Musculoskeletal Trauma
General Concepts
Terminology
Fracture:
Cortical discontinuity in a bone (or cartilage).
Dislocation:
Disruption of normal articulating anatomy of a joint.
Fracture/Dislocation:
Fracture at/near joint resulting in dislocation.
Approach to Describing a Fracture
1.
Describe the film
2.
Type
·
Complete vs.
Incomplete (Greenstick/Buckle)
·
Shape
·
Simple vs.
Comminuted (>2 parts)
·
Open vs.
Closed
3.
Location
·
Diaphysis:
the shaft of the bone. (proximal, mid-shaft, distal).
·
Metaphysis:
the widening portion adjacent to the growth plate.
·
Epiphysis:
the end of the bone adjacent to the joint.
·
Physeal
(in pediatrics) + Salter Harris.
4.
Displacement
Describing the distal fragment
unless otherwise indicated.
·
Rotation:
Internal rotation vs. External Rotation
·
Angulation:
Varus vs. Valgus (VaLgus = Lateral)
·
Translation:
* Medial vs. Lateral Displacement
* Superior vs. Inferior: Bayonet
Apposition/Foreshortening vs. Distraction (must measure amount)
5.
Joint Involvement.
Salter-Harris Classification
Most widely used system for
describing physeal fractures = childhood fractures that involve the physeal
plate. They are relatively common and important to differentiate from other
injuries because the involvement of the physis (growth plate) may cause
premature closure resulting in limb shortening and abnormal growth.