Exam 2 - Extremities trauma

What is the diagnosis?

Supraspinatus tear

What is the normal width of the AC joint?

• < 5mm

• Less than 2-3mm difference bilaterally

What term describes that direction and degree of angulation of the distal fragment relative to the proximal fragment?

Alignment

What is the diagnosis?

Salter type 1 fx of the distal radius

What is the diagnosis?

Slipped femoral capital epiphysis (SCFE)

• d/t repetitive trauma

What is meant by the term apposition?

Closeness of the bony contact at the fracture site

A Salter-Harris Type __ is the most common.

2

A fx of the posterior rim of the radius with associated carpal dislocation best seen on the lateral wrist x-ray is called a/an __.

Barton’s fx

An avulsion fx of the radial styloid could be called a/an __.

Hutchinson’s fx

Chauffeur’s fx

Backfire fx

List the distal row of carpals from lateral to medial.

Trapezium → Trapezoid → Capitate → Hamate

Which metacarpal does the capitate articulate with?

3rd

The __ is the most commonly fractured carpal.

Scaphoid

The most common location for a scaphoid fx is the __.

Waist region

The __ is the second most common carpal fx.

Triquetrum

__ represents the most common wrist dislocation.

Posterior perilunate dislocation

The “Pie sign” is associated with a/an __.

Anterior lunate dislocation

A widened space between the scaphoid and lunate could be called a/an __ sign.

Terry Thomas sign

A positive Terry Thomas sign, a foreshortened appearance of the scaphoid and a signet ring sign suggest a/an __.

Rotatory subluxation of the scaphoid

An avulsion fx of the dorsal aspect of the base of the distal phalanx of digit number two could be called a/an __.

Mallet finger

Baseball finger

An oblique intra-articular fx of the base of the first metacarpal associated with dorsal subluxation of the first metacarpal could be called a/an __ fracture.

Bennett’s fx

An intra-articular comminuted fx at the base of the 1st metacarpal could be called a/an __ fx.

Rolando’s fx

An avulsion fx at the insertion of the ulnar collateral ligament at the base of the proximal phalanx of the 1st digit could be called a/an __.

Skier’s thumb

Gamekeeper’s thumb

What is the first elbow ossification center to be visualized on a child elbow radiographs?

Capitulum

A transverse fx of the neck of the 4th metacarpal could be called a/an __.

Boxer’s fx

Barroom fx

What are the two types of incomplete fractures that could be seen primarily in children?

Greenstick/hickory stick fx

Torus fx

The radial capitellar line is noted passing through the center of the capitulum on the elbow radiographs. This is most likely __.

Normal

The anterior humeral line is noted passing through the anterior third of the capitulum on a child’s lateral elbow radiographs. This suggests a/an __.

Supracondylar fx of the distal humerus

What is the most common fx in the elbow of a child?

Supracondylar fx of the humerus

What is a sail sign?

Elevation of the anterior fat pad of the elbow

What is the order of ossification for the secondary growth centers of the elbow?

CRITOE

Capitulum → Radial head → medial (Internal) epicondyle → Trochlea → Olecranon → lateral (External) epicondyle

A fx of the distal radius with a dislocation of the distal radioulnar joint is called a/an __.

Galeazzi fx

Fx of the distal radius approximately 1 inch from the distal articular aspect of the radius with posterior angulation of the distal fragment is called a/an __.

Colles’ fx

What is the MC fx in the elbow of an adult?

Radial head and/or neck

List the proximal row of carpals from lateral to medial.

Scaphoid → Lunate → Triquetrum → Pisiform

Where is the pronator quadratus fat pad located?

Palmer aspect of the distal forearm

Where should a normal anterior humeral line intersect?

Middle 1/3 of the capitulum

What is the normal volar tilt of the distal radius?

10-15 degrees (true lateral view)

Where should a normal radial capitellar line intersect?

Middle of the capitulum (any view)

Where do you draw arc #2 on a PA wrist radiograph?

Distal articular surface of scaphoid, lunate, and triquetrum

What is the most common forearm fx in a child?

Torus fx

A fracture of the proximal ulna with an anterior dislocation of the radius is called a/an __.

Monteggia fx

What is a nightstick fx?

Fx of ulna

d/t direct trauma

Fx of the distal radius approximately one inch from the distal articular surface of the radius with anterior angulation of the distal fragment is called a/an __.

Smith’s fx

Elevation of the clavicle relative to the acromion process with a coracoid to clavicle distance measuring 12mm would indicate a __.

Grade 2 AC joint separation

Elevation of the clavicle relative to the acromion process with a coracoid to clavicle distance measuring 15mm would indicate a ___.

Grade 3 AC joint separation

Which Salter injuries are intra-articular?

Salter 3 & 4

A complete tear of the acromioclavicular ligament and an intact coracoclavicular ligament suggests a/an __.

Grade 2 AC joint separation

What is the normal coracoid to clavicle distance?

11-13mm

< 5mm difference left to right

A traumatic widening of the acromion process to clavicle distance without clavicle elevation indicates a __.

Grade 1 AC joint separation

Elevation of the clavicle relative to the acromion process with a normal coracoid to clavicle distance indicates a __.

Grade 2 AC joint separation

What is a shearing injury involving the physis (growth plate) called?

Salter type 1 fx

What is the normal width of the AC joint?

• > 5mm

• > 2mm difference left to right

What is the location for most clavicle fractures?

Middle third

What is a flap fx?

Avulsion fx of greater tuberosity

What is the most common type of Salter injury?

Type 2

What direction is the most common shoulder dislocation?

Anterior (97%)

What is a fracture that involves the epiphysis and physis called?

Salter type 3

Most rotator cuff injuries involve which rotator cuff muscle?

Supraspinatus

What is a fracture fo the epiphysis, physis, and metaphysis called?

Salter type 4

What is a Bankart lesion?

Avulsion fx of the inferior aspect of the glenoid fossa

What is a Hill-Sach’s deformity?

An impaction fx at the superior lateral aspect of the humeral head

What is a crushing injury of the growth plate (physis) called?

Sater type 5

What is a Thurston-Holland fragment?

Metaphyseal fragment associated with a Salter type 2 fx

What are the routine x-ray views of the shoulder?

• AP w/ internal rotation

• AP w/ external rotation

• Y-view

A tensile force will likely create which type of fx?

Transverse or horizontal fx d/t tensile forces

Describe the spatial relationship of apposition

Closeness of the bony contact at the fx site

A complete tear of the acromioclavicular ligament and the coracoclavicular ligament suggests a/an __.

Grade 3 AC joint separation

What type of fx typically results from angulation or angulation and compression forces?

Oblique fx

What is the diagnosis?

Transverse midclavicular fx

What is the diagnosis?

Radial neck fx

What is the diagnosis?

Supracondylar fx of the humerus

What is the diagnosis?

Chisel fx

What is the diagnosis?

Olecranon fx

What is the diagnosis?

Posterior perilunate dislocation

What is the diagnosis?

Bennet’s fx

What is the diagnosis?

Bankart’s fx

What is the diagnosis?

Triquetral avulsion fx

An intra-articular comminuted fx at the base of the first metacarpal is called a/an __.

Rolando’s fx

What is the diagnosis?

Rotatory subluxation of the scaphoid

What is the diagnosis?

Colle’s fx

A transverse fx of the distal radius with palmer angulation of the distal fragment could be called a/an __.

Smith’s fx

What is the diagnosis?

Galeazzi fx

An oblique fx of the proximal ulna with anterior dislocation of the radius is called a/an __.

Monteggia fx

What is the diagnosis?

Mallet finger

What is the diagnosis?

Skier’s thumb

What is the diagnosis?

Transverse scaphoid waist fx

What is the diagnosis?

Grade 2 AC joint separation

What is the diagnosis?

Posterior AND lateral elbow dislocation

What is the diagnosis?

Rolando’s fx

What is the diagnosis?

Boxer’s fracture of 5th metacarpal

What is the diagnosis?

Anterior lunate dislocation

What is the diagnosis?

Scapholunate instability (Terry Thomas sign)

What is the diagnosis?

Scaphoid waist fx with AVN

What is the diagnosis?

Smith’s fx

What is the diagnosis?

Torus fx

What is the diagnosis?

Nightstick fx (transverse fx of the proximal third of the ulna)

What is the diagnosis?

Transverse fx of ulna and radius

What is the diagnosis?

Avulsion fx medial epicondyle

What is the diagnosis?

Salter type 2 fx

What is the diagnosis?

Salter type 2 fx of distal femur