Computed Tomography scan can be useful for displaced or angulated fractures, complex intra-articular fractures, vertebral, and pelvic fractures.Oblique views are also helpful for detecting subtle spiral fractures where the AP and lateral views are normal, yet a fracture is strongly suspected.Īnkle AP mortise view is helpful since it includes distal tibia, distal fibula, talus, and proximal metatarsals. Oblique views are helpful for fully disclosing the nature and extent of many fracture patterns, especially when the injury involves the ankle, elbow, hand (especially for scaphoid fracture), or foot. It isvaluable to obtain comparison views of the contralateral side, especially if there is suspected physeal injuries which may have very subtle radiographic abnormalities.Īnteroposterior (AP) and lateral views are the most common. Radiographs should include the joints immediately proximal and distal to a fractured long bone. X-Rays: At minimum, two views are obtained, taken at 90-degree angles.Evidence of neurovascular compromise necessitates urgent, often operative, orthopedic treatment. Assessment of two-point discrimination is probably the best test of sensory function. Check the integrity of pulses and speed of capillary refill, as well as testing sensory and motor function. Checking neurovascular function distal to the injury is essential in evaluating any child with a potential fracture.Pain on motion and limitation of motion signal the need for further examination. Observe the spontaneous movement, attempts to get the patient to voluntarily move the involved part through its expected range, and passive movement. Palpation and assessment of active and passive motion: localized swelling and tenderness on palpation are significant findings and should alert the examiner to the likelihood of an underlying fracture.Comparison with the opposite extremity and measurement of circumference can be very helpful when findings are subtle. Evaluate the overlying skin and soft tissues for swelling, ecchymosis, abrasions, punctures, and lacerations. Visual inspection: Gross position of the extremity allows you to appreciate for presence or absence of deformity, distortion or abnormal angulation, and longitudinal shortening.In severe ankle fractures, ankle replacement surgery may be required. Physical therapy after removal of a cast or brace is also usually needed. Surgery to pin broken bones is often but not always required, so an accurate diagnosis is essential. TreatmentĪ physician’s care is required to address this problem. There may also be deformity, and if the break is open, the bone may be visible, protruding through the skin. Walking is difficult or impossible, and swelling and bruising are immediate in the foot and ankle. The victim may sense a popping or tearing feeling, and a popping sound may be heard at the time of the fracture. The most obvious symptom is acute and immediate pain in the ankle. It is a common injury in sports such as football, soccer, and distance jumping. CausesĪnkle fracture is usually caused by a sharp blow or unusual stress to the bone or an unnatural rotation or twisting, such as caused by a sudden change in direction. The ligaments of the ankle joint may also be dislocated and/or ruptured. There are three main bones that might be involved in an ankle fracture: medial or lateral malleolus the posterior lip of the tibia and/or the talar dome. Open fractures mean the bone has protruded through the skin Displaced fractures usually require surgery. Breaks in which the bone is broken all the way around and displaced.These usually occur in mature, adult bones. Breaks in which the bone is broken all the way around, but one piece is not displaced (moved away from) the other piece.These always occur in the bones of children, which are less brittle than those of adults. "Torus" or "greenstick" fractures, in which the bone is not broken all the way around.Types of Fracturesįractures can be classified in several different ways, including: Some fractures, called stress fractures, are microscopic, and these can usually be treated by restricting activity on the limb that is broken. A fracture (or broken bone) is a disruption, or break, in a bone.
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