2. Osseous Trauma
1) Acute Osseous Trauma:
1- Complete Fractures.
2- Incomplete Fractures
3- Radiologically Occult Fractures:
a) Bone contusions
b) Avulsion Fractures.
2) Chronic Osseous Trauma:
a) Insufficiency Fractures.
b) Fatigue Fractures.
3. Radiologically Occult Fractures
Imaging Modalities:
1)
2)
3)
•
•
Conventional Radiography: Mostly negative in many acute
and chronic osseous injuries ( Occult injuries)ز
Radioisotope Scanning :
It has Limitations
- Can be falsely negative foe 24-72 hours after injury.
- Positive scan is non-specific.
- Examination requires 4-6 hours , so delay diagnosis.
MRI: is highly sensitive. A normal MRI excludes the presence
of an osseous injury.
Linear low signal T1 with low signal edema.
High signal (edema) T2 with linear low signal (fracture line)
4. Acute Osseous Trauma
A) Impaction Injuries:
1- Contusion: bone contusion or bruises.
STIR or fat Sat T2 == focal areas of
increased signal- easily missed on non-fat
Sat spin echo T2 as edema and
surrounding fat display similar intensities.
• Sites: ACL tear –Patellar Dislocation
5. Acute Osseous Trauma
• 2- Avulsion Injuries: Occur when excessive
tensile forces result in a piece of bone or cartilage being
pulled away from the host bone by ligament , tendon or
capsular structures.
• Common sites:
• Knee , femur , humerus , elbow ,Ankle & Foot.
6. :Chronic Osseous Trauma
• Fatigue fractures –abnormal stress
across normal bone.
• Insufficiency fractures—normal stress
across abnormal bone.
- Femoral neck
- Sacrum
- Supraacetabular
- Pubic bones, superior and inferior
pubic rami
12. Description of Fractures
By direction of fractures line.
By the relationship of the fragments.
By the number of the fragments.
By communication with the atmosphere.
Age of fracture (recent-healing- healed (
Type of union ( normally alignedmalaligned(.
13. Description of Fractures
By direction of fractures line.
= Transverse.
= Oblique.
= Longitudinal.
= Spiral
14.
15.
16.
17. Description of Fractures
By the relationship of the fragments.
- Displacement.
- Shortening.
- Angulation.
- Rotation.
Most fractures display more than one of
these abnormalities of position.
18.
19.
20. Description of Fractures
Number of fragments:
1- Simple: Two fragments.
2- Comminuted : More than two
fragments.
30. Common Fracture Eponyms
Boxer's Fracture.
Fracture head of the
fifth metacarpal with
palmar angulation.
31. Fracture Healing
1. Indistinctness of Fracture line.
2. Bony callus formation.
3. Bridging of fracture and obliteration of
fracture line.
4. Remodeling of bone.