Lecture 3: Radiographic Evolution of Fx 3 (LE)

Hip

Hip: Proximal Femur Fx

• Average Age:

• Gender:

• MOI:

• 2 Types:

• Age:

  • 77 yrs

• Gender:

  • Females w Osteoporosis

• MOI:

  • Falls

    • Normal stress on an abnormal bone

    • Risk of fx at femoral head

• 2:

  • Intracapsular

  • Extracapsular

Hip: Proimal Femur Fx

• What is the difference between…

  • Intracapsular and Extracapsular Fx

• Intra:

  • Concerned w Blood Supply

    • Can lean to Avascular Necrosis

• Extra:

  • Not as concerned w Blood Supply

What type of fx is this?

Intracapsular Fx

Hip: Slipped Femoral Capital Epiphysis

• MC Pop:

• Occurs where?

• What does the pt complain of? (3)

• Pop:

  • Adolescents

  • 2x more often in boys

• Where:

  • Weakened epiphyseal plat

• C/O

  • Vague hip or knee pain (3 months)

  • Limited ROM

  • Leg Length Discrepancy

Knee

Knee: Distal Femoral Fx

• What are the 6 classifications of Distal Femoral Fx?

• Non displaced

• Impacted

• Displaced

• Comminuted

• Condylar

• Intercondylar

Name these fractures:

• 1

• 2

• 3

• 4

• 1: Non-Displaced

  • Fairly aligned well

• 2: Impacted Fx

  • Force from above causing impact

  • MOI: Jumping

• 3: Displacement

  • Ant Direction

• 4: Comminuted

  • Multiple Fx Sites

Name thes fractures:

• 5:

• 6:

• 5: Condylar

• 6: Intercondylar

Knee: Salter Harris Fx

• What type of fx is this?

• This type of fx is unique to what population?

• Where can this fx occur?

• What:

  • Fx involving the growth plate

• Pop:

  • Peds

• Occur:

  • Anywhere there is a growth plate

    • Long Bones

Knee: Salter Harris Fx

• What are the 5 types of Salter Harris Fx?

Knee: Proximal Tibial Fx

• Where does this fx mostly occur?

• How does this fx occur?

• MOI?

• __ Fx

• Where:

  • Medial and Lateral Plateaus

• How:

  • Varus and Valgus stresses w loading from the femur above

• MOI:

  • Car Pedestrian Accident

• Stress Fx

Knee: Tibial Plateau Fx

• Describe the 6 types of Tibial Plateau Fx utilizing the Hohl Classification System:

Knee: Tibial Plateau Fx

• What type Tibial Plateau Fx are these:

  • 1

  • 2

• 1:

  • Type 1

• 2:

  • Type 6

Patella

Patella Fx:

• What are the 2 main forms of Injury?

• Patellar fx is described by what? (2)

• MOI:

  • Falls

  • Dashboard Impact

• Described

  • Direction of Fx

  • Displaced or Not

Patellar Fx:

• What type of Patellar Fx are these?

Avulsion Fx of the Patella

» Flip «

Transverse Displaced

Ankle

Ankle: Malleolar Fx

• What are the 3 Anatomical Classification of Ankle Fx:

• Unimalleolar

  • Medial OR Lateral Melleolus

• Bimalleolar

  • Bilateral Malleolus

• Trimalleolar

  • Includes Fx of Posterior Rim of the Tibia

What type of Ankle Malleolar fx is this?

Trimalleolar Fx

What type of Ankle Malleolar Fx is this?

Bimalleolar Fx

Ankle: Malleolar Fx

• MC seen in the clinic following what?

• What should the PT acquire?

• What should the PT assess for? (3)

• Seen:

  • Following ORIF

• ACQUIRE THE FILM

• Assess:

  • Mortise Integrity

  • Expectation of ROM

  • WB

Ankle: Malleolar Fx

• What are Expectations for ROM? (3)

• DF Limited

• Difficulty w getting back to normal gait

• Stressed placed more distally

  • More stress on the MTP and Midfoot

In this Ankle Malleolar Fx, what is surrounding the screw?

• Why occurring?

• Sclerotic Bone

  • Why:

    • Due to screw moving too much

    • Pt may be too active

What is occurring at the blue arrow?

Stress Fx