Fractures in these regions can be classified as: intertrochanteric fracture; pertrochanteric: intertrochanteric, involving both trochanters; subtrochanteric fracture; greater trochanteric avulsion fracture Having three parts, this is a more unstable fracture and may be associated with ligamentous injury. 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. Classification. CT or MR may be more sensitive than conventional radiographs for detection of avulsion injuries. Males are affected more commonly than females with a median age of injury of 56 years. Practical points. Terminology. 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 Classically, these fractures are extra-articular transverse fractures and can be thought of as a reverse Colles fracture.. fracture through the physis Anterior cruciate ligament (ACL) avulsion fracture or tibial eminence avulsion fracture is a type of avulsion fracture of the knee. fracture may arise as proximally as the level of fibular neck and not visualized on ankle films, requiring knee or full-length tibia-fibula radiographs (Maisonneuve fracture) unstable: usually requires ORIF; Weber C fractures can be further subclassified as 6. Practical points Plain radiograph. Associations Both the end of the fibula (1) and the tibia (2) are broken and the malleolar fragments (arrow: medial malleolus, arrowhead: lateral malleolus) are displaced. The complex of the medial collateral ligaments of the ankle joint is collectively called deltoid ligament.It attaches the medial malleolus to multiple tarsal bones. 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. When a fracture is identified, a careful search for adjacent soft tissue injury should be undertaken. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. 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. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. Classification. It is interesting to note that the word chauffeur comes from the French for "someone who warms" the car engine. The superficial layer has variable attachments and crosses two joints while the deep layer has talar attachments and crosses one joint: The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5. Pathology Nasal bone fractures, when isolated, are most commonly displaced fractures of one of the paired nasal bones. They are distinct from a lateral condyle fracture which is a very different fracture despite the similar name. The fractures involve the medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus. Classification. Gaillard F, Lustosa L, Murphy A, et al. Posterior cruciate ligament (PCL) avulsion fractures are a type of avulsion fracture of the knee that represent the most common isolated PCL lesion. Symptoms of a Lisfranc fracture depend on the severity of the injury. Jones fracture. Anterior cruciate ligament (ACL) avulsion fracture or tibial eminence avulsion fracture is a type of avulsion fracture of the knee. transverse fracture 1.5-2 cm from tip of proximal tuberosity. Insufficiency fractures are a type of stress fracture, which are the result of normal stresses on abnormal bone. The lack of a metaphyseal fracture component in the coronal plane (evaluated with lateral x-ray or CT) distinguishes a Tillaux fracture from a triplanar fracture. Practical points 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. As a historical note, there are four methods of judicial hanging, and the process is more complicated than may be evident at first glance. The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5. Phalanx fractures are common injuries, although less common than metacarpal fractures. Epidemiology Classification. CT or MR may be more sensitive than conventional radiographs for detection of avulsion injuries. Trimalleolar fractures refer to a three-part fracture of the ankle. Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. 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. fracture through the physis Intimate partner violence should be considered in patients where the clinical details do not match the fracture, or the injury occurs in an intimate setting 7. Classification. transverse fracture 1.5-2 cm from tip of proximal tuberosity. ACEP Now April 14, 2020, This page was last edited 19:56, 12 January 2021 by, http://radiopaedia.org/articles/weber_ankle_fracture_classification, http://www.ncbi.nlm.nih.gov/pubmed?term=12595378, https://www.acepnow.com/article/tips-for-managing-weber-b-ankle-fractures/?singlepage=1, https://www.wikem.org/w/index.php?title=Ankle_fracture&oldid=292390, Examine for ecchymoses, abrasions, or swelling, 4 sensation distributions: saphenous nerve (medial mal), superficial fib (lat mal), sural nerve (lateral 5th digit), deep fib (1st web space), Note skin integrity and areas of tenderness or crepitus over ankle, Range joint passively and actively to evaluate for stability, Perform anterior drawer test (positive exam suggests torn ATFL), Perform a crossed-leg test to detect syndesmotic injury, Palpate midfoot and base of 5th metatarsal for tenderness, AP: Best for isolated lateral and medial malleolar fractures, Best for evaluating for unstable fracture or soft tissue injury, At a point 1 cm proximal to tibial plafond space between tib/fib should be 6mm, Lateral: Best for posterior malleolar fractures, Consider proximal tib/fib films and talus fractures, System based on level of the fibular fracture and characterizes stability of fracture, Tibial plafond and the two malleoli is referred to as the ankle "mortise" (or talar mortise), Fibula fracture below ankle joint/distal to plafond, Usually stable: occasionally requires ORIF, Fibula fracture at the level of the ankle joint/at the plafond, Can extend superiorly and laterally up fibula, Tibiofibular syndesmosis intact or only partially torn, No widening of the distal tibiofibular articulation, Use gravity or weight bearing stress X-rays to determine stability, Fibula fracture above the level of the ankle joint/proximal to plafond, Tibiofibular syndesmosis disrupted with widening of the distal tibiofibular articulation, Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention, Stable, nondisplaced, isolated malleolar fracture: Splint or cast, early wt bearing, RICE, Unstable or displaced fracture: Requires ORIF, ortho consult, reduce and splint, If stable (see Weber classification) treat like severe, Signs of medial (deltoid) ligament disruption such as medial swelling, ecchymosis, or TTP, Widening of medial clear space (suggests deltoid ligament injury), Immediate reduction or ortho consult in ED. It comprises of: a vertical fracture through the epiphysis; a horizontal fracture through the physis; an oblique fracture through the metaphysis Pathology Mechanism. Classification. There is no associated bone fragment. intra-articular glenoid fracture. Pathology Mechanism. forced inversion of plantarflexed foot. 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. fracture may arise as proximally as the level of fibular neck and not visualized on ankle films, requiring knee or full-length tibia-fibula radiographs (Maisonneuve fracture) unstable: usually requires ORIF; Weber C fractures can be further subclassified as 6. There is no associated bone fragment. Vertical fracture through the distal tibial epiphysis (Salter-Harris III) with a horizontal extension through the lateral aspect of the physis. 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 Pathology. Most authors regard it as a type 4 Salter-Harris fracture. Jones fracture. Classification. Lateral malleolar fracture with deltoid injury OR bimalleolar OR trimalleolar fracture Bimalleolar fracture and right ankle dislocation on X-ray (anteroposterior). Calcaneal fracture. fracture may arise as proximally as the level of fibular neck and not visualized on ankle films, requiring knee or full-length tibia-fibula radiographs (Maisonneuve fracture) unstable: usually requires ORIF; Weber C fractures can be further subclassified as 6. The term is sometimes used to describe intra-articular fractures with Spinal fractures are usually the result of significant trauma to a normally formed skeleton or the result of trauma to a weakened spinal column. forced inversion of plantarflexed foot. For pediatric patients, see: ankle fracture (peds), Isolated medial or posterior malleolar fracture, Lateral malleolar fracture with deltoid injury OR bimalleolar OR trimalleolar fracture, Tips for Managing Weber B Ankle Fractures By Joseph Noack, MD; and Spencer Tomberg, MD. 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 Lisfranc injuries, also called Lisfranc fracture-dislocations, are the most common type of dislocation involving the foot and correspond to the dislocation of the articulation of the tarsus with the metatarsal bases. Having three parts, this is a more unstable fracture and may be associated with ligamentous injury. Gross anatomy. Both the end of the fibula (1) and the tibia (2) are broken and the malleolar fragments (arrow: medial malleolus, arrowhead: lateral malleolus) are displaced. Radiopaedia.org, the wiki-based collaborative Radiology resource On plain film, dorsal avulsion injuries are best detected on a lateral projection, where typically an avulsed flake of bone is identified lying posteriorly to the triquetral bone (see pooping duck sign). 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. Radiopaedia.org, the wiki-based collaborative Radiology resource Males are affected more commonly than females with a median age of injury of 56 years. Jones fracture. Lisfranc injury. 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. Coronoid process fractures have been classified into three types within the Regan and Morrey classification system 1:. They may represent an isolated tendinous injury or occur in combination with an avulsion fracture of the dorsal base of the distal phalanx. When a fracture is identified, a careful search for adjacent soft tissue injury should be undertaken. 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. Pathology Mechanism. 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. Epidemiology They have different prognosis and treatment depending on the location of the fracture. Epidemiology. fracture through the physis more: Jones fracture. 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). There is no associated bone fragment. The superficial layer has variable attachments and crosses two joints while the deep layer has talar attachments and crosses one joint: Posterior cruciate ligament (PCL) avulsion fractures are a type of avulsion fracture of the knee that represent the most common isolated PCL lesion. Looser zones are also a type of insufficiency fracture. Sternal fractures occur in ~5% of blunt chest trauma with the manubrium being the most commonly injured part. Epidemiology Fractures of the sternum are seen in between 3-6.8% of all motor vehicle collisions 1. The fractures involve the medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus. As the physiological closure of the physeal plate begins medially, the lateral (open) physis is prone to this type of fracture. The ligament is composed of two layers. Anderson and D'Alonzo high risk of nonunion. Strictly speaking, the fracture is misnamed and should more correctly be called "hangee" fracture. Examples of soft tissue injuries include: vascular The superficial layer has variable attachments and crosses two joints while the deep layer has talar attachments and crosses one joint: more: Jones fracture. Lisfranc injury. For example, someone who lives alone may not be able to do so without the use of one arm. Radiopaedia.org, the wiki-based collaborative Radiology resource Common symptoms include tenderness and swelling at the site of injury and the top of your foot. Gross anatomy. transverse fracture 1.5-2 cm from tip of proximal tuberosity. 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.. Common symptoms include tenderness and swelling at the site of injury and the top of your foot. Both the end of the fibula (1) and the tibia (2) are broken and the malleolar fragments (arrow: medial malleolus, arrowhead: lateral malleolus) are displaced. The term is sometimes used to describe intra-articular fractures with It is also known as backfire fracture or lorry driver fracture 1. Treatment and prognosis forced inversion of plantarflexed foot. As a historical note, there are four methods of judicial hanging, and the process is more complicated than may be evident at first glance. scapular fracture; clavicle fracture; distal radial fracture (especially Colles fracture) Treatment and prognosis. Most authors regard it as a type 4 Salter-Harris fracture. Lisfranc injury. Gross anatomy. Trimalleolar fractures refer to a three-part fracture of the ankle. extra-articular lover fracture (or Casanova fracture) It comprises of: a vertical fracture through the epiphysis; a horizontal fracture through the physis; an oblique fracture through the metaphysis It is interesting to note that the word chauffeur comes from the French for "someone who warms" the car engine. Check out the new My Emergency Department app - a single source of truth for all your ED team's guidelines, policies and education content. 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. Symptoms of a Lisfranc fracture depend on the severity of the injury. Plain radiograph. They may represent an isolated tendinous injury or occur in combination with an avulsion fracture of the dorsal base of the distal phalanx. Epidemiology Fractures of the sternum are seen in between 3-6.8% of all motor vehicle collisions 1. Lateral malleolar fracture with deltoid injury OR bimalleolar OR trimalleolar fracture Bimalleolar fracture and right ankle dislocation on X-ray (anteroposterior). 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: Dorsal avulsion fracture. As a historical note, there are four methods of judicial hanging, and the process is more complicated than may be evident at first glance. 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. Terminology. Radiopaedia.org, the wiki-based collaborative Radiology resource 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. Lisfranc injuries, also called Lisfranc fracture-dislocations, are the most common type of dislocation involving the foot and correspond to the dislocation of the articulation of the tarsus with the metatarsal bases. Trimalleolar fractures refer to a three-part fracture of the ankle. The fractures involve the medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus. The complex of the medial collateral ligaments of the ankle joint is collectively called deltoid ligament.It attaches the medial malleolus to multiple tarsal bones. Plain radiograph. Vertical fracture through the distal tibial epiphysis (Salter-Harris III) with a horizontal extension through the lateral aspect of the physis. calcaneal tuberosity avulsion fracture. Pathology. Salter-Harris type I fractures describe a fracture that is completely contained within the physis. 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. base of 5 th metatarsal 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. They may represent an isolated tendinous injury or occur in combination with an avulsion fracture of the dorsal base of the distal phalanx. There are two classification systems 5,6. Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading.. Falls, motor vehicle collisions, pedestrian accidents, cycling and diving are common causes of injury 6,7. Insufficiency fractures are a type of stress fracture, which are the result of normal stresses on abnormal bone. 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. This page is for adult patients. 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. Jefferson fracture is the eponymous name given to a burst fracture of the atlas. 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 Fractures in these regions can be classified as: intertrochanteric fracture; pertrochanteric: intertrochanteric, involving both trochanters; subtrochanteric fracture; greater trochanteric avulsion fracture type 1: avulsion of the tip of the coronoid process The lack of a metaphyseal fracture component in the coronal plane (evaluated with lateral x-ray or CT) distinguishes a Tillaux fracture from a triplanar fracture. 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 Differential diagnosis 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 Coronoid process fractures have been classified into three types within the Regan and Morrey classification system 1:. Classification. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. 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. Examples include: Jefferson fracture: ring fracture of C1; hangman fracture: bilateral pedicle or pars fracture of C2; dens fracture; flexion teardrop fracture: unstable flexion fracture; extension teardrop fracture: stable injury Salter-Harris type I fractures describe a fracture that is completely contained within the physis. It is also known as backfire fracture or lorry driver fracture 1. Differential diagnosis 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 It comprises of: a vertical fracture through the epiphysis; a horizontal fracture through the physis; an oblique fracture through the metaphysis Epidemiology 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. 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). 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 The lack of a metaphyseal fracture component in the coronal plane (evaluated with lateral x-ray or CT) distinguishes a Tillaux fracture from a triplanar fracture. Looser zones are also a type of insufficiency fracture. They are distinct from a lateral condyle fracture which is a very different fracture despite the similar name. Phalanx fractures are common injuries, although less common than metacarpal fractures. Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading.. Dorsal avulsion 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. Calcaneal fracture. Classically, these fractures are extra-articular transverse fractures and can be thought of as a reverse Colles fracture.. They have different prognosis and treatment depending on the location of the fracture. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. 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. more: Jones fracture. Sternal fractures occur in ~5% of blunt chest trauma with the manubrium being the most commonly injured part. 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