Recognizing Fractures and Dislocations

Chapter 22 Recognizing Fractures and Dislocations



Recognizing an Acute Fracture




image A fracture is described as a disruption in the continuity of all or part of the cortex of a bone.














TABLE 22-1 DIFFERENTIATING FRACTURES, OSSICLES, AND SESAMOIDS























Finding Acute Fracture Sesamoids and Accessory Ossicles*
Abrupt disruption of cortex Yes No
Bilaterally symmetrical Almost never Almost always
“Fracture line” Unsharp, jagged Smooth
Bony fragment has a cortex completely around it No Yes

* Old, unhealed fractures will not be bilaterally symmetrical.




Recognizing Dislocations and Subluxations







TABLE 22-2 DISLOCATIONS OF THE SHOULDER AND HIP















Shoulder Hip
Anterior, subcoracoid most common Posterior and superior more common
Caused by a combination of abduction, external rotation, and extension Frequently caused by knee striking dashboard transmitting force to hip
Associated with fractures of humeral head (Hill-Sachs lesion) and glenoid (Bankart lesion) Associated with fractures of posterior rim of the acetabulum


Describing Fractures





TABLE 22-3 HOW FRACTURES ARE DESCRIBED


















Parameter Terms Used
Number of fracture fragments Simple or comminuted
Direction of fracture line Transverse, oblique (diagonal), spiral
Relationship of one fragment to another Displacement, angulation, shortening, and rotation
Open to the atmosphere (outside) Closed or open (compound)



How Fractures are Described: by the Direction of the Fracture Line (Table 22-4)






TABLE 22-4 DIRECTION OF FRACTURE LINE AND MECHANISM OF INJURY















Direction of Fracture Line Mechanism
Transverse Force applied perpendicular to long axis of bone; fracture occurs at point of impact
Diagonal (also known as oblique) Force applied along the long axis of bone; fracture occurs somewhere along shaft
Spiral Twisting or torque injury



How Fractures are Described: by the Relationship of One Fracture Fragment to Another


imageBy convention, abnormalities of the position of bone fragments secondary to fractures describe the relationship of the distal fracture fragment relative to the proximal fragment. These descriptions are based on the position the distal fragment would have normally assumed had the bone not been fractured.










Mar 2, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on Recognizing Fractures and Dislocations

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