Conveniently the Salter-Harris types can be remembered by the mnemonic SALTR.. type I. slipped; 5-7%; fracture plane passes all the way through the growth Spondylolysis is present in ~5% of the population 2 and higher in the adolescent athletic population. Mechanism. In reality, the majority of fractures that involve the physis have at least a small fragment of metaphysis associated with them and are therefore type II injuries. The imaging modality of choice, permitting identification of; Salter-Harris type I fractures describe a fracture that is completely contained within the physis. Pathology Mechanism. Fusion of the apophysis to the metatarsal base usually occurs within the following 2-4 years 3,4. It can occur in a variety of settings, including: trauma; osteoporosis Epidemiology. Usually, this kind of fracture occurs as the result of a fall on an outstretched arm and is often associated with a distal radius fracture. Pathology. There is no associated bone fragment. Dorsal avulsion fracture. Non-operative management 6 may be indicated in the setting of minimally displaced fracture. These include: stress fracture of the 5 th metatarsal; Jones fracture; avulsion fracture of the proximal 5 th metatarsal; os vesalianum pedis; os peroneum; normal apophysis of the proximal 5 th metatarsal ; The biomechanics of the fractures differ as do their natural It is also known as backfire fracture or lorry driver fracture 1. The Lisfranc ligament attaches the medial cuneiform to the 2 nd metatarsal base via three bands, the dorsal ligament, interosseous ligament and the Although it appears complicated, it is This typically involves separation of the tibial attachment of the ACL to variable degrees. Epidemiology. Classification. Pathology. intra-articular glenoid fracture. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. Radiographic features Plain radiograph. Although traditionally the mandible and base of skull are thought to form a complete bony ring, interrupted only by the TMJs.This should mean that the mandible should fracture in two places (akin to the bony pelvis) making single fractures uncommon, but this in fact not the case, with ~40% of Skeletal traction may not be required if the fracture pattern is stable and the fracture is outside the weight bearing zone. Mandibular fractures are relatively common especially among young men. Jefferson fracture is the eponymous name given to a burst fracture of the atlas. Important aspects of evaluation include: occipital condyle integrity. The apophysis of the proximal 5 th metatarsal (plural apophyses) lies laterally and is oriented longitudinally parallel to the shaft.. Apophysis of the fifth metatarsal base appears on plain radiographs at age 12 years for boys and 10 years for girls. Colles fracture or other carpal bone fractures) evidence of avascular necrosis if the fracture is subacute; Importantly if no fracture is seen it is essential to recommend repeat x-rays (including dedicated scaphoid views) in 7-10 days 1. Radiographic features Plain radiograph. Galeazzi fracture-dislocations are unstable requiring surgical intervention, which involves open reduction and internal fixation (ORIF) of the radial fracture, intraoperative assessment of the distal radioulnar joint for reducibility and stability, and subsequent Kirschner wire fixation of the ulna to the radius, triangular fibrocartilage complex usually mid-diaphyseal; occur in tandem with angulation; incomplete fracture, with cortical breach of only one side of the bone It should be noted that cartilaginous injuries cannot be detected radiologically and that imaging of simple nasal bone fractures often adds little to patient management. associated fractures (e.g. Fractures in these regions can be classified as: intertrochanteric fracture; pertrochanteric: intertrochanteric, involving both trochanters; subtrochanteric fracture; greater trochanteric avulsion fracture These include: stress fracture of the 5 th metatarsal; Jones fracture; avulsion fracture of the proximal 5 th metatarsal; os vesalianum pedis; os peroneum; normal apophysis of the proximal 5 th metatarsal ; The biomechanics of the fractures differ as do their natural Tibial tuberosity avulsion fractures are uncommon. CT is the best modality for identifying an occipital condyle fracture 6. For example, someone who lives alone may not be able to do so without the use of one arm. It assesses the pattern of fractures, involvement of the radioulnar joint and presence of a distal ulnar fracture.. The fracture complex results from a direct blow to the malar eminence and results in three distinct fracture components that disrupt the anchoring of the zygoma. In addition to reporting the presence of the fracture a number of features should be sought and in many instances commented upon as relevant negatives: Treatment and prognosis. Dorsal avulsion fracture. Traditionally this avulsion fracture has been ascribed to the insertion of peroneus brevis and is caused by forcible inversion of the foot in plantar flexion, as may occur while stepping on a curb or climbing steps. It is also known as backfire fracture or lorry driver fracture 1. Dorsal avulsion fractures account for about 95% all triquetral fractures, most of the remainder are body fractures 4. Fracture of the coronoid process is thought to result from elbow hyperextension with either avulsion of the brachialis tendon insertion or shearing off by the trochlea 1.. Fusion of the apophysis to the metatarsal base usually occurs within the following 2-4 years 3,4. In addition to stating that a medial epicondylar fracture is present, a number of features should be sought and commented upon: avulsion. Pathology Anatomy. fracture through the adjacent humeral metaphysis; Radiology report. In isolation, treatment of bowing fractures is debated 2. Due to the aforementioned characteristics, the fracture typically resembles: Salter-Harris 3 fracture on AP Salter-Harris 2 fracture on lateral Small dislocations and the vertical fracture itself are frequently overlooked, and CT is advised if there is concern. Epidemiology. Conveniently the Salter-Harris types can be remembered by the mnemonic SALTR.. type I. slipped; 5-7%; fracture plane passes all the way through the growth Vertebra plana (plural: vertebrae planae), also known as the pancake, silver dollar or coin-on-edge vertebra, is the term given when a vertebral body has lost almost its entire height anteriorly and posteriorly, representing a very advanced compression fracture. Pathology Mechanism. The Lisfranc ligament attaches the medial cuneiform to the 2 nd metatarsal base via three bands, the dorsal ligament, interosseous ligament and the The Lisfranc joint articulates the tarsus with the metatarsal bases, whereby the first three metatarsals articulate respectively with the three cuneiforms, and the 4 th and 5 th metatarsals with the cuboid.. comminuted fracture: suggests impaction. Vertebra plana (plural: vertebrae planae), also known as the pancake, silver dollar or coin-on-edge vertebra, is the term given when a vertebral body has lost almost its entire height anteriorly and posteriorly, representing a very advanced compression fracture. degree of displacement; location of the displaced fragment; presence of a fracture of the adjacent humeral metaphysis Fractures are best visualized on coronal and sagittal reformatted images. associated fractures (e.g. usually mid-diaphyseal; occur in tandem with angulation; incomplete fracture, with cortical breach of only one side of the bone There are two classification systems 5,6. Epidemiology. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. Pathology Anatomy. Barton fractures are fractures of the distal radius.It is also sometimes termed the dorsal type Barton fracture to distinguish it from the volar type or reverse Barton fracture.. Barton fractures extend through the dorsal aspect to the articular surface but not to the volar aspect. Pathology. This fracture is very different, and much less common, than the torus fracture that results in buckling of the cortex on the concave side of the bend and an intact convex surface. Jefferson fracture is the eponymous name given to a burst fracture of the atlas. Epidemiology These fractures have an incidence 0.4% to 2.7%, and males are affected more-so than females. degree of displacement; location of the displaced fragment; presence of a fracture of the adjacent humeral metaphysis The Frykman classification of distal radial fractures is based on the AP appearance and encompasses the eponymous entities of Colles fracture, Smith fracture, Barton fracture, chauffeur fracture.. An elongated lateral tubercle of the posterior process of the talus is referred to as a Stieda process, so occasionally these fractures are described as Stieda process fractures.. A Cedell fracture is a fracture of the medial tubercle of the posterior process. In addition to stating that a medial epicondylar fracture is present, a number of features should be sought and commented upon: avulsion. Bowing fractures usually accompany another fracture and in those cases, treatment is determined according to the type and severity of the accompanying injury. Radiographic features. In isolation, treatment of bowing fractures is debated 2. Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. Radiographic features. Looser zones are also a type of insufficiency fracture. It was originally described as a four-part fracture with double fractures through the anterior and posterior arches, but three-part and two-part fractures have also been described. Fractures in these regions can be classified as: intertrochanteric fracture; pertrochanteric: intertrochanteric, involving both trochanters; subtrochanteric fracture; greater trochanteric avulsion fracture A Shepherd fracture refers to a fracture of the lateral tubercle of the posterior process. Epidemiology These fractures have an incidence 0.4% to 2.7%, and males are affected more-so than females. Anderson and D'Alonzo Colles fractures are the most common type of distal radial fracture and are seen in all adult age groups and demographics. Plain radiograph. Dorsal avulsion fractures account for about 95% all triquetral fractures, most of the remainder are body fractures 4. Segond fracture is an avulsion fracture of the knee that involves the lateral aspect of the tibial plateau and is very frequently (~75% of cases) associated with disruption of the anterior cruciate ligament (ACL). This typically involves separation of the tibial attachment of the ACL to variable degrees. An elongated lateral tubercle of the posterior process of the talus is referred to as a Stieda process, so occasionally these fractures are described as Stieda process fractures.. A Cedell fracture is a fracture of the medial tubercle of the posterior process. cardiopulmonary resuscitation (CPR): rib fracture occurs in 1 in 3 5; fetal rib fractures: caused by skeletal dysplasias; radiation-induced rib fractures 8,9; spontaneous: spontaneous rib fracture; Radiographic features Plain radiograph. Classification. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. They should not be confused with fatigue fractures which are due to abnormal stresses on normal bone, or with pathological fractures, the result of diseased, weakened bone due to focal pathology such as The Salter-Harris classification was proposed by Salter and Harris in 1963 1 and at the time of writing (June 2016) remains the most widely used system for describing physeal fractures.. Fracture of the coronoid process is thought to result from elbow hyperextension with either avulsion of the brachialis tendon insertion or shearing off by the trochlea 1.. Epidemiology. Coronoid process fractures have been classified into three types within the Regan and Morrey classification system 1:. Radiographic features Plain radiograph. This typically involves separation of the tibial attachment of the ACL to variable degrees. Insufficiency fractures are a type of stress fracture, which are the result of normal stresses on abnormal bone. Dorsal avulsion fracture. Sometimes the fractures may not seem very apparent on x orbital blow-out fracture; frontal process of the maxilla; Nasal septal hematoma should also be actively assessed. Classification. fracture through the adjacent humeral metaphysis; Radiology report. The Bado classification is used to subdivide the fracture-dislocation into four types which all have different treatment options and prognoses and is based on the principle that the direction in which the apex of the ulnar fracture points is the same Classification. cardiopulmonary resuscitation (CPR): rib fracture occurs in 1 in 3 5; fetal rib fractures: caused by skeletal dysplasias; radiation-induced rib fractures 8,9; spontaneous: spontaneous rib fracture; Radiographic features Plain radiograph. Classification. It is more common in men than in women 1.. Looser zones are also a type of insufficiency fracture. Coronoid process fractures have been classified into three types within the Regan and Morrey classification system 1:. It was originally described as a four-part fracture with double fractures through the anterior and posterior arches, but three-part and two-part fractures have also been described. Pathology. Posterior cruciate ligament (PCL) avulsion fractures are a type of avulsion fracture of the knee that represent the most common isolated PCL lesion. Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. Traditionally this avulsion fracture has been ascribed to the insertion of peroneus brevis and is caused by forcible inversion of the foot in plantar flexion, as may occur while stepping on a curb or climbing steps. Mechanism. Although it appears complicated, it is In addition to stating that a medial epicondylar fracture is present, a number of features should be sought and commented upon: avulsion. Classification. Vertebra plana (plural: vertebrae planae), also known as the pancake, silver dollar or coin-on-edge vertebra, is the term given when a vertebral body has lost almost its entire height anteriorly and posteriorly, representing a very advanced compression fracture. Management depends not only on the type of fracture but also importantly on the functional status and living situation of the patient. Epidemiology These fractures have an incidence 0.4% to 2.7%, and males are affected more-so than females. They should not be confused with fatigue fractures which are due to abnormal stresses on normal bone, or with pathological fractures, the result of diseased, weakened bone due to focal pathology such as type I: avulsion of anterior glenoid margin; type II: transverse or oblique fracture through glenoid fossa exiting inferiorly; type III: oblique fracture through glenoid fossa exiting superiorly and associated with acromioclavicular joint injury; type IV: transverse fracture exiting through the medial scapular border Associations ~65% of patients with spondylolysis will progress to spondylolisthesis 2, which is seen radiographically in ~25% 4; in most patients this occurs before the age of 16; spina bifida occulta The fracture is easy to recognize on plain film. It is more common in men than in women 1.. Associations ~65% of patients with spondylolysis will progress to spondylolisthesis 2, which is seen radiographically in ~25% 4; in most patients this occurs before the age of 16; spina bifida occulta Traction (either skin or skeletal traction) is usually a temporary solution when surgery is required. Galeazzi fracture-dislocations are unstable requiring surgical intervention, which involves open reduction and internal fixation (ORIF) of the radial fracture, intraoperative assessment of the distal radioulnar joint for reducibility and stability, and subsequent Kirschner wire fixation of the ulna to the radius, triangular fibrocartilage complex Posterior cruciate ligament (PCL) avulsion fractures are a type of avulsion fracture of the knee that represent the most common isolated PCL lesion. There are two classification systems 5,6. CT. scapular fracture; clavicle fracture; distal radial fracture (especially Colles fracture) Treatment and prognosis. Rarely, a torus fracture may refer to the fracture of an oral torus, and there is potential for the two terms to be confused 10. Classification. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. The apophysis of the proximal 5 th metatarsal (plural apophyses) lies laterally and is oriented longitudinally parallel to the shaft.. Apophysis of the fifth metatarsal base appears on plain radiographs at age 12 years for boys and 10 years for girls. It is interesting to note that the word chauffeur comes from the French for "someone who warms" the car engine. scapular fracture; clavicle fracture; distal radial fracture (especially Colles fracture) Treatment and prognosis. It is more common in men than in women 1.. Management depends not only on the type of fracture but also importantly on the functional status and living situation of the patient. Important aspects of evaluation include: occipital condyle integrity. Tibial tuberosity avulsion fractures are uncommon. Fusion of the apophysis to the metatarsal base usually occurs within the following 2-4 years 3,4. In reality, the majority of fractures that involve the physis have at least a small fragment of metaphysis associated with them and are therefore type II injuries. It can occur in a variety of settings, including: trauma; osteoporosis comminuted fracture: suggests impaction. scapular fracture; clavicle fracture; distal radial fracture (especially Colles fracture) Treatment and prognosis. It is for this reason that the 5 th metatarsal base must be included in the lateral ankle projection of an ankle series, especially when performed for an In reality, the majority of fractures that involve the physis have at least a small fragment of metaphysis associated with them and are therefore type II injuries. intra-articular glenoid fracture. Classification. Although it appears complicated, it is Salter-Harris type I fractures describe a fracture that is completely contained within the physis. Mechanism. Terminology. On the frontal knee radiograph, it may It is also known as backfire fracture or lorry driver fracture 1. The Frykman classification of distal radial fractures is based on the AP appearance and encompasses the eponymous entities of Colles fracture, Smith fracture, Barton fracture, chauffeur fracture.. It assesses the pattern of fractures, involvement of the radioulnar joint and presence of a distal ulnar fracture.. Pathology. Radiographic features. A Shepherd fracture refers to a fracture of the lateral tubercle of the posterior process. In addition to reporting the presence of the fracture a number of features should be sought and in many instances commented upon as relevant negatives: For example, someone who lives alone may not be able to do so without the use of one arm. Important aspects of evaluation include: occipital condyle integrity. CT. may miss up to 50% of rib fractures even with dedicated oblique rib projections 1; Ultrasound Colles fractures are the most common type of distal radial fracture and are seen in all adult age groups and demographics. Some advocate the reduction of a bowing fracture where angulation exceeds 20 degrees. The fracture is easy to recognize on plain film. For example, someone who lives alone may not be able to do so without the use of one arm. Pathology Mechanism. A Shepherd fracture refers to a fracture of the lateral tubercle of the posterior process. Non-operative management 6 may be indicated in the setting of minimally displaced fracture. Practical points. Case Discussion. Case Discussion. Anderson and D'Alonzo Pathology. Classification. Plain radiograph. Insufficiency fractures are a type of stress fracture, which are the result of normal stresses on abnormal bone. Galeazzi fracture-dislocations are unstable requiring surgical intervention, which involves open reduction and internal fixation (ORIF) of the radial fracture, intraoperative assessment of the distal radioulnar joint for reducibility and stability, and subsequent Kirschner wire fixation of the ulna to the radius, triangular fibrocartilage complex type I: avulsion of anterior glenoid margin; type II: transverse or oblique fracture through glenoid fossa exiting inferiorly; type III: oblique fracture through glenoid fossa exiting superiorly and associated with acromioclavicular joint injury; type IV: transverse fracture exiting through the medial scapular border Spondylolysis is present in ~5% of the population 2 and higher in the adolescent athletic population. This case illustrates the difference in the appearance of an avulsion fracture and an apophysis at the base of the 5th metatarsal, as both are present simultaneously in this 10 year old patient. may miss up to 50% of rib fractures even with dedicated oblique rib projections 1; Ultrasound There is no associated bone fragment. It is for this reason that the 5 th metatarsal base must be included in the lateral ankle projection of an ankle series, especially when performed for an In isolation, treatment of bowing fractures is debated 2. Rarely, a torus fracture may refer to the fracture of an oral torus, and there is potential for the two terms to be confused 10. Typically, Monteggia fracture-dislocations occur as the result of a fall onto an outstretched hand (FOOSH) 4.. The imaging modality of choice, permitting identification of; Some advocate the reduction of a bowing fracture where angulation exceeds 20 degrees. These include: stress fracture of the 5 th metatarsal; Jones fracture; avulsion fracture of the proximal 5 th metatarsal; os vesalianum pedis; os peroneum; normal apophysis of the proximal 5 th metatarsal ; The biomechanics of the fractures differ as do their natural Tibial tuberosity avulsion fractures are uncommon. Plain radiograph. Pathology. Looser zones are also a type of insufficiency fracture. Insufficiency fractures are a type of stress fracture, which are the result of normal stresses on abnormal bone. On the frontal knee radiograph, it may The fracture complex results from a direct blow to the malar eminence and results in three distinct fracture components that disrupt the anchoring of the zygoma. Radiographic features. They are particularly common in patients with osteoporosis, and as such, they are most frequently seen in elderly women.The relationship between Colles fractures and osteoporosis is strong enough that when an older male patient It is for this reason that the 5 th metatarsal base must be included in the lateral ankle projection of an ankle series, especially when performed for an Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. The Bado classification is used to subdivide the fracture-dislocation into four types which all have different treatment options and prognoses and is based on the principle that the direction in which the apex of the ulnar fracture points is the same Classification. The fracture is easy to recognize on plain film. associated fractures (e.g. In addition to reporting the presence of the fracture a number of features should be sought and in many instances commented upon as relevant negatives: orbital blow-out fracture; frontal process of the maxilla; Nasal septal hematoma should also be actively assessed. Typically, Monteggia fracture-dislocations occur as the result of a fall onto an outstretched hand (FOOSH) 4.. Rarely, a torus fracture may refer to the fracture of an oral torus, and there is potential for the two terms to be confused 10. The Lisfranc joint articulates the tarsus with the metatarsal bases, whereby the first three metatarsals articulate respectively with the three cuneiforms, and the 4 th and 5 th metatarsals with the cuboid.. They are particularly common in patients with osteoporosis, and as such, they are most frequently seen in elderly women.The relationship between Colles fractures and osteoporosis is strong enough that when an older male patient Segond fracture is an avulsion fracture of the knee that involves the lateral aspect of the tibial plateau and is very frequently (~75% of cases) associated with disruption of the anterior cruciate ligament (ACL). The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5. Pathology Anatomy. 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