DI Mod 4

Closed fracture
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Terms in this set (130)
Closed fracture
Image: Closed fracture
Open fracture
Image: Open fracture
Simple fracture
Image: Simple fracture
Comminuted fracture
Image: Comminuted fracture
Avulsion fracture
Image: Avulsion fracture
Impaction fracture
Image: Impaction fracture
Complete fracture
Image: Complete fracture
Incomplete fracture (Greenstick)
Image: Incomplete fracture (Greenstick)
Incomplete fracture (Torus/buckling)
Image: Incomplete fracture (Torus/buckling)
Stress fracture
Image: Stress fracture
Salter Harris fracture (type I-V)Most common is Type II at 75%Rotator cuff tearTendonitis & BursitisT: Fluid in tendon sheath or tendon B: fluid in bursaClavicle fractureProximal: hard to see, least common Middle: MC (80%) Distal: 15%Scapular fractureMost go through body, usually requires a direct blow severe trauma.Anterior shoulder dislocation (95%)Hill Sach (60%) & Bankart (5%) deformityFlip fracturePosterior shoulder dislocation (trough sign)Inferior Shoulder DislocationGrade 1 AC joint sprain (mild)AC leg stretches, not visible on x-rayGrade 2 AC joint sprain (moderate)Will see slight clavicle elevation on x-ray.Grade 3 AC joint sprain (severe)Wide AC joint, elevated distal clavicle.Surgical neck fx of the Humerus (FOOSH)NOT a flap fractureElbow trauma (FOOSH):MC in child: Supracondylar fx MC in adult: radial head fxSupracondylar fracture (Humerus)common in kidsIntracondylar fracture (Humerus)50% of distal humerus fx in adultsEpicondylar fracture (Humerus)Usually in adolescent athletes (common in baseball)Olecranon fracture (proximal ulna)20% of adult elbow fx.Coronoid fracture (proximal ulna)Chisel fracture (proximal radius)MC in adult elbow injuryRadial neck fractureNightstick fractureMonteggia fractureGaleazzi fractureNursemaids elbow (pulled elbow)Posterior or Posterolateral Elbow dislocationSail signColles Fracture - distal radiusSmith's FxChauffers fxUlnar styloid fxScaphoid fxTriquetrum fxLunate dislocationPerilunate DislocationScaphoid DislocationMetacarpals: Boxers fxMetacarpals: Barroom fx1st Metacarpal: Bennett's Fx1st Metacarpal: Rolando FxPhalange Fx: Mallet FingerPhalangeal Dislocation: Gamekeeper's thumbProximal femoral neck fxProximal hip fractures:Sub Trochanteric Stress FxSubtrochanteric Stress Fx - complete FxFemoral shaft fxPosterior Hip DislocationAnterior Hip DislocationCentral Hip dislocationSlipped Capital Femoral Eiphysis3 pelvic rings -> if fx in one, look for another fxPelvic inlet, obturator foramen (x2)Unstable pelvic trauma:fx disrupts pelvic ring (look for other fractures)Iliac Wing: Duverney'sAvulsionASIS avulsion:Ischial tuberosity avulsion:Saddle Fracture:Pelvic Ring Fracture: MalgaignePelvic Ring Fracture: Pubic DiastasisPelvis Dislocation: Sprung Pelvis or Open BookSacrum Fx: Fx in Arcuate LineHonda SignOttawa knee rule - when to x-ray- >55 - Tenderness on patella or fibular head - Unable to flex to 90 - Unable to take 4 steps immediately and in officeDistal Femur: Supracondylar FxPatella FractureTibial Plateau Fx - Bumper or Fender FxFBI Sign - Fat/Blood InterfaceSegond FractureTibial Spine AvulsionProximal Tibia: Trampoline FracturePelligrini SteidaProximal Fibular FracturePatella DislocationOsgood Schlatter'sDerangement of Knee - ligament injuriesOttawa X-Ray Rule:- pain and tenderness in malleolar zone ankle xray - pain and tenderness in midfoot and tenderness at navicular or base of 5th metatarsal foot xray - pain and unable to weight bear immediately and in officeMalleolus FxLateral, medial, posterior malleolus fxMaisonneuve's FractureTillaux'sToddler's FractureAnkle DislocationCalcaneus: Compression/Lover's FractureCalcaneus Avulsion FractureAchilles Fat Pad - Kagers Fat PadLisfrancs fracture/dislocationJones (Dancer's)Chopart'sMarching FractureOsteochondritis DissecansCanadian C-Spine Rules: High risk factors -> image>65, dangerous mechanism, sensory lossCanadian C-Spine Rules: Low Risk Factors -> no to any of these -> imageo Simple rearend MVC o Sitting position in ED o Ambulatory at any times o Delayed onset of neck pina o Absence of midline c-spine tendernessImage if:Unable to rotate neck 45 degrees left and rightLateral Cervical View Xray:- detects 90% of fractures, use CT if you suspect fx and can't see it, use MRI if near deficit or bone bruise/ligament injury is suspectedInstability Signs on Lateral cervical Image:- 3.5 mm horizontal translation of 1 segment over another - 11 deg + of angular deformity b/w two adjacent segmentsFlexion injuries:Compression Fx, Teardrop, Facet dislocation, Clay ShovellersJefferson's Fracture:Type 2 odontoid fracture:Type 3 odontoid fracture:Teardrop fracture:Burst fracture:Compression/Wedge FractureUnilateral Facet DislocationBilateral Facet DislocationClay Shoveler's FractureExtension injuries:Hangman's, teardropHangman's fracture:Teardrop fractureInstability Signs on Lateral View:· Acute local kyphosis · Disruption of George's Line · Disruption of Post cervical line · Gapping of facets · Fanning of SP'sSternal Fracture:Rib Fracture:Adynamic (paralytic) ileus:- Excess bowl gas centrally over lumbar spine b/c of loss of peristalsis in gut - assume more significant trauma, find the fracturCompression Fracture:Burst fracture:Seat-belt (Chance) fracture:Fracture Dislocation:TVP Fracture:Posterior Limbus Bone: