fractures and related injuries - rochester, ny · fractures and related injuries! types: location...

Presentation material for educational purposes only. All rights reserved. © 1999 URMC Radiology. 1 / 30

Introduction to the Radiology ofIntroduction to the Radiology ofFractures and Related InjuriesFractures and Related Injuries

Matthew ChamMedical Student

University of RochesterSchool of Medicine & Dentistry


Introduction to the Radiology ofFractures and Related Injuries

! Types: location and mechanisms of injury

! Classifications and grading

! Radiologic vs. Clinical features

! Variants


Types of Fractures! Incomplete vs Complete

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SimpleFractures

! Alignment &displacementof fragments

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! Directions of the fracture lines

Simple Fractures

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Other terms: fracture line not seen

! Impaction, depression, and compression

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Uncommon fractures

! Stress and pathologic etiologies

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Fractures involving the growth plate! Salter-Harris Classification

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Injuries of non-articulating joints

! Acromioclavicular & coracoclavicular separation! Sprain or tears in the AC and (or) CC ligaments, resulting in AC

separation with inferior displacement of the scapula and extremity

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Anterior dislocation of the humeral head

! Depressionfractures

! Hill-Sacks& Bankartlesions

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Proximal HumeralFractures

! Classification bylocation and extentof displacement

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Fracture-dislocation of the humeral head

! Classification by anatomic location and displacement

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Distal Humeral Fractures

! Muller Classification of Extra-articular extension

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DistalDistalHumeralHumeralFracturesFractures

!! MullerMullerClassification ofClassification ofintra-articularintra-articularextensionextension

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! Posteriorelbow

Dislocations

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Radial Headfracture

! MasonClassification

I = undisplacedI = undisplaced

II = displacedII = displaced

III = comminutedIII = comminuted

IV = dislocatedIV = dislocated

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OlecranonFractures

! Horne-TanzerClassification

IA = Oblique proximal 3rdIA = Oblique proximal 3rd

IB = Transverse proximal 3rdIB = Transverse proximal 3rd

IIA = Oblique middle 3rdIIA = Oblique middle 3rd

IIB = Transverse middle 3rdIIB = Transverse middle 3rd

III = Oblique distal 3rdIII = Oblique distal 3rd

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Fractures ofthe forearm

! Monteggiafracture-dislocations

Bado classification of fracturesBado classification of fracturesof the proximal ulna:of the proximal ulna:

I = with anterior radialI = with anterior radialdislocationdislocation

II = with posterior radialII = with posterior radialdislocationdislocation

III = with lateral radialIII = with lateral radialdislocationdislocation

IV = with anterior radialIV = with anterior radialdislocation and fracturedislocation and fracture

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! Colles fracture

Fractures ofthe forearm

Fractures to the distalFractures to the distalradius, usually with lateral orradius, usually with lateral ordorsal displacement of thedorsal displacement of thedistal fragmentdistal fragment

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! Smith fractures (reverse Colle’s fractures)

Type 1Type 1 Type 2Type 2 Type 3Type 3

Fractures of the forearm

Fractures of the distal radius with volar displacementFractures of the distal radius with volar displacementand angulation of the distal fragmentand angulation of the distal fragment

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Fractures of the wrist

! Scaphoid fracturesSecond most common injurySecond most common injuryof the upper limbof the upper limb

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! Bennett fracture-dislocationFractures of the hand

Intra-articular fracture of the proximal end of the first metacarpal, withIntra-articular fracture of the proximal end of the first metacarpal, withdorsal and lateral dislocation of the distal segment.dorsal and lateral dislocation of the distal segment.

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Fractures of the Proximal Femur! Intra- and Extracapsular fractures

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Blood supply of the femoral head

! Interruption of this blood supplysecondary to intracapsular fracturemay lead to osteonecrosis

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Fractures of the Proximal Femur

! Impaction of the femoral neck into the femoral head

NormalNormal ImpactionImpaction G

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! Acetabular fracture ( )

! Posterior dislocation of thefemoral head

patient 1patient 1 patient 2patient 2

Posterior columnPosterior columnfx of acetabulumfx of acetabulum

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Anterior dislocation of the femoral head

patient Cpatient C

patient Cpatient C

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Fractures of the distal femur! Supracondylar, condylar, and intercondylar extension

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Fractures of thedistal femur

! intercondylar fracture

AP viewAP viewlateral viewlateral view

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Summary

! simple vs. comminuted fractures

! stress and pathologic fractures

! intra- vs. extra-articular involvement

! dislocation vs. separation

! depression fractures and associated lesions

! effects of fractures on blood supply

fractures and related injuries - rochester, ny · fractures and related injuries! types: location...

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