Rad 2B: Week 1 Lecture sdog

What is an open fracture?

A fracture that penetrates the skin

What is a closed fracture?

A fracture that does not penetrate the skin

What does it mean for a fracture to be comminuted?

Multiple fracture lines resulting in bony fragments

What is a triangular cortical fragment seen in comminuted fractures called?

Butterfly fragment

3 multiple choice options

What does it mean for a fracture to be non-comminuted?

Single fracture line resulting in two fragments

What is an Avulsion Fracture?

Tearing away of Bone by forceful muscular or ligamentous pulling

Where does avulsion fractures typically occur?

- Tuberosities of long bones

- Cervical spinous processes

What is an Impaction Fracture?

When a portion of bone is driven into its adjacent segment

Is the fracture line in an impaction fracture normally opaque or lucent at region of impaction ?

Opaque

1 multiple choice option

What are the two types of impaction fractures?

Depressed and Compression

3 multiple choice options

What is a depressed fracture?

Inward collapse of outer bone surface

1 multiple choice option

Where do depressed fractures normally occur?

- Tibial Plateau

- Frontal bone

What is a compression fracture?

Decreased volume of bone due to trabecular collapse/ telescoping

Where do compression fractures normally occur?

Vertebral bodies

What is a complete fracture?

Cortex to Cortex fracture

Is a complete fracture more common in adults or children?

Adults

What is an incomplete fracture?

Only one side is broken leading to buckling or bending on the opposite side

Is an incomplete fracture more common in adults or children?

Children

What is a greenstick fracture?

An incomplete fracture that comes from tension on convex side causing a transverse fracture

3 multiple choice options

What is a torus fracture?

Compression forces cortex to bulge outward

What is the AKA for Torus Fracture?

Buckling Fracture

Where does a Torus Fracture usually occur?

Metaphysis (4 cm proximal to the distal end)

What is an infraction fracture?

From of incomplete impaction fracture without displacement

What is the most common infraction fracture?

Freiberg infraction (metatarsal head)

What is a pathologic fracture?

Fracture through a bone weakened by localized or systemic disease process

What orientation of fracture would indicate pathology in a long bone?

Transverse fracture orientation

What is a Chip Fracture?

Type of avulsion fracture where a small portion of bone is broken from parent bone

Where does a chip fracture typically occur?

Short tubular bones ( ex. phalanx)

What are two types of stress fractures?

Fatigue and Insufficiency Fractures

What is a fatigue fracture caused by?

repetitive micro-trauma to bone leading to micro-fractures

Which stress fracture is considered actual fatigue failure of bone?

Fatigue Fracture

1 multiple choice option

What is an insufficiency fracture?

Stress fracture through diseased bone

What molecule does MRI align using magnetic waves?

Hydrogen

3 multiple choice options

For an Occult fracture, are there clinical signs or radiographic signs of fracture?

Clinical signs only

2 multiple choice options

What modality is the only one you can find bone bruising in?

MRI

3 multiple choice options

What is the most common location for an occult fracture?

Scaphoid

3 multiple choice options

What is the second most common location for an occult fracture?

Ribs

3 multiple choice options

How do you define a bone bruise?

Hemorrhage and bone marrow edema at trabecular micro fractures

What are all the AKA's for a pseudofracture?

Looser's Lines, Milkman's syndrome, Increment fractures, umbau zonen

How do you define a pseudofracture clinically ?

Discreet regions of unmineralized osteoid

How do you define a pseudofracture radiographically?

Linear lucencies at 90 degree angle to cortex

What conditions of psuedofractures seen in?

Bone softening conditions: Paget's, rickets, osteomalacia, and fibrous dysplasia

1 multiple choice option

What is an oblique fracture?

45 degrees to long axis of bone

What is a spiral fracture?

Torsion + axial compression + angulation

What is a transverse fracture?

90 degrees to long axis of bone

Is a oblique, spiral, or transverse fracture uncommon through healthy bone?

Transverse

2 multiple choice options

What are you looking for in fracture spatial relationships?

Alignment, Apposition, Rotation

What does alignment mean when reading fracture radiographs?

Position of distal fragment in relation to proximal fragment

2 multiple choice options

What does apposition mean when reading fracture radiographs?

Closeness of bony contact at fracture site

What does partial apposition mean?

Partial bony contact

What does rotation mean when reading fracture radiographs?

Rotational malposition of fragments