Rad 2b week 6-10

T or F: Wrist dislocations are more common than wrist fractures

False (vice versa)

What finding of grip strength is a strong indicator of wrist fracture?

>20% decrease

What is the term for a lucency on the anterior wrist seen on lateral wrist x-ray?

Pronator quadratus sign

What does Pronator quadratus sign indicate?

Wrist fracture

What is the term for Fracture distal radius with posterior angulartion of distal fragment?

Colles fracture

What is the name sign of Cole's fracture?

Dinner fork deformity

What is the most common influencing factor of colle's fracture?

Osteoporosis

What is the MOI of Colle's fracture?

FOOSH

What is the term for fracture of distal radius with anterior angulation of distal fragment?

Smith fracture

What is the AKA of smith fracture?

Reversed colles fracture

What is the MOI of smith fracture?

Fall on hyper flexed wrist

What is the term for fracture of the distal radius with proximal dislocation of the carpus?

Barton's posterior rim fracture

What is the MOI of barton's posterior rim fracture?

FOOSH

What is the term for fracture of the anterior rim of the radius?

Reversed barton's fracture

What is the term for fracture of the radial styloid?

Chauffeur fracture

What are the AKAs of chauffeur fracture?

Backfire fracture / Hutchinson's fracture

What is the most common carpal to fracture?

Scaphoid

What is the normal age of scaphoid fracture?

15-40 yo

What is the MOI of scaphoid fracture?

Hyperextension with radial flexion

What is the most common occult fracture

Scaphoid

T or F: Scaphoid fractures are often occult and therefore overlooked

True

What part of the scaphoid is most commonly fractured?

Waist

What is the term for fat stripe displacement in the radial compartment of the wrist with scaphoid fracture?

Navicular/scaphoid fat stripe sign

Which pole of the scaphoid has the most perfusion?

Distal pole

How long do scaphoid fractures take to heal?

6-20 weeks

What are the potential complications of scaphoid fracture?

AVN

Non-union

What is the AKA of scaphoid AVN?

Preiser disease

What % of scaphoid fracture comes with AVN?

30%

What % of scaphoid fracture comes with non-union?

30%

How is non-union of scaphoid treated?

Herbert screw

What ligament is disrupted in scapholunate dissociation?

Scapholunate ligament

What is the name sign of scapholunate dissociation on x-ray?

Terry Thomas sign

What is the name sign scaphoid dislocation on x-ray?

Signet ring sign

What is the Ddx of scapholunate dissociation?

Lunotriquetral coalition (wide joint in 50%)

What is the second most common carpal to fracture?

Triquetrum

What type of fracture is a triquetrum fracture typically?

Avulsion

What is the AKA of triquetrum fracture?

Fisher's fracture

What is the typical MOI of triquetrum fracture?

Hyperflexion

What is the name sign of trquetrum fracture on x-ray?

Pooping duck sign

What part of the hamate is most commonly fractured?

The hook

What dislocation is commonly found with hamate fracture?

4th and 5th metacarpal

What view is used to view hamate fracture?

tangential view

What modality is best for viewing hamate fracture?

CT

What is the most common complication of hamate fracture?

Non-union

What is the most common carpal to dislocate?

Lunate

What is the name sign of lunate dislocation on PA views?

Pie sign

What is the name sign of lunate dislocation on lateral wrist x-rays?

Tea cup sign

What is the term for dorsal displacement of all carpal bones expect lunate?

Periluante dislocation?

What view is best for viewing perilunate dislocation?

Lateral wrist

What is the diagnostic finding of perilunate dislocation?

Loss of continuity of the carpal arcs

What are the complications of perilunate dislocation?

Chondrolysis

carpal instability

traumatic arthritis

What is the term for Transverse fracture of the neck of the 2nd or 3rd metacarpal?

Boxer's fracture

What is the MOI of Boxer's fracture?

straight, jabbing type of blow with the fist

What is the term for Transverse fracture involving the neck of the 4th or 5th metacarpals?

Bar room fracture

What is the MOI of bar room fracture?

"roundhouse" type of blow from inexperienced fighter

What is the term for fracture dislocation + avulsion at the base of the 1st metacarpal?

Bennet's fracture

What is the MOI of Bennett's fracture?

Forced abdjuction following an injury where there is a grip applied to an object (ski pole or handlebar)

What direction is the shaft of the 1st metacarpal displaced in Bennett's fracture?

Dorsal and radial displacement

What is the AKA of Rolando fracture?

Comminuted Bennett's fracture

What is the least common of all 1st metacarpal injuries?

Rolando fracture

What is the term for Small avulsion fracture at ulnar side of 1st proximal phalanx base?

Gamekeeper's fracture

What is the AKA of Gamekeeper's fracture?

Skier's thumb

What is the MOI of Gamekeeper's fracture?

Severe abduction of 1st MCP joint

What type of lesion often accompanies gamekeeper's fracture?

Stener lesion (disruption of the ulnar collateral ligament and gets stuck on the aponeurosis)

Which distal phalanx is most commonly fractured?

3rd (middle finger)

What are the 4 types of distal phalanx fractures?

Transverse

Longitudinal

Comminuted

Chip

What is the most common type of distal phalanx fracture?

Comminuted

What is the term for flexion deformity caused by a posterior chip fracture?

Mallet / baseball finger

What injury must be ruled out with mallet finger?

Nail bed injury

What is the most common direction of phalangeal dislocation?

Posterior

What fracture is commonly associated with phalangeal dislocation?

Volar plate fracture

What is the most common skeletal injury of birth and childhood?

Clavicle fracture

What are the most common shoulder injuries from age 20-40?

shoulder dislocation

AC joint separation

clavicle fractures

What are the most common shoulder injuries in the elderly?

shoulder dislocation

humerus surgical neck fracture

What are the radiographic projections of the shoulder?

AP internal rotation and external rotation

Baby arm (abduction view)

Grashey

Scapular Y

(also AC, scapula, and clavicle)

What factors make clavicle fracture difficult to identify?

S-shape

overlap with upper rib cage

What tilt of the x-ray tube is needed to evaluate clavicle?

15 degrees cephalic

What % of all fractures are clavicle fractures?

15%

What % of shoulder fractures are clavicle fractures?

44%

What gender is more commonly affected by clavicle fracture?

Male

What part of the clavicle is most commonly fractured?

Middle clavicle (75-80%)

What part of the clavicle will be displaced superiorly in the event of a middle clavicle fracture due to action of the SCM?

Medial fragment

What ligament is often injured in lateral clavicle fracture?

CC ligament

What % of clavicle fractures heal without complication?

95%

What are the potential complications of clavicle fracture?

Neurovascular damage

Non-union

Osteoarthritis of acromioclavicular joint

What is the diagnostic criteria for non-union of the clavicle?

Lack of callus within 6 weeks and gap is > 1.5 cm

What structures can be damaged by clavicle fracture?

subclavian artery and vein

brachial sympathetic chain

What is the term for resorption of the distal segment of the clavicle following injury?

Post-traumatic osteolysis of the distal clavicle

What demographic is osteolysis of the distal clavicle common in?

Weightlifters

What is the shape of an osteolysed distal clavicle?

Frayed

irregular

Cup

T or F: Scapula fracture indicates a minor trauma

False (severe trauma)

What views are used to evaluate scapula fracture?

Axillary view

A-P scapula

True lateral view

What is the AKA of true lateral view of the scapula?

Y view

What is the Y view used to evaluate in scapula fracture?

Glenoid fracture

What part of the scapula is usually fractured?

Body and neck (80%)

What is the AKA of greater tuberosity avulsion fracture?

Flap Fracture

Hidden fracture

When is flap fracture occult?

When non-displaced

What injury is greater tuberosity avulsion commonly associated with?

Anterior dislocation

What is the best view for visualizing greater tuberosity avulsion?

External rotation

What does displacement greater than 1 cm in greater tuberosity avulsion indicate?

Rotator cuff tear