Fractures o

Fractures

o bone discontinuity or breaks / cracks of the bone

o Signs : shortening of the limb for the extremities ; inflammation and physical deformities in general

o Symptoms : pain

Terminologies

• Subluxation - partial bone dislocation

• Luxation - complete bone dislocation

• Dislocation - bones are being misplaced / goes out of its natural attachment (from the joint), causes damage to the joint

• Displacement - the anatomy is being misplaced from its original alignment

Types of fractures

 Simple Fracture - bone discontinuity wherein the bone fragment still remain inside the skin

 Compound fracture - bone discontinuity wherein the bone fragment penetrates the skin which causes an open wound

• Green stick fracture - bone discontinuity which the bone fragmentation is deemed to be incomplete

o Twig like break

o The discontinuity appears on the lateral side of the affected bone

• Transverse fracture - the bone discontinuity is oriented transversely or horizontally

o The breakage is end to end

• Comminuted fracture – the bone deeds continuity which causes the bone to undergo fragmentation

o Most difficult to treat through surgery

• Spiral fracture - the bone discontinuity which the bone is forcefully twisted or rotated which causes a “break”

• Oblique fracture - the bone discontinuity that occurs when the bone undergoes forceful compression or bending

• Avulsion fracture - bone discontinuity which characteristically caused by forceful pulling of the tendon to the bone attachment

o Example of osgord schlatter disease - an avulsion fracture of the proximal tibial tuberosity it is best demonstrated in lateral projection

• Clay shoveler’s fracture - a bone discontinuity which occurs in :

o Cervical spine lower portion

o Thoracic spine upper portion

• Impacted fracture – bone discontinuity which the both ends are jammed or compressed with each other

Eponyms

 Eponyms are the medical term which is derived from the name of an individual who discovered the condition / anatomy for example the Huntington’s disease and angle of louis

• Maisonneuve – this pathology has the following features proximal fibula fracture and interosseus membrane tear

• Best demonstrated in conventional radiography

• Jefferson’s fracture – type of bone discontinuity which occurs in the c1 or atlas

• Burst fracture of the lateral masses or bodies of the vertebrae

• Etiological base : ex. When the chin receives so much force or over extension this can cause Jefferson’s disease or hangman fracture

• Hangman fracture - the fracture of the c2 or axis/epistropheus which specifically occurs on the pars interarticularis

• Appears in strangulation

• Whiplash injury

• Depressed fracture ( ping pong fracture) – the depressed fracture is caused by blonde for stroma to the head

• Pterion (sintido komon) – pterion is the point of the skull where the bones from the cranium is fused. It is the weakest part of the cranium. The MMA or Middle Meningeal Artery is located here, prone to rupture pterion sustains fracture

• Blow out fracture - the fracture which occurs on the orbital floor

• Affected bones : outer rim of the orbit

• FrontalZygomaMaxillary

• Le fort fracture - the fracture which occurs in the maxillary bone

• Lf I: horizontal fracture – separation of maxilla from the base of the skull

• LF II : pyramid like fracture - involvement of the nasal bone

• LF III : horizontal or transverse fracture - which also include : nasal, zygoma, and temporal bone

• Bennett’s fracture – fracture which occurs on the base of the first metacarpal

• Boxers fracture – the fracture which occurs on the head of the fifth metacarpal

• Tuft fracture - fracture which occurs on the distal phalanges

• Tripod fracture - fracture occurring on : zygomatic bone, maxilla, and temporal bone.

• Basilar fracture - the fracture which occurs on the base of the skull

• Usually from fall or blunt force trauma

• Signs:

 raccoon eyes - or blood pulling on the eye area

 battle sign - blood pulling on the mastoid area

• Countercoup fracture – type of fracture that is sustained from a blunt force trauma from contralateral side

• Barton's fracture – intra-articular fracture which occurs on the distal radius and ulna

• Smith's fracture - fracture of distal radius / ulna which is accompanied by palmar anterial/ventral displacement

 Pag natukod yung dorsum

• Colle’s fracture – fracture of the distal radius/ulna which is accompanied by dorsal/posterior displacement

 Pag natukod yung palm

• Monteggia fracture - fracture which occurs on proximal ulna accompanied by dislocation of distal radius

• Galleazzi fracture - fracture which occurs on proximal radius accompanied by dislocation of distal ulna

 Shoulder fractures - causes shoulder instability due to repeated or reoccurring shoulder dislocation that causes labral tear

• Hill- sachs defect - chip fracture of the postero-lateral portion of the humeral head

• Bankart lesion - fracture occurring on the glenoid cavity ; antero-inferior rim

 Lower extremities

• Pott’s fracture – tri-malleolar fracture

o Nabasag yung malleolus

o An ankle fracture – occurs in distal tibia (medial malleioli) or distal fibula (lateral melleioli)

o Causes complete articular damage of mortise joints

• Stellate fracture – a common muted fracture of the patella which resembles glass like appearance

o Resembles constellation like patterns

Eponym fractures Images

Maisonneuve fracture

Jefferson’s fracture

Hangman fracture

depressed fracture or ping pong fracture

Blowout fracture

Le fort fracture

Bennett’s fracture

Boxers fracture

Tuft fracture

Tripod fracture

Basilar fracture

Countercoup fracture

Barton’s fracture

Monteggia fracture

Galleazzi fracture

Hill sachs defect & Bankart lesion

Pott’s fracture

Stellate fracture

 Osteogenesis imperfecta aka brittle bone disease

o Osteo – bone

o Genesis – development /beginning

o An imperfect development of the bones also known as brittle bone disease

o It is a congenital disease

o Defective or imperfect bone tissue formation ( ossification) which causes the bone of the patient to be porous

o Radiographic appearance : multiple fracture in various stages of healing and malformed bone alignment

o Two types of Osteogenesis imperfecta :

 O. I. Congenita - the manifestation of sign and symptoms of the osteogenesis imperfecta is during the fetal development. Have negative prognosis and low health outcome ( sustaining multiple fractures while inside the womb)

 O. I. - the manifestations of signs and symptoms of the osteogenesis imperfecta occurs in early childhood. Have positive prognosis

o Modality: conventional radiography

 Achondroplasia aka short stature

o A – absence

o Chondr – cartilage

o Absence of cartilage which contributes to normal growth

o This is different from dwarfism

o Clinical signs

 Macrocephaly - an abnormal bulging of head or bulging of forehead

 Genu varum – bowing of legs

 Maximum height of 4 ft.

 Shortened limbs (upper and lower limbs)

o Modality: conventional radiography specifically Roentgenogram

 Osteopetrosis aka marble bone disease

o Abnormal generalized increase of bone density

o Radiographic appearance: marble like appearance due to high bone density

o For comparison:

 Osteoporosis - at degenerative disease which causes low density due to abnormal metabolic activity

 Osteomalacia - abnormal softening of the bone

 Osteopenia – abnormal degrees of bone density

 Polydactyly - having extra set of finger toes nipples

o Nubbin - refers to the extra set of appendages (finger and toes) which is non functional

 Syndactyly aka webbed digit

o A congenital disease

o Fusion or failure of the digit / fingers to separate

 Congenital club foot aka talipes equinovenus

o A congenital disease

o Malformation which prevents weight bearing of the foot

o Most affected: ankle

o Modality: conventional radiography, kite method (AP/LAT), Kandle method (PA Axial) - used for assessing the gravity of the mug formation

o Treatment: orthopedic cast, poseti cast (poseti method)

 Developmental dysplasia of the hip Fractures