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RADIOLOGY

FRACTURES AND DISLOCATIONS

MASCARENAS, MA. ANTHEA Z.


ABCS OF ASSESSMENT
Adequacy
adequate views and image quality
alignment- long axes of bones
Bones
cracks and deformities
Cartilage
joint space- width, asymmetry, etc.
Soft tissue
swelling, joint effusion
Normal Bone

Epiphysis
Epiphyseal Plate
Metaphysis
Diaphysis
Bone Structure and Development

Structure
Cortical bone (compact)
Cancellous Bone (trabecula)
Development
Intramembranous ossification
in flat bones
Thin CT to bone
Endochondral ossification
in long, irregular, short bones
Fetal cartilage to bone
Know the Bones
Know the Bones
Know the Bones
Know the Bones
Types of Fractures
COMPLETE INCOMPLETE
Bone is completely broken into Bone is incompletely divided
two or more fragments and the periosteum remains in
continuity
Examples: Examples:
Transverse Fracture Greenstick fracture
Oblique Fracture Torus fracture
Spiral Fracture Stress Fracture
Impacted Fracture Compression
Comminuted Fracture
Segmental Fracture
Fracture Classifications

Longitudinal Transverse Oblique Spiral Incomplete T Fracture

Impacted Comminuted Pathological Close Open Avulsion


Fracture Radiographs

OPEN FRACTURE COMMINUTED SPIRAL FRACTURE


Fracture penetrating Bone broken down Atleast one part of
the skin , immediate into two or more the bone was twisted
treatment fragments
Usually due to severe
Prone to infection forces
Fracture Radiographs

OBLIQUE FRACTURE TRANSVERSE FRACTURE IMPACTED FRACTURE


trabecular structure of the
fracture that travels on A fracture that occurs
bone pushed together by a
a diagonal across the at right angle to the
direct trauma at long axis
long axis of e bone bones axis
of the bone leading to
compression
Fracture Radiographs

GREEN STICK FRACTURE COMPRESSION FRACTURE HAIRLINE FRACTURE


An incomplete fracture of Usually seen in spines,
But MRI or CT scan is A very thin crack or
the bone of a child due to break to the bones
bones not yet fully used to confirm any
calcified injury to the spinal cord
Fracture Radiographs

STRESS FRACTURE SKULL FRACTURE DEPRESSION FRACTURE


A fracture that is not Greater than 3mm, as A depressed skull
visibly seen. compared to suture fracture is a is a break
Microscopic which is less than 2 in the cranium
derangement mm in width
Fracture Radiographs

CLAVICLE FRACTURE SUPRACONDYLAR SCAPHOID FRACTURE


collar bone fracture MC fracture in children Early x-ray may appear
negative. Due to
Due to fall on the Note that the patient is in outstretched hand, dull
shoulder or direct trauma severe pain deep ache at radial side
Fracture Radiographs

COLLES FRACTURE SMITHS FRACTURE


Fracture at lower end of radius, that Reverse Colles fracture involving the
usually involves as well the dislocation distal radius. This happens upon falling
of the radioulnar joint on flexed wrist/ direct blow to the
Falling on wrist extension forearms
Fracture Radiographs

BENNETS FRACTURE EPIPHYSEAL FRACTURE


RADIAL HEAD FRACTURE
Due to forced abduction of
the thumb
Dislocation of base of 1st
metacarpal
Dislocations
When the bones are Most frequently
no longer in proper dislocated joints
contact Shoulder
Can be caused by Elbow
twisting or indirect Thumb
force, or even Finger
muscular contraction Jaw
Knee
Signs and Symptoms
Deformity or Joint may be locked
abnormal in one position
appearance Swelling of the joint
Pain or tenderness
aggravated by
movement
Loss of normal
function
RICE
Shoulder Dislocation

Take past medical history


Check for circumflex
nerve function
X-ray to rule out fracture

Methods of reduction
Scapular rotation
traction
Posterior Elbow Dislocation

Typical mechanism
A fall backward on the arm
with the elbow flexed
position and
The forearm supinated is the
most common mechanism
The injury causes the radius
and the ulna to dislocate
posterior to the humerus
There may also be frequent
association withradial head
fracture or coracoid process
of ulna
Patellar Dislocation

Mechanism of acute
dislocation
Patient bears weight on slightly
flexed knee
Sudden external rotation or
twisting load to femur causes
the patella to slide superiorly
over the lateral femoral
condyle
As the flexes, the patella jumps
over the lateral condyle and the
knee collapses
Hip Dislocation Acetabular Fracture
Posterior Hip Dislocation

CT scanning can be useful in this evaluation as on this image where we see the
relationship right femoral head lateral and posterior to its proper location in the
acetabulum.
C-3 Fracture/ dislocation
C-2 Fracture
C2 Fracture
Anterior subluxation
hangmans fracture
Post Op Halo placement
C2 Fracture
minimal
displacement
Post-Op
placement of a
halo device
Cervical Dislocation C4-5

Anterior dislocation C4-5


Facet joint dislocation
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