5* metatarsal stress fractures
are difficult to heal and are high-risk to progress to a complete fracture
Most common fracture associated with a LisFranc injury?
Base of 2*° metatarsal fracture (Fleck Sign)
Most common site of stress fracture in young athletes?
Tibial stress fracture
Tibial stress fractures
most common on compressive side (posteromedial tibia)
If stress fracture on tensile side (midshaft anterior)
these have worse healing
Compressive side stress fractures
heal well as bones are constantly in opposition
Tensile side stress fractures
have more difficulty to heal.
Femoral stress fractures tend to be compressive in youth
(heal well) and tensile in older adults (don’t heal well).
Older woman with sudden pain after arising from a seated position?
SONK = spontaneous osteonecrosis of the knee-a misnomer as this is really an insufficiency fracture most commonly of the medial femoral condyle NOT osteonecrosis.
Usually unilateral and no history of trauma but is often associated with a meniscal injury
Older woman with sudden pain after arising from a seated position? SONK = spontaneous osteonecrosis of the knee-a misnomer as this is really an insufficiency fracture most commonly of the medial femoral condyle NOT osteonecrosis.
Runners running on hard surfaces are prone to which location of stress fracture in the foot?
Navicular stress fracture.
Analogous to the scaphoid the navicular bone is at high risk of AVN with a displaced fracture
Runners running on hard surfaces are prone to which location of stress fracture in the foot? Navicular stress fracture.
Navicular esteonecrosis
Kohler’s disease
Metatarsal stress fractures
March fracture-think military recruits marching all day
The most commonly fractured tarsal bone
calcaneal bone, stress fractures tend to be intra-articular (75%).
The stress fracture line runs perpendicular to the trabecular lines
The most commonly fractured tarsal bone = calcaneal bone, stress fractures tend to be intra-articular (75%).
High risk locations for stress fractures-to progress to complete/displaced fractures?
Tensile side of femoral neck, transverse patellar fractures (longitudinal patellar fracture is lower risk), anterior tibial midshaft fracture, 5” metatarsal fracture, talus fracture, navicular fracture, sesamoid great toe fracture
What is the name for lucent bands that traverse bones at right angles to the cortex?
Looser zones.
When you see these think insufficiency fractures associated with osteomalacia or Rickets
What is the name for lucent bands that traverse bones at right angles to the cortex? Looser zones.
Most common location for fractures in setting of osteoporosis?
-Spine, then bip, then wrist
Insufficiency fracture of soft bone in femur or tibia in patient with Paget’s disease
= banana fracture
Fractures associated with an anterior inferior shoulder dislocation
Hill Sachs fracture (posterolateral humeral head impaction fracture), bankart fracture (soft vs bony lesion) at anteroinferior glenolabrum complex, and greater tuberosity avulsion fracture
Posterior shoulder dislocation is most commonly associated with which fracture
reverse Hill Sachs fracture (anteromedial humeral head impaction fracture-need surgery to prevent AVN)
