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14 Cards in this Set

  • Front
  • Back
5 ways to describe a fracture
1. closed vs open
2. simple vs comminuted
3. Extraarticular vs intraarticular
4. Path of fracture line
5. Position of fracture
Some different ways to describe path of fracture line
- transverse, oblique, spiral, longitudinal
- angulation: degree of ang deformity created by #
- displacement: separation of fragments
- impaction: fragements driven together
- foreshortening: overlap of fragments
Fractures in Children
1. plastic bowing
2. Torus #
3. Greenstick #
4. Salfter-Harris #
1. bend rather than break - caused by pathology
2. compression, slight bubble in bone, axial compression
3. Only break on 1 side of cortex
4. Slipped, Above, Lower, Through, Ruined - intraarticular
Positioning of Cervical Spine
1. AP
2. Lateral
3. Odontoid
1. AP - supine or erect w/ chin up if possible, aimed at level of C4
2. Lateral - supine or erect w/ chin up if possible, aimed at level of C4 to the left side
3. Supine or erect, CR aimed at centre of open mouth
Positioning of Lumbar Spine
1. AP
2. Lateral and L5-S1
1. AP - supine w/ knees flexed to open up disc spaces, may be erect if a WB view is needed, CR aimed at L4
2. Lateral - lateral recumbent, knees flexed, CR aimed at L4
3. L5-S1 - lateral recumbent, knees flexed, CR aimed 4cm inferior to iliac crest and 5cm posterior to ASIS
ABCS of Cervical Spine
A - anterior, middle, posterior columns --> 2/3 = unstable
B - alignment of bones on top of each other
C - cartilage height, roughly same in Cx spine
S - tissue in front C4 = 1/4 VB, C7 = 1 VB
Pathomechanics of Cx Spine Trauma (5)
- Axial compression
- flexion***
- extension
- distraction
- rotation
Jefferson Fracture
- where?
- MOI?
- View/ position?
- where: C1
- MOI:
--> blow to top of head forcing C1 lateral massess laterally, splits bony ring and tears transverse ligament, rings break in several places
--> bilateral displacement >2mm
--> unstable if >7mm
--> 1-2mm or unilateral can be due to rotational F
- View: odontoid - patient erect or supine w/ mouth open, CR pointed into centre of mouth
Odontoid Fractures
- Classification
- MOI
Type 1: upper parts of dens, rare, potentially unstable
Type 2: base of dens, unstable
Type 3: base extending into body, unstable, best prognosis for healing
MOI: FLEXION or extension
Where: C2
Hangman's Fracture
- MOI
- Position of fracture
MOI: hyperexstension and distraction - chin on dashboard, hanging
Where is fracture: C2, pars interarticularis/ pedicle/ both
Cx Spine Facet Joint Dislocations
- MOI
- Description of dislocation
- X-ray
MOI: hyperflexion w/o compression, unstable
Description: subluxed, perched, locked
X-ray: disruption of parallel lines, anterior displacement of body = >50%
Cx Spine Anterior subluxation
- MOI
- X-ray
MOI: hyperflexion
Characteristics: localised kyphosis, widened interspinous distance, posterior disc space widening, facet joint subluxation, better seen on F/E views
Avulsion Fracture/ Clay-Shoveller's Fracture
- Characteristics of #
- MOI:
Characteristics: fractuers of spinous procecces
MOI: flexion + rotation of body
Anterior Wedge Compression #
- characteristics
- MOI
- characteristics: loss of vertebral body height, large disc space,
MOI: caused by hyperflexion, assoc w/ Osteoporosis