Cham

Presentation material for educational purposes only. All rights reserved. 1999 URMC Radiology.
1 / 30
Introduction to the Radiology of
Fractures and Related Injuries
Matthew Cham
Medical Student
University of Rochester
School of Medicine & Dentistry
Presentation material for educational purposes only. All rights reserved. 1999 URMC Radiology. 2 / 30
! Types: location and mechanisms of injury
! Classifications and grading
! Radiologic vs. Clinical features
! Variants
Types of Fractures
! Incomplete vs Complete
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0
Simple
Fractures
! Alignment &
displacement
of fragments
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!
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! Directions of the fracture lines
Simple Fractures
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Other terms: fracture line not seen
! Impaction, depression, and compression
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!
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Uncommon fractures
! Stress and pathologic etiologies
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!
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Fractures involving the growth plate
! Salter-Harris Classification
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!
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4
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Injuries of non-articulating joints
! Acromioclavicular & coracoclavicular separation
! Sprain or tears in the AC and (or) CC ligaments, resulting in AC
separation with inferior displacement of the scapula and extremity
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!
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7
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Anterior dislocation of the humeral head
! Depression
fractures
! Hill-Sacks
& Bankart
lesions
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!
F
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5
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5
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Proximal Humeral
Fractures
! Classification by
location and extent
of displacement
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!
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Fracture-dislocation of the humeral head
! Classification by anatomic location and displacement
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!
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Distal Humeral Fractures
! Muller Classification of Extra-articular extension
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Distal
Distal
Humeral
Humeral
Fractures
Fractures
! !
Muller Muller
Classification of Classification of
intra-articular intra-articular
extension extension
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!
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! Posterior
elbow
Dislocations
!
1
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3
7
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Radial Head
fracture
! Mason
Classification
I = undisplaced I = undisplaced
II = displaced II = displaced
III = comminuted III = comminuted
IV = dislocated IV = dislocated
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5
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3
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Olecranon
Fractures
! Horne-Tanzer
Classification
IA = Oblique proximal 3rd IA = Oblique proximal 3rd
IB = Transverse proximal 3rd IB = Transverse proximal 3rd
IIA = Oblique middle 3rd IIA = Oblique middle 3rd
IIB = Transverse middle 3rd IIB = Transverse middle 3rd
III = Oblique distal 3rd III = Oblique distal 3rd
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Fractures of
the forearm
! Monteggia
fracture-
dislocations
Bado classification of fractures Bado classification of fractures
of the proximal ulna: of the proximal ulna:
I = with anterior radial I = with anterior radial
dislocation dislocation
II = with posterior radial II = with posterior radial
III = with lateral radial III = with lateral radial
IV = with anterior radial IV = with anterior radial
dislocation and fracture dislocation and fracture
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! Colles fracture
Fractures of
the forearm
Fractures to the distal Fractures to the distal
radius, usually with lateral or radius, usually with lateral or
dorsal displacement of the dorsal displacement of the
distal fragment distal fragment
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! Smith fractures (reverse Colles fractures)
Type 1 Type 1 Type 2 Type 2 Type 3 Type 3
Fractures of the forearm
Fractures of the distal radius with volar displacement Fractures of the distal radius with volar displacement
and angulation of the distal fragment and angulation of the distal fragment
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Fractures of the wrist
! Scaphoid fractures
Second most common injury Second most common injury
of the upper limb of the upper limb
normal scaphoid bone
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H
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! Bennett fracture-dislocation
Fractures of the hand
Intra-articular fracture of the proximal end of the first metacarpal, with Intra-articular fracture of the proximal end of the first metacarpal, with
dorsal and lateral dislocation of the distal segment. dorsal and lateral dislocation of the distal segment.
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!
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Fractures of the Proximal Femur
! Intra- and Extracapsular fractures
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Blood supply of the femoral head
! Interruption of this blood supply
secondary to intracapsular fracture
may lead to osteonecrosis
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Fractures of the Proximal Femur
! Impaction of the femoral neck into the femoral head
Normal Normal Impaction Impaction
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! Acetabular fracture ( )
! Posterior dislocation of the
femoral head
patient 1 patient 1
patient 2 patient 2
Posterior column
Posterior column
fx of acetabulum
fx of acetabulum
!
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Anterior dislocation of the femoral head
patient C patient C
patient C patient C
6
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Fractures of the distal femur
! Supracondylar, condylar, and intercondylar extension
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Fractures of the
distal femur
! intercondylar fracture
AP view AP view lateral view lateral view
6
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Summary
! simple vs. comminuted fractures
! stress and pathologic fractures
! intra- vs. extra-articular involvement
! dislocation vs. separation
! depression fractures and associated lesions
! effects of fractures on blood supply

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Presentation material for educational purposes only. All rights reserved. 1999 URMC Radiology.

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