appears on a plain radiograph as a sharp lucent line that is often irregular or jagged and occasionally branches
Linear skull fracture
- often stellate (star-shaped) with multiple fracture lines radiating outward from a central point
- tangential views are required to determine the amount of depression
Depressed
- A break in bone at the base of the skull.
- very difficult to demonstrate radiographically
- air-fluid levels in the sphenoid sinus and/or clouding of the mastoid air cells are often the only radiographic finding suggesting a fracture
- important to include erect or cross-table lateral skull radiography
- CT and MRI are often used to better identify fractures and associated soft tissue damage within the skull
Basilar Skull Fractures
develops when the fracture line communicates with the mastoid air cells, resulting in blood accumulating in the cutaneous tissue.
postauricular ecchymosis
bleeding from a fracture site in the anterior portion of the skull base.
periorbital ecchymosis
- maybe difficult to recognize initially because of the edema
- may be indicated by clinical signs, which include black eyes, flattening of the cheek, and/or a restriction of the movement of the mandible
- best demonstrated on underexposed films taken in the basal (submentovertical) projection (“jug handle” view)
Zygomatic Arch Fracture
- generally detected by the patient’s inability to open the mouth and pain when moving the mandible
- these fracture also cause a misalignment of the patient’s teeth
Mandibular Fractures
- serious because of the adjacent nasal cavity, paranasal sinuses, orbit and close proximity of the brain
- the maxilla also transmits cranial nerves and major blood vessels
Fractures of the Maxilla
Maxillary fractures three major classifications:
- LeFort 1 (horizontal fracture)
- LeFort 2 (pyramidal fracture)
- LeFort 3 (transverse fracture)
- refers to a separation of the body of the maxilla from the base of the skull above the palate and below the zygomatic process
- results in a freely movable jaw
LeFort I (horizontal fracture)
- involves vertical fractures through the maxilla at the malar and nasal bones, forming a triangular separation of the maxilla.
LeFort II (pyramidal fracture)
most extensive and serious type of maxillary fracture; it extends across the orbits
Lefort III ( transverse fracture)
- results from a direct blow to the front of the orbit, thus transferring the force to the orbital walls and floor
- occurs in the thinnest, weakest portion of the orbit, i.e., the orbital floor just above the maxillary sinuses
- modified parietoacanthial projection (modified Waters method) is the preferred screening study
- CT is the best modality for imaging the orbits
Blow-out
- consists of fractures of the zygomatic arch and the orbital floor or rim combined with separation of the zygomaticofrontal suture
- occurs when the zygomatic or malar bone is fractured at all three suture: frontal, temporal, and maxillary
Tripod
- the most frequently fractured facial bone
- usually transverse and depresses the distal portion of the nasal bones
- may be accompanied by a fracture of the ascending process of the maxillae (anterior nasal spine) or of the nasal septum
Nasal Bone Fracture
- results when a bone is out of its joint and not in contact with its normal articulation
- Common sites for are the shoulders, hip, and acromioclavicular joints
JOINT DISLOCATION OR LUXATION
most frequently dislocated joint of the body. Because it moves in several directions, your ____ can dislocate forward, backward or downward. The most common variety is a forward (anterior) dislocation.
Shoulder dislocation
dislocation is described by which joint is affected and by the direction of the phalanx distal to the joint relative to the phalanx proximal to the dislocated joint (eg, dorsal dislocation at the PIPJ). It is important to assess for any associated fractures pre- and post-reduction:
Dislocations to the interphalangeal joints
- a partial dislocation, often occurring with fracture
- ankle and the vertebral column are the common sites of ___
SUBLUXATION
- also referred to as nonaccidental trauma (NAT)
- term associated with a physical form of child abuse
- Physical child abuse often co exists with both emotional and sexual abuse
- Physical signs include bruises, burns, abrasions, and fractures in various stages of healing
- Radiographic signs of child abuse include hematomas, and single or multiple fractures of varying ages, especially in areas where it is difficult for the child to self-inflict the injury
BATTERED CHILD SYNDROME
- common form of avascular necrosis affecting the femoral head
- the cause of this disorder is unknown
- tends to occur in males between the ages of 4 to 10 years and often follows injury or trauma to the affected hip
- clinically these patients present with a limp that is accompanied by little or no pain
- Radiographically the bone in the center of the epiphysis is fragmented and the head of the femur is flattened.
LEGG-CALVE-PERTHES DISEASE
causes of ____ injuries include direct trauma, hyperextension-flexion injuries (whiplash), osteoporosis or metastatic destruction.
VERTEBRAL COLUMN INJURIES
- most frequent type of injury involving a vertebral body
- generally occur in the thoracic and lumbar vertebrae
- also associated with osteoporosis
COMPRESSION FRACTURES
- “burst fracture” of the first cervical vertebra (atlas)
- generally occurs as a result of a severe axial force that causes compression, as in a diving accident
- vertebral arch literally bursts
JEFFERSON FRACTURE
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module 124
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module 251
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module 3 congenital17
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module 4 respiratory51
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module 3 inflammatory13
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module 3 traumatic35
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module 3 traumatic 228
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module 3 neoplastic14
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module 5 gastrointestinal system CONGENITAL HEREDITARY14
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module 5 inflammatory12
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module 5 degenerative11
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module 5 neurogenic, diverticular, traumatic, neoplastic diseases13
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module 6 hepatobiliary28
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module 7 urinary34
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module 8 repro MALE12
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module 8 repro FEMALE7
