Professional Documents
Culture Documents
Lindsay Gould
July 2006
JEFFERSON FRACTURE
Fracture of C1 ring Axial loading injury with compression force to C1 Unilateral or bilateral fractures of anterior and posterior arches of C1
CLAY-SHOVELERS FX
Avulsion fracture of spinous process of C7 or T1 Sudden load on flexed spine
HANGMANS FRACTURE
Bilateral pedicle or pars fractures involving C2 vertebral body A/w anterior subluxation or dislocation of C2 vertebral body Severe extension injury (MVC causing head to hit dashboard, hanging)
CLAVICULAR FRACTURE
Extremely common Does not completely ossify until late teens Fall on outstretched hand, fall onto outside of shoulder, direct hit to clavicle Treatment: Figure-of-8 sling; No activities that exacerbate pain; full recovery in 12 weeks.
SCAPULAR FRACTURE
Uncommon Scapular body fx are the MC type Commonly (80-90%) associated with other injuries lung and chest Dont require surgery GLENOID (cartilage) fracture requires surgery when unstable or fragments are far out of alignment
HUMERUS FRACTURE
Proximal occur near the shoulder joint; treatment depends on rotator cuff tendon position Mid-shaft Injury to radial nerve causes wrist drop and numbness of the hand dorsum Distal are uncommon in adults; often require surgery Most heal without surgery Over 90% with nerve injury have complete recovery of nerve in 3-4 months
HOLSTEIN-LEWIS FRACTURE
Distal third humeral fracture 18% are associated with radial nerve palsy, particularly if break is between middle and distal thirds of humerus Due to direct blow or torsion injury Competitors in throwing events
ULNAR FRACTURE
Forearm is struck by an object Nightstick Fracture
MONTEGGIA FRACTURE
Giovanni Monteggia 1814 Fracture of Ulna Dislocation of radial head within the elbow joint
Treatment: Surgery
RADIAL HEAD
Most common part broken in elbow fracture MC caused by fall onto outstretched hand +/- surgery depending on displacement
GALEAZZI FRACTURE
Fracture of Radius Injury of the distal radio-ulnar joint of wrist (shortening and dislocation of distal ulna) Mechanism: fall on outstretched hand with elbow flexed Treatment: Surgery to repair radius, then inspection of distal radio-ulnar joint
NURSEMAIDS ELBOW
Common in young children (< 5 yo) Subluxation of radius at elbow joint -bone has slid out of proper position Classically a sudden pull on childs arm Present with arm flexed a/g body If treated (replaced) quickly, immobilization is not necessary For multiple subluxations, cast to allow ligaments to heal
SMITHS FRACTURE
Fracture of radius near the wrist joint Displaced anteriorly (in front of normal position) MC found after falling on to the back of the hand
COLLES FRACTURE
Fracture of radius Displaced posteriorly (behind normal position) MC after fall onto outstretched hand Treatment: Cast +/- surgery, depending on shortening and displacement of radius
SCAPHOID BONE FX
Scaphoid sits below the thumb; shaped like a kidney bean Retrograde blood supply Many are misdiagnosed as sprain May not show up on xray until healing begins (may immobilize empirically and repeat xray in 1-2 wks) May cast for trial period with routine xrays Total healing time of 10-12 weeks
BOXERS FRACTURE
Classically at the base of 5th metacarpal (metacarpal neck) Seen after punching person or object Commonly a bump over the back of palm just below the small finger knuckle; may not go away even with treatment Treatment: casting or surgery (pins)
BENNETTS FRACTURE
Intra-articular fracture/dislocation of base of 1st metacarpal Small palmar fragment continues to articulate with trapezium Mechanism: forced abduction of thumb
ROLANDO FRACTURE
Fracture through thumb metacarpal base Comminuted intraarticular fracture
Prognosis is worse than Bennetts Treatment: open reduction and internal fixation
INTERTROCHANTERIC HIP FX
Occurs lower than femoral neck fracture Bone blood flow is usually intact, so repair, not replacement is performed Treatment: Metal plate and screws
FEMORAL SHAFT FX
Severe injury Treatment: Intramedullary rod (MC), plate and screws, or external fixator
SUPRACONDYLAR FEMUR FX
Unusual injury just above knee joint High risk of knee arthritis later More common in pts with severe osteoporosis and those with previous knee replacement surgery
PATELLAR FRACTURE
Fall onto kneecap or when quadriceps is contracting, but knee joint is straightening (eccentric contraction) Attempt straight leg raise
yes? Non-operative treatment may be possible no? surgery combo of pins, screws, and wires
Treatment: If non-displaced, may be treated without surgery. Surgery for displaced fractures
POTTS FRACTURE
Fracture of the lower end of fibula with displacement of tibia Causes the foot to turn out
TALUS FRACTURE
Complications: Ankle arthritis Subtalar arthritis Foot deformity Avascular necrosis
CALCANEUS FRACTURE
Fall from heights or MVC Like an orange if you stand on it, the calcaneus widens and squashes flat Inversion and eversion are affected (subtalar joint b/w talus and calcaneus)
Avulsion (Dancers)
Jones fracture
TORUS FRACTURE
Buckle fracture Compression fracture of a long bone, mostly in children; usually occurs near metaphysis Better seen on lateral films Distal radius is most common site Treatment: well-fitting immobilizing cast for 2-4 weeks
GREENSTICK FRACTURE
Usually from a quick twisting motion occompanied by axial compression such as a fall backwards on the outstretched hand Supinated twist palmar angulation Pronated twist dorsal angulation No disruption of cortex; may have buckling on opposite side of bone from the break; incomplete break
THE END
(FINALLY!!!!)