Fracture (Imaging)

Question 1

What are 4 examples of abnormal stresses that can occur with/in fractures?

Answer 1

1. stress
2. pathologic
3. periprosthetic
4. bone graft

Question 2

Bone Healing

1. Callus: ___ bone heals via this process
2. Creep Substitution: ___ bone heals via this process
3. Osteoblastic activity: ___ bone heals via this process

Answer 2

1. Cortical bone
2. Cancellous bone
3. Compressed bone

Question 3

Which type of imaging is primarily used to evaluate MSK trauma?

Answer 3

Conventional Radiography

Question 4

Alignment of Fractures

1. ___ = fragments are not displaced
2. ___ = fragments are no longer in anatomic position (described by relative displacements, such as medial, lateral, distracted, etc.)

Answer 4

1. Non-displaced
2. Displaced

Question 5

When considering bone healing and setting as part of medical management for pediatrics, the clinican must be able to appreciate where the bone is going to ___, the distance form the ___ (closer is better), and the potential for bone ___.

Answer 5

1. remodel
2. growth plate (closer is better)
3. bone length discrepancies

Question 6

A clinician may choose to use ___ to save time by screening for abdominal, chest, and spine injuries at once.

Answer 6

Computed Tomography (CT)

Question 7

What are the 5 types of fractures in the Salter-Harris Classificaiton for epiphyseal fractures (pediatrics)?

Answer 7

1. Type I = straight across
2. Type II = above (most common - 75%)
3. Type III = below
4. Type 4 = through
5. Type 5 = eraser of growth plate (crush injury)

Question 8

Types of Fractures:

1. ___ = all cortices broken (2 fragments)
2. ___ = cortices partially broken
3. ___ = >2 fragments

Answer 8

1. Complete
2. Incomplete
3. Comminuted

Question 9

____ usually occur secondary to:

• Failure to order image
• Failure to recognize on image
• subtle fractures

Answer 9

Commonly Missed Fractures

Question 10

Commonly Missed Fractures

• Spine
  
  • C_/C_
  • C_/C_
  • ___ fracture (osteoporotic)
• LE
  
  • Femoral Neck
  • ___
  • ___
  • Talar Dome
• UE
  
  • ____
  • ____

Answer 10

• Spine
  
  • C1/C2
  • C8/C7
  • Compression fracture
• LE
  
  • femoral neck
  • Patella
  • Calcaneous
  • Talar Dome
• UE
  
  • scaphoid
  • Radial head

Question 11

Age, degree of local trauma, amount of bone loss, type of bone, how well immoblizied, infection, local malignancy, radiation necrosis, hormones, avascular necrosis, and local stress are all factors that can influence ___.

Answer 11

Rate of healing for bone

Question 12

What are the 3 healing phases of bone?

Answer 12

1. Inflammatory (acute)
2. Reparative (sub-acute)
3. remodeling (chronic)

Question 13

In general, CT is primarily used to evualte __.

Answer 13

Complex anatomy

Question 14

Closed fractures are often associated with which type of fracture?

Answer 14

Simple Fractures

Question 15

In regards to fracture description, what category does the following fall under:

• impaction
• depression
• compression
• avulsion

Answer 15

Special features of fractures

Question 16

In regards to pedaitric fracture description, what are 3 possible locations for the fracture to be located?

Answer 16

1. Epiphysis (growth plate)
2. Metaphysis
3. Diaphysis

Question 17

True or False: fractures do not have patterns that can be predicted.

Answer 17

False.

Fractures have patterns that can be predicted by the condition of the bone (behavior of the bone qualities) and the mode of injury.

Question 18

In general, MRI is primarily used to evaulate ___.

Answer 18

Soft tissue Injuries

Question 19

Surgical Intervention Types: might be needed if bone healing doesn’t occur properly

1. ___ = externally reduced
2. ___ = internally reduced
3. ___ = artificial means to stabilize fractures (e.g. screws, cage, or plates) => internally (Ilizarov technique) or externally

Answer 19

1. Closed Reduction
2. Open Reduction
3. Fixation

Question 20

___ = protocol series of radiographs that screen injuries post-trauma.

Includes:

• Lateral C-spine
• AP chest
• AP pelvis

Answer 20

Trauma Survey

Question 21

• Growth plates
• growth lines
• secondary centers of ossification
• nutrient foramina
• cartilage

Are all examples of imaging concerns for which age-group of patients?

Answer 21

Pediatrics

Question 22

Open fractures are often associated with which type of fracture?

Answer 22

Compound

Question 23

Directions of Fracture Lines

• Referenced according to the long axis of the bone = what 4 types?

Answer 23

• transverse
• Spiral
• longitudinal
• oblique

Question 24

What are the 3 types of incomplete fractures seen in children?

Answer 24

1. greenstick
2. plastic bowing (low load, prolonged stress)
3. torus fracture = buckel (load is really high so bone folds in on itself)