has a better healing potential than transverse or oblique fractures.

Answer 18

FT

A: more surface area = better healing potential (because of bigger surface area = more fx healing points)

Question 19

Modified TF
A. A butterfly fragment is a diamond-shaped fragment split from the main fragments in a comminuted fracture.
B. The butterfly fragment is a result of compression and bending in a high level injury.

Answer 19

FT

A: it is a triangular wedge-shaped fragment

Question 20

Modified TF
A. A transverse fracture occurs with a diagonally oriented fracture line.
B. An oblique fracture occurs at right angles to a long axis or cortices.

Answer 20

FF

A: Oblique fx
B: Transverse fx

Question 21

Modified TF
A. An oblique fracture is caused by combined compression, bending, and torsional forces.
B. A spiral fracture is caused by a torsional force.

Answer 21

TT

Question 22

Modified TF
A. In an incomplete fracture, all cortices have been disrupted.
B. In a complete fracture, only one cortex is disrupted.

Answer 22

FF

A: complete fx
B: incomplete fx

Question 23

Modified TF
A. Depression fracture occurs due to one surface of a bone is driven into the surface of another
B. In an avulsion fracture, both surfaces of a bone are forced together.

Answer 23

TF

B: Compression fracture occurs when both surfaces of a bone are forced together

Question 24

TRUE OR FALSE: A fracture is the disruption of the structural continuity of bone or cartilage.

Answer 24

True, the bone or cartilage is ripped off from its original position.

Question 25

Modified TF: Displacement of fx fragments A. Anterior and posterior displacements are seen on the lateral view. B. Superior and inferior displacements are seen in the anteroposterior or lateral view.

Answer 25

TT

Question 26

TRUE OR FALSE: Fracture lines in the transverse direction are perpendicular to the longitudinal axis, through the shaft of the bone.

Answer 26

True

Question 27

Modified TF A. Stress fractures include microfractures, fatigue fractures, and insufficiency fractures. B. On the x-ray film, the stress fracture may appear normal.

Answer 27

TT Note: Initially, the x-ray is (-), but when taken again, callus formation can be seen as an attempt of the bone to heal the stress fx.

Question 28

Modified TF A. Displacement is the loss of apposition or contact. B. Angulation is deviation from the displacement.

Answer 28

TF B: deviation from alignment

Question 29

Modified TF A. Medial or lateral displacement is seen on anteroposterior view. B. Superior or inferior apex of angulation is seen in both lateral and AP views.

Answer 29

TT

Question 30

TRUE OR FALSE: Bones may be described & referenced by standard anatomic landmarks.

Answer 30

True

Question 31

Modified TF A. MRI is the recommended diagnostic modality for early detection of stress fractures of the extremities. B. The MRI will be done using T1 weighted imaging.

Answer 31

TF B: T2

Question 32

TRUE OR FALSE: In a stress fracture, the fracture line or periosteal reaction may not be evident for up to 8 weeks.

Answer 32

False: may not be evident for up to 6 weeks.

Question 33

TRUE OR FALSE: A stress fracture is described as an irregular localized area of decreased radiodensity on x-ray.

Answer 33

False, it's increased radiodensity

Question 34

Modified TF A. An example of a stress fracture is a radioulnar fracture due to osteomyelitis. B. Stress fractures can be due to repetitive minor trauma to otherwise normal bone.

Answer 34

FT A: it's pathological fracture

Question 35

Modified TF A. Stress fractures caused by repetitive minor trauma frequently occur in the LE, especially the tarsals. B. This type of stress fractures is very common in soldiers and gymnasts.

Answer 35

FT A: frequently occur in the LE, especially the metatarsals

Question 36

TRUE OR FALSE: Stress fractures can be caused by normal loading on abnormal bone, such as vertebral compression fracture in elderly osteoporotic women.

Answer 36

True

Question 37

Modified TF: Pathological fractures A. Can be caused by local processes such as osteogenesis imperfecta, osteopetrosis, osteoporosis, and Paget’s disease. B. Can be caused by systemic processes such as tumors, infections, disuse, and irradiation.

Answer 37

FF A: These are systemic processes B. These are local processes

Question 38

Modified TF: Distal end of long bones A. The intra-articular area consists of the joint space B. The extra-articular area has a presence of bone flaring

Answer 38

TT

Question 39

Modified TF A. The diaphysis is the shaft of a long bone. B. The epiphysis is the distal or proximal ends of long bone.

Answer 39

TT

Question 40

TRUE OR FALSE: The extra-articular part of the proximal end of long bones consists of the metaphyseal area and expanding end of the shaft.

Answer 40

True