The term "hangman fracture" was introduced by Schneider in 1965 5. Lee P, Hunter TB, Taljanovic M. Musculoskeletal colloquialisms: how did we come up with these names? The Weber ankle fracture classification (or Danis-Weber classification) is a simple system for classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint, specifically the distal tibiofibular syndesmosis.It has a 2007;89 (1): 58-63. fractures involving a single facial buttress, Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture), Watson-Jones classification (tibial tuberosity avulsion fracture), Nunley-Vertullo classification (Lisfranc injury), pelvis and lower limb fractures by region. Triquetral fracture. Falls, motor vehicle collisions, pedestrian accidents, cycling and diving are common causes of injury 6,7. Radiographic features. These injuries are almost always due to 4. 2005;234 (3): 733-9. 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: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Langner S, Langner RA, Langner SS, Langner WM, Langner HC, Langner. open reduction and internal fixation (ORIF), Gustilo Anderson classification (compound fracture), Anderson and Montesano classification of occipital condyle fractures, Traynelis classification of atlanto-occipital dissociation, longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), AO/OTA classification of distal humeral fractures, Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), AO classification of distal femur fractures, Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, fragment number and orientation/relationship. Hill-Sachs defect. Engaging Hill-Sachs Lesion: Is There an Association Between This Lesion and Findings on MRI? 2016;21(5):163-71. 5. 4. W B Saunders Co. (2001) ISBN:0721690270. Radiology report. Even if a pseudoarthrosis occurs (non-union) most patients are asymptomatic; if symptoms do occur later, surgical intervention can be carried out 1,2. Acute Shoulder Trauma: What the Surgeon Wants to Know. Strictly speaking, the fracture is misnamed and should more correctly be called "hangee" fracture. Pathology. 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. (2009) ISBN:1582557845. Michael B. Zlatkin. As physeal closure has to begin at one end, triplane fractures have occasionally been reported in other sites too, e.g. fracture through the physis Tibial tuberosity avulsion fractures are uncommon. Marshall RA, Mandell JC, Weaver MJ, Ferrone M, Sodickson A, Khurana B. Dorsal avulsion fracture. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. 11. Pribaz JR, Bernthal NM, Wong TC et-al. 4. Case 15: with concurrent bony Bankart lesion, humeral avulsion of the glenohumeral ligament (HAGL), Gustilo Anderson classification (compound fracture), Anderson and Montesano classification of occipital condyle fractures, Traynelis classification of atlanto-occipital dissociation, longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), AO/OTA classification of distal humeral fractures, Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), AO classification of distal femur fractures, Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, wedge shape defect in the posterolateral aspect of the humeral head, best appreciated on AP internal rotation view, smaller defects can be difficult to identify, on abduction-internal rotation views, the physiological depression at humeral head-neck junction should not be mistaken for Hill-Sachs defect and is evident 2 cm from superior humeral head margin, loss of the normal circular shape in the posterolateral region of the superior humeral head on axial images, anatomic shape can be preserved but the presence of bone marrow edema in the posterolateral humeral head indicates an acute injury, normal flattening of the posterolateral humeral head caudal to the level of coracoid should not be misinterpreted as a Hill-Sachs defect, in patients with a Hill-Sachs defect but without an anterior labral tear, particular attention should be made to assessing for potential, 1. Flexion teardrop fractures represent a fracture pattern occurring in severe axial/flexion injury of the cervical spine. 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 Terminology. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. 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. 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. fracture through the physis ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. When a fracture is identified, a careful search for adjacent soft tissue injury should be undertaken. May. Radiographics. Although often the fracture is undisplaced 5, depending on how sagittal the fracture orientation is, variable proximal migration of the fracture occurs, with an articular step which comes into contact with the scaphoid 4. Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading.. The bony defect can be treated with bone grafting or placement of soft tissue within the defect,but this is generally reserved for large, engaging defects 6,7. 29 (6): 842-6. Tibial tuberosity avulsion fractures are uncommon. It was first described in 1940 by American radiologists Harold Arthur Hill (1901-1973)and Maurice David Sachs(19091987)3,11,12. Plain films usually suffice in the assessment of chauffeur fractures. As the physiological closure of the physeal plate begins medially, the lateral (open) physis is prone to this type of fracture. 7. Almost invariably, if the fracture involves a paranasal sinus, middle ear or mastoid air cells, then they will contain some blood, which is a helpful clue to the presence of an underlying fracture. This typically involves separation of the tibial attachment of the ACL to variable degrees. Radiographic features. 2. Open book pelvic injuries are most often the result of high-energy trauma and are associated with significant morbidity and mortality due to associated vascular injuries.. In adolescents with closing epiphyseal plate(s) they are the most common ankle joint fractures -along with Tillaux fractures. 6. The fracture extends proximally in a variable oblique direction (from essentially transverse to almost sagittal) from the distal radial articular surface through the lateral cortex of the distal radius, thus separating the radial styloid from the rest of the radius 4,5. J Hand Surg Am. Insufficiency fractures are a type of stress fracture, which are the result of normal stresses on abnormal bone. 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 J Pediatr Orthop B. They are important to recognize because they indicate extensive underlying ligamentous injury and spinal instability. B. J. Manaster, David G. Disler, David A. Osteoporosis is the most common cause of insufficiency fractures, although there are many causes 7-9: Early diagnosis is best made with a bone scan or MRI, as plain films may initially appear normal. Epidemiology. (2018) World neurosurgery. (2010) ISBN:3642065686. 7. It is often associated with a Bankart lesion of the glenoid. Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery.Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team. Radiology report. Symptoms comprise of pain and inability to weight bear. 2014;23 (3): 227-30. They are important to recognize because they indicate extensive underlying ligamentous injury and spinal instability. Epidemiology. Lippincott Williams & Wilkins. Mallet finger refers to injuries of the extensor mechanism of the finger at the level of the distal interphalangeal joint (DIP).They are the most prevalent finger tendon injury in sport. 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 2014;87(1034):20130673. 3. Plain radiograph. Practical points. The term "hangman fracture" was introduced by Schneider in 1965 5. Standard ankle series suggested; AP, lateral and mortise (best view to define displacement). Case 1: with a concurrent radial styloid fracture, Case 2: with a concurrent scaphoid fracture, Case 19: with distal radius and ulnar fractures, Gustilo Anderson classification (compound fracture), Anderson and Montesano classification of occipital condyle fractures, Traynelis classification of atlanto-occipital dissociation, longitudinal versus transverse petrous temporal bone fracture, naso-orbitoethmoid (NOE) complex fracture, cervical spine fracture classification systems, AO classification of upper cervical injuries, subaxial cervical spine injury classification (SLIC), thoracolumbar spinal fracture classification systems, AO classification of thoracolumbar injuries, thoracolumbar injury classification and severity score (TLICS), Rockwood classification (acromioclavicular joint injury), Neer classification (proximal humeral fracture), AO classification (proximal humeral fracture), AO/OTA classification of distal humeral fractures, Milch classification (lateral humeral condyle fracture), Weiss classification (lateral humeral condyle fracture), Bado classification of Monteggia fracture-dislocations (radius-ulna), Mason classification (radial head fracture), Frykman classification (distal radial fracture), Hintermann classification (gamekeeper's thumb), Eaton classification (volar plate avulsion injury), Keifhaber-Stern classification (volar plate avulsion injury), Judet and Letournel classification (acetabular fracture), Harris classification (acetebular fracture), Young and Burgess classification of pelvic ring fractures, Pipkin classification (femoral head fracture), American Academy of Orthopedic Surgeons classification (periprosthetic hip fracture), Cooke and Newman classification (periprosthetic hip fracture), Johansson classification (periprosthetic hip fracture), Vancouver classification (periprosthetic hip fracture), Winquist classification (femoral shaft fracture), Schatzker classification (tibial plateau fracture), AO classification of distal femur fractures, Lauge-Hansen classification (ankle injury), Danis-Weber classification (ankle fracture), Berndt and Harty classification (osteochondral lesions of the talus), Sanders CT classification (calcaneal fracture), Hawkins classification (talar neck fracture), anterior superior iliac spine (ASIS) avulsion, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, avulsion fracture of the proximal 5th metatarsal, Mayfield classification of carpal instability, dorsal intercalated segment instability (DISI), volar intercalated segment instability (VISI), scaphoid nonunion advanced collapse (SNAC), triangular fibrocartilaginous complex (TFCC) injuries, ulnar-sided wrist impaction and impingement syndromes, calcium pyrophosphate dihydrate deposition disease, pain is usually on the ulnar aspect of the wrist, exacerbated by extension/flexion of the wrist, swelling over the dorsum of the hand with a tender dorsal aspect of triquetrum may be found on exam. Palmer W, Bancroft L, Bonar F et al. 8. Comparison to the contralateral elbow may be of benefit. Pathology. May. J Bone Joint Surg Am. The bony defect itself often does not require treatment, however, the associated glenohumeral instability and coexistent anterior labral injuries often do require surgical repair. They are most often seen in the setting of osteoporosis, although any process which weakens bone is a risk factor. Associations The Hill-Sachs Lesion: Diagnosis, Classification, and Management. Essentials of Skeletal Radiology. The imaging modality of choice, permitting identification of; Radiographics. Triplane fracture. 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. Surgical intervention is rarely required, but a persistently symptomatic chip fracture may require excision. 5. There is no associated bone fragment. 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. There is no associated bone fragment. ISBN:0323072437. A pathological fracture, although a type of insufficiency fracture, is a term in general reserved for fractures occurring at the site of a focal bony abnormality.Some authors use the term stress fracture synonymously with fatigue fracture, and thus some caution with the term is suggested.. 2012;263 (3): 645-60. The fracture is seen on lateral radiographs as an oblique lucency through the spinous process, usually of C7. Pathology Anatomy. Triplane or triplanar fracturesare of the distal tibia only occurring in adolescents. Springer Verlag. Triquetral fractures are carpal bone fractures generally occurring on the dorsal surface of the triquetrum. 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.. Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults; 90% are seen in children younger than 10 years of age, with a peak age of 5-7 years 4,6.These fractures are more commonly seen in boys 4 and are the most common elbow fractures in children (55-80%) 8.. (1999) Seminars in arthritis and rheumatism. 3. Trimalleolar fractures refer to a three-part fracture of the ankle. Having three parts, this is a more unstable fracture and may be associated with ligamentous injury. Fractures of the entire posterior process of the talus are extremely rare. Robinson P. Essential Radiology for Sports Medicine. 2. In significantly displaced fractures, rigid internal fixation allowing early mobilization is an option, although conservative management for these patients also is an option 1,2. J Bone Joint Surg Am. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Associations Ultrasound 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: Males are affected more commonly than females with a median age of injury of 56 years. pseudo-Jefferson fracture, or pseudospread of the atlas on the axis. Trimalleolar fractures refer to a three-part fracture of the ankle. There are many types of cervical spine fracture, some of which are unstable; general indicators of instability include 9: The fulcrum of movement is different in children than adults, C2/3 compared to C5/6, respectively; hence, in children, cervical fractures are more common in upper vertebrae. Having three parts, this is a more unstable fracture and may be associated with ligamentous injury. Due to the aforementioned characteristics, the fracture typically resembles: Small dislocations and the vertical fracture itself are frequently overlooked, and CT is advised if there is concern. Gyftopoulos S, Yemin A, Beltran L, Babb J, Bencardino J. 2011;45 (1): 39-44. Multidetector computed tomography of pediatric lateral condylar fractures. Classification. Epidemiology. A Cedell fracture is a fracture of the medial tubercle of the posterior process. The term is sometimes used to describe intra-articular fractures with There is usually significant displacement. Wolfgang Dhnert. Laer LV. Pathology. Terminology. There is usually significant displacement. Terminology. Smith fractures, also known as Goyrand fractures in the French literature 3, are fractures of the distal radius with associated volar angulation of the distal fracture fragment(s). Cervical spine fractures. AJR Am J Roentgenol. Epidemiology. Reference article, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-1450, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":1450,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/hill-sachs-defect/questions/1407?lang=us"}. 2010;194 (4): 1061-4. Analysis of 51 tibial triplane fractures using CT with multiplanar reconstruction. 32 (5): 456-60. Practical points. Check for errors and try again. (2004) ISBN:1588906809. The fracture is seen on lateral radiographs as an oblique lucency through the spinous process, usually of C7. It is also known as backfire fracture or lorry driver fracture 1. Relat. The term "hangman fracture" was introduced by Schneider in 1965 5. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Gaillard F, Yap J, Iqbal S, et al. Lateral spurring (overgrowth) after pediatric lateral condyle fractures. Classically, these fractures are extra-articular transverse fractures and can be thought of as a reverse Colles fracture.. Hill H & Sachs M. The Grooved Defect of the Humeral Head. 1. Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. Epidemiology. A Literature Review with a Focus on Shoulder and Elbow Surgery. Kanellopoulos AD, Yiannakopoulos CK, Badras LS. Imaging Features and Management of Stress, Atypical, and Pathologic Fractures. Smith fractures, also known as Goyrand fractures in the French literature 3, are fractures of the distal radius with associated volar angulation of the distal fracture fragment(s). The plain radiographic investigation of the fingers involves three projections (AP oblique and lateral). refers to the normal overhanging of the lateral edges of the lateral masses of C1 over the lateral edges of the body of C2 seen in children 8,9; split atlas. Mallet finger refers to injuries of the extensor mechanism of the finger at the level of the distal interphalangeal joint (DIP).They are the most prevalent finger tendon injury in sport. Alonso-Bartolom P, Martnez-Taboada VM, Blanco R, et al. History and etymology. 2004;32 (9): 452-4. Traumatic Fracture of the Pediatric Cervical Spine: Etiology, Epidemiology, Concurrent Injuries, and an Analysis of Perioperative Outcomes Using the Kids' Inpatient Database. These injuries are almost always due to 2013;200(3):608-17. Epidemiology. 6. Epidemiology These fractures have an incidence 0.4% to 2.7%, and males are affected more-so than females. Pathology. Unable to process the form. Terminology. Insufficiency fracture of the sternum caused by osteopenia: plain film findings in seven patients. Long-term bisphosphonate use has also been associated with insufficiency fractures 5. Imaging differential considerations include: ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. (2010) ISBN:1441959726. fractures involving a single facial buttress, Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture), Watson-Jones classification (tibial tuberosity avulsion fracture), Nunley-Vertullo classification (Lisfranc injury), pelvis and lower limb fractures by region. 9. May be used to reveal associated ligamentous injuries, osteochondral fractures and chondral fractures 7. Classification. Epidemiology These fractures have an incidence 0.4% to 2.7%, and males are affected more-so than females. The fractures involve the medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus. 2005;25 (5): 1239-54. A Cedell fracture is a fracture of the medial tubercle of the posterior process. 8. Curr Rev Musculoskelet Med. lateral displacement of patella (not necessarily seen in transient dislocation) medial patellar contusion +/- corresponding lateral femoral condyle contusion; joint effusion; The presence of an abnormal medial patellar retinaculum should suggest the diagnosis of Insufficiency fracture. Passias PG, Poorman GW, Segreto FA, Jalai CM, Horn SR, Bortz CA, Vasquez-Montes D, Diebo BG, Vira S, Bono OJ, De La Garza-Ramos R, Moon JY, Wang C, Hirsch BP, Zhou PL, Gerling M, Koller H, Lafage V. Traumatic Fractures of the Cervical Spine: Analysis of Changes in Incidence, Cause, Concurrent Injuries, and Complications Among 488,262 Patients from 2005 to 2013. injury to lateral tubercle is caused by inversion or extreme equinus; injury to medial tubercle is uncommon and is caused by forced dorsiflexion and pronation 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. 28 (6): 413-20. 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. Fred HL, Rizvi SA, Lied B, Rnning P, Helseth E. The epidemiology of traumatic cervical spine fractures: a prospective population study from Norway. In general, young patients have little subsequent impairment. 3. Schatzker J, Tile M. The Rationale of Operative Fracture Care. Looser zones are also a type of insufficiency fracture. 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 Practical points Sliker CW, Mirvis SE, Shanmuganathan K. Assessing cervical spine stability in obtunded blunt trauma patients: review of medical literature. 7. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Gaillard F, Mellam Y, Bell D, et al. Topics covered include: trauma systems and management; surgical procedures; epidemiological studies; surgery (of all tissues); Reference article, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-18455. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. Saunders. The "engaging" Hill-Sachs was described by Burkhart and De Beer in 2000 10. Coronoid process fractures may be diagnosed on a plain film series of the elbow, generally on a lateral or a 45 internal oblique view 4. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Gaillard F, Bell D, Jones J, et al. Unable to process the form. Plain radiograph. [Skull and cervical spine fractures]. 2. Mosby. AJR Am J Roentgenol. Radiology. pseudo-Jefferson fracture, or pseudospread of the atlas on the axis. 6. CT is commonly necessary for fracture characterization of the fragment size, the degree of anteromedial involvement, and complex fracture-dislocation. The fractures involve the medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus. The Weber ankle fracture classification (or Danis-Weber classification) is a simple system for classification of lateral malleolar fractures, relating to the level of the fracture in relation to the ankle joint, specifically the distal tibiofibular syndesmosis.It has a 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 Yochum TR, Rowe LJ. It was originally named by British surgeon Jonathan Hutchinson (1828-1913). 1992;185(3):847-52. 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.. Tibial tuberosity avulsion fractures are uncommon. Masquijo JJ, Allende V. Triplane fracture of the distal femur: a case report. The key to correctly interpreting pediatric elbow injuries is an understanding of the order and age at which the various secondary centers of ossification become visible (see ossification centers of the elbow). Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults; 90% are seen in children younger than 10 years of age, with a peak age of 5-7 years 4,6.These fractures are more commonly seen in boys 4 and are the most common elbow fractures in children (55-80%) 8.. 13 (1): 68-78. Radiology. Smith fractures, also known as Goyrand fractures in the French literature 3, are fractures of the distal radius with associated volar angulation of the distal fracture fragment(s). 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. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. Epidemiology These fractures have an incidence 0.4% to 2.7%, and males are affected more-so than females. Goldfarb C, Yin Y, Gilula L, Fisher A, Boyer M. Wrist Fractures: What the Clinician Wants to Know. When ossification is present then care must be taken in not over-calling separation, on account of the apophysis beginning its ossification laterally, and as such the gap between the ossified component and the rest of the humerus can be considerable 2. Clin. Treatment options comprise of surgery (e.g. Plain radiograph. These injuries are sustained either from direct trauma typically a blow to the back of the wrist or from forced dorsiflexion and abduction. (2018) Radiographics : a review publication of the Radiological Society of North America, Inc. 38 (7): 2173-2192. fractures involving a single facial buttress, Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture), Watson-Jones classification (tibial tuberosity avulsion fracture), Nunley-Vertullo classification (Lisfranc injury), pelvis and lower limb fractures by region. Pathology. Almost invariably, if the fracture involves a paranasal sinus, middle ear or mastoid air cells, then they will contain some blood, which is a helpful clue to the presence of an underlying fracture. Saraf SK, Khare GN. MRI is as sensitive as bone scanning, with the added benefit of higher specificity, both in isolating the exact anatomic location and in distinguishing fractures from tumors or infection. terrible triad of the elbow; elbow dislocation Practical points Chauffeur fracture. 1990;154 (5): 1025-7. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. injury to lateral tubercle is caused by inversion or extreme equinus; injury to medial tubercle is uncommon and is caused by forced dorsiflexion and pronation 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. J Pediatr Orthop. 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 Classically, these fractures are extra-articular transverse fractures and can be thought of as a reverse Colles fracture.. (2013) The Journal of the American Academy of Orthopaedic Surgeons. {"url":"/signup-modal-props.json?lang=us\u0026email="}, Gaillard F, Yap J, Baba Y, et al. Philadelphia, Pa. : Lippincott Williams & Wilkins, c2005. Sacral insufficiency fracture--a case of post-coital back pain. J Shoulder Elbow Surg. Skeletal Radiol. TIS. Pathology. 2012;20(4):242-52. Radiology. 9. Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading.. They are important to recognize because they indicate extensive underlying ligamentous injury and spinal instability. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. Vande Berg B & Omoumi P. Dislocation of the Shoulder Joint Radiographic Analysis of Osseous Abnormalities. Commonest history is trauma to the outstretched hand with carpal extension 4: The usual injury mechanism is falling onto an outstretched hand in ulnar deviation. There are two classification systems 5,6. Emergency Radiology, Imaging and Intervention. Somford M, Van der Linde J, Wiegerinck J, Hoornenborg D, Van den Bekerom M, Van Deurzen D. Eponymous Terms in Anterior Shoulder Stabilization Surgery. In children, these injuries are believed to occur due to sudden traction on the common extensor origin by the extensor musculature. The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5. Having three parts, this is a more unstable fracture and may be associated with ligamentous injury. These fractures are avulsion fractions of the ossification center of the lateral condyle, and as such are sometimes referred to as a lateral epicondyle avulsion fracture; either term is acceptable. terrible triad of the elbow; elbow dislocation Terminology. Journal of the Belgian Society of Radiology. Classification. When reporting these injuries, care should be taken to ensure that one is not looking at normal ossification of the lateral epicondyle. The triquetral may be fractured by means of impingement from the ulnar styloid, shear forces, or avulsion from strong ligamentous attachments. In general, they are seen in the elderly, more frequently in women 2. Burnet S, Mahadevan G, Lee A et-al. Vertical fracture through the distal tibial epiphysis (Salter-Harris III) with a horizontal extension through the lateral aspect of the physis. The imaging modality of choice, permitting identification of; Some authors suggest a better detection rate with 20 tilted or internal oblique radiographs 6,9. Avulsion fracture of the medial and lateral epicondyles of the humerus. 110: e427-e437. 8. For example, someone who lives alone may not be able to do so without the use of one arm. Chapman VM, Grottkau BE, Albright M et-al. 2010;39 (3): 267-72. 4. Marmor L. An unusual fracture of the tibial epiphysis. 3. Brown SD, Kasser JR, Zurakowski D et-al. Kocher M, Millis MB. Guo R, Cardenas J, Wu C. Triquetral Fractures Overview. (1995) ISBN:1853171786. 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 Terminology. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. Burgener FA, Kormano M, Pudas T. Bone and Joint Disorders. Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. Before the apophysis begins to ossify (10-11 years of age), soft tissue swelling may be the only finding, and the degree of displacement cannot be evaluated on plain films. Open book pelvic injuries are most often the result of high-energy trauma and are associated with significant morbidity and mortality due to associated vascular injuries.. Workman T, Burkhard T, Resnick D et al. 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. Options, therefore, include: Treatment of the underlying cause of bone weakness is also essential. Open book pelvic injuries result from an anteroposterior compression injury to the pelvis and result in a combination of ligamentous rupture and/or fractures to both the anterior and posterior Lateral epicondyle fracturesof the elbow are rare epicondylar fractures. 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. Management depends not only on the type of fracture but also importantly on the functional status and living situation of the patient. Sandstrom C, Kennedy S, Gross J. 7. An injury to the growth plate between the lateral epicondylar center of ossification and the rest of the humerus does not contribute to bone length;growth arrest is therefore not an issue 1. As a historical note, there are four methods of judicial hanging, and the process is more complicated than may be evident at first glance. Reference article, Radiopaedia.org (Accessed on 11 Dec 2022) https://doi.org/10.53347/rID-1505, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":1505,"questionManager":null,"mcqUrl":"https://radiopaedia.org/articles/insufficiency-fracture/questions/1164?lang=us"}. There are two classification systems 5,6. Fractures in children: epidemiology and activity-specific fracture rates. They are usually seen in the setting of other injuries 1-3. Anterior cruciate ligament (ACL) avulsion fracture or tibial eminence avulsion fracture is a type of avulsion fracture of the knee. Triplane fracture of the proximal tibia. (2011). Dorsal avulsion fractures account for about 95% all triquetral fractures, most of the remainder are body fractures 4. 2013;95 (7): e42. B. J. Manaster, David G. Disler, David A. CT. J Am Acad Orthop Surg. Males are affected more commonly than females with a median age of injury of 56 years. J Pediatr Orthop. History and etymology. Becce F, Theumann N, Bollmann C et al. Femoral neck fractures in osteogenesis imperfecta treated with bisphosphonates. Orthop Traumatol Surg Res. Chauffeur fractures are considered type III fractures. Capsulotendinosis and filling of the Hill-Sachs defect can be performed via open (Connolly procedure) or arthroscopic (remplissage) approaches 6,7. MRI of the Shoulder. Possible signs include swelling,localized/referred pain, and/or deformity of the ankle. Epidemiology A Hill-Sachs defect is the terminology of preference over other terms, such as Hill-Sachs lesions, and Hill-Sachs fractures 14.. Repeat dislocations lead to larger defects, which can result in an "engaging" Hill-Sachs defect, which engages the anterior glenoid when the shoulder is abducted and externally rotated 4 (see article: on-track and off-track shoulder Goldfarb CA, Yin Y, Gilula LA et-al. The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5. Dorsal avulsion fractures account for about 95% all triquetral fractures, most of the remainder are body fractures 4. 2. (2002) ISBN: 0323011896 -, 6. Horst K, Von Harten R, Weber C et al. The reason is due to the stickiness of clay. Salter-Harris type I fractures describe a fracture that is completely contained within the physis. Looser zones are also a type of insufficiency 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. Examples of soft tissue injuries include: vascular Check for errors and try again. Unable to process the form. Schatzker J, Tile M. The Rationale of Operative Fracture Care. CT or MR may be more sensitive than conventional radiographs for detection of avulsion injuries. 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 Late presentation of fractures of the lateral condyle of the humerus in children. As the late sequelae, there may be lateral spurring (especially in children)5. They are the second commonest carpal bone fracture, after the scaphoid. Lateral epicondyle fracture (elbow). This typically involves separation of the tibial attachment of the ACL to variable degrees. 1. 8. 2004;183 (5): 1489-95. It is interesting to note that the word chauffeur comes from the French for "someone who warms" the car engine. 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