wajufija's version from 2015-12-06 18:51


Question Answer
Jefferson Fracture of C1 arches caused by blow to the top of the head
Hangman's Fracture of the posterior elements of C2 caused by hyperextension (think of head hitting dashboard in MVA)
Clay Shoveler'sFracture of C6 or C7 spinous process
Flexion-TeardropAnterior fracture of vertebral body caused by severe flexion; usually associated with spinal cord injury
ChanceAnterior compression fracture of vertebral body with fracture of the transverse process associated with hyperflexion of the waist; seen in MVAs when restrained by a lap belt; Generally affects T12, L1, or L2
SmithAnterior compression fracture of vertebral body with fracture of posterior body as well; seen in MVAs when restrained by a lap belt; Generally affects T12, L1, or L2
SpondylolysisFracture or defect of pars articularis portion of the lamina; Associated with "Scottie Dog" abnormality

Hand & Wrist

Question Answer
Bennett FractureCorner fracture at base of thumb which extends into the carpometacarpal joint space; this is the attachment point for the thumb adductors and therefore requires surgical internal fixation
Rolando FractureSimilar to Bennett Fracture but the fracture is comminuted and more serious
Pseudo-Bennett FractureFracture of the base of the thumb which does NOT extend into the joint space
Mallet or Baseball FingerAvulsion fracture at the base of the distal phalynx where the extensor digitorum tendon inserts; Can lead to inability to extend distal phalynx if not treated properly
Gamekeeper's ThumbAvulsion injury to the ulnar aspect of the first MCP joint; this is insertion site of ulnar collateral ligament
Difference between lunate and perilunate dislocationThe key is the relationship between the radius and the capitate. If they are in line and the capitate is displaced volarly, it is a lunate dislocation. If the capitate is diplaced dorsally compared to the radius, it is a perilunate dislocation (the whole hand dislocates dorsally)
Scaphoid (Navicular) Fracture Assessment and managementIn acute setting, if initial plain films are negative but clinical signs are present, obtain an MRI. If this is not indicated, cast wrist and obtain follow-up radiographs in 1 week looking for disuse osteoporosis and hyperemia around fracture site
Epidemiology of Hook of Hamate FractureSeen in sports injuries that involve athletes holding the butt of a club, bat, or racket in the palm of their hand. Can also occur with fall on outstreched hand
Fracture associated with Lunate/Perilunate dislocationTriquetral fracture. Will see avulsion fracture fragment on dorsum of hand (virtually diagnostic for triquetral fracture)
Kienbock MalaciaAvascular necrosis of Lunate diagnosed by increased density in the lunate which may go on to collapse and fragmentation. Either traumatic or idiopathic
Define Negative ulnar varianceWhen the ulna is shorter than the radius as seen on a hand/wrist radiograph. Increased incidence of Kienbock Malacia


Question Answer
CollesFracture of distal radius and ulna with dorsal angulation caused by fall on outstretched hand
SmithFracture of distal radius and ulna with volar angulation. Much less common
Plastic Bowing Deformity of forearmBending of the radius and/or ulna instead of frank fracture. Occurs only in children. Usually treated by breaking bones and allowing them to heal
MonteggiaFracture of mid-ulnar shaft with dislocation of the proximal radius. If untreated, the dislocation of the radial head can lead to avascular necrosis and elbow dysfunction
GalleaziFracture of shaft of Radius with distal ulnar dislocation. Much more common than Monteggia Fracture
Diagnosis of Elbow fractureLook for displacement of anterior and posterior fat pads. Normally posterior fat pad not visible at all. Fat pad from joint space gets displaced by blood from the fracture. Fracture often not visible on radiographs. No need to radiographically visualize fracture. Can treat acute trauma with pain and visible posterior fat pad as fracture
DDx for visible posterior elbow fat padAcute setting: Fracture (Radial head in adults, supracondylar in kids); Chronic: Infection, Arthritis (various forms), and any non-traumatic joint effusion