Associations 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 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. CT or MR may be more sensitive than conventional radiographs for detection of avulsion injuries. scapular fracture; clavicle fracture; distal radial fracture (especially Colles fracture) Treatment and prognosis. Lisfranc injury. They are distinct from a lateral condyle fracture which is a very different fracture despite the similar name. 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). scapular fracture; clavicle fracture; distal radial fracture (especially Colles fracture) Treatment and prognosis. Epidemiology The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5. It is also known as backfire fracture or lorry driver fracture 1. It is interesting to note that the word chauffeur comes from the French for "someone who warms" the car engine. 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 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. Classically, these fractures are extra-articular transverse fractures and can be thought of as a reverse Colles fracture.. It is interesting to note that the word chauffeur comes from the French for "someone who warms" the car engine. Anderson and D'Alonzo 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. fracture through the physis Insufficiency fractures are a type of stress fracture, which are the result of normal stresses on abnormal bone. Strictly speaking, the fracture is misnamed and should more correctly be called "hangee" fracture. 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 forced inversion of plantarflexed foot. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. Gaillard F, Lustosa L, Murphy A, et al. They are distinct from a lateral condyle fracture which is a very different fracture despite the similar name. Jefferson fracture is the eponymous name given to a burst fracture of the atlas. Gross anatomy. Phalanx fractures are common injuries, although less common than metacarpal fractures. Associations Management depends not only on the type of fracture but also importantly on the functional status and living situation of the patient. Falls, motor vehicle collisions, pedestrian accidents, cycling and diving are common causes of injury 6,7. 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. 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.. 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). Lateral malleolar fracture with deltoid injury OR bimalleolar OR trimalleolar fracture Bimalleolar fracture and right ankle dislocation on X-ray (anteroposterior). Looser zones are also a type of insufficiency fracture. 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. Classification. Vertical fracture through the distal tibial epiphysis (Salter-Harris III) with a horizontal extension through the lateral aspect of the physis. Radiopaedia.org, the wiki-based collaborative Radiology resource The term "hangman fracture" was introduced by Schneider in 1965 5. Epidemiology. This typically involves separation of the tibial attachment of the ACL to variable degrees. Phalanx fractures are common injuries, although less common than metacarpal fractures. Classification. Lisfranc injury. 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. Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. Pathology. 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. Dorsal avulsion fracture. Classification. The term "hangman fracture" was introduced by Schneider in 1965 5. 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. 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. Jefferson fracture is the eponymous name given to a burst fracture of the atlas. Sternal fractures occur in ~5% of blunt chest trauma with the manubrium being the most commonly injured part. Practical points There is no associated bone fragment. base of 5 th metatarsal fracture. 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. Epidemiology. A trochanteric fracture is a fracture involving the greater and/or lesser trochanters of the femur.. scapular fracture; clavicle fracture; distal radial fracture (especially Colles fracture) Treatment and prognosis. Treatment and prognosis They may represent an isolated tendinous injury or occur in combination with an avulsion fracture of the dorsal base of the distal phalanx. Gaillard F, Lustosa L, Murphy A, et al. 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 more: Jones fracture. Pathology Mechanism. The term is sometimes used to describe intra-articular fractures with Pathology Nasal bone fractures, when isolated, are most commonly displaced fractures of one of the paired nasal bones. 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 Looser zones are also a type of insufficiency fracture. Radiopaedia.org, the wiki-based collaborative Radiology resource Treatment and prognosis Falls, motor vehicle collisions, pedestrian accidents, cycling and diving are common causes of injury 6,7. Management depends not only on the type of fracture but also importantly on the functional status and living situation of the patient. They have different prognosis and treatment depending on the location of the fracture. Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. There is no associated bone fragment. Salter-Harris type I fractures describe a fracture that is completely contained within the physis. Classification. Fractures in these regions can be classified as: intertrochanteric fracture; pertrochanteric: intertrochanteric, involving both trochanters; subtrochanteric fracture; greater trochanteric avulsion fracture high risk of nonunion. There are two classification systems 5,6. Dorsal avulsion fracture. Phalanx fractures are common injuries, although less common than metacarpal fractures. 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. Classification. Lateral malleolar fracture with deltoid injury OR bimalleolar OR trimalleolar fracture Bimalleolar fracture and right ankle dislocation on X-ray (anteroposterior). Classification. When a fracture is identified, a careful search for adjacent soft tissue injury should be undertaken. Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading.. Examples of soft tissue injuries include: vascular When a fracture is identified, a careful search for adjacent soft tissue injury should be undertaken. The mechanism of injury is variable, and can occur both during flexion or extension, and with or without compression 5. The term is sometimes used to describe intra-articular fractures with Salter-Harris type I fractures describe a fracture that is completely contained within the physis. Epidemiology. Falls, motor vehicle collisions, pedestrian accidents, cycling and diving are common causes of injury 6,7. There are two classification systems 5,6. fracture through the physis The fractures involve the medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus. When a fracture is identified, a careful search for adjacent soft tissue injury should be undertaken. The term "hangman fracture" was introduced by Schneider in 1965 5. Gaillard F, Lustosa L, Murphy A, et al. 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 There are two classification systems 5,6. 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: Classification. Cervical spine fractures can occur secondary to exaggerated flexion or extension, or because of direct trauma or axial loading.. As a historical note, there are four methods of judicial hanging, and the process is more complicated than may be evident at first glance. 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. Common symptoms include tenderness and swelling at the site of injury and the top of your foot. calcaneal tuberosity avulsion fracture. This page is for adult patients. Anterior cruciate ligament (ACL) avulsion fracture or tibial eminence avulsion fracture is a type of avulsion fracture of the knee. Symptoms of a Lisfranc fracture depend on the severity of the injury. 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). forced inversion of plantarflexed 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. Common symptoms include tenderness and swelling at the site of injury and the top of your foot. transverse fracture through diaphysis. The superficial layer has variable attachments and crosses two joints while the deep layer has talar attachments and crosses one joint: forced inversion of plantarflexed foot. Classification. Pathology. 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 Males are affected more commonly than females with a median age of injury of 56 years. 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.. Symptoms of a Lisfranc fracture depend on the severity of the injury. Coronoid process fractures have been classified into three types within the Regan and Morrey classification system 1:. Pathology Mechanism. Practical points. As a historical note, there are four methods of judicial hanging, and the process is more complicated than may be evident at first glance. Salter-Harris type I fractures describe a fracture that is completely contained within the physis. The term is sometimes used to describe intra-articular fractures with Trimalleolar fractures refer to a three-part fracture of the ankle. Classification. 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). The ligament is composed of two layers. Classification. The superficial layer has variable attachments and crosses two joints while the deep layer has talar attachments and crosses one joint: 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.. 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.. Anderson and D'Alonzo Lisfranc injury. intra-articular glenoid fracture. Practical points Odontoid process fracture, also known as a peg or dens fracture, occurs where there is a fracture through the odontoid process of C2. 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. 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. 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 Epidemiology. Check out the new My Emergency Department app - a single source of truth for all your ED team's guidelines, policies and education content. Classification. Jones fracture. Epidemiology Fractures of the sternum are seen in between 3-6.8% of all motor vehicle collisions 1. Sternal fractures occur in ~5% of blunt chest trauma with the manubrium being the most commonly injured part. Differential diagnosis intra-articular glenoid fracture. Trimalleolar fractures refer to a three-part fracture of the ankle. Jones fracture. Classically, these fractures are extra-articular transverse fractures and can be thought of as a reverse Colles fracture.. Spinal fractures are usually the result of significant trauma to a normally formed skeleton or the result of trauma to a weakened spinal column. Pathology. fracture through the physis 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. Epidemiology. Plain radiograph. Most authors regard it as a type 4 Salter-Harris fracture. Having three parts, this is a more unstable fracture and may be associated with ligamentous injury. The ligament is composed of two layers. Jefferson fracture is the eponymous name given to a burst fracture of the atlas. Calcaneal fracture. Radiopaedia.org, the wiki-based collaborative Radiology resource 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. For example, someone who lives alone may not be able to do so without the use of one arm. Fractures in these regions can be classified as: intertrochanteric fracture; pertrochanteric: intertrochanteric, involving both trochanters; subtrochanteric fracture; greater trochanteric avulsion fracture For example, someone who lives alone may not be able to do so without the use of one arm. calcaneal tuberosity avulsion fracture. Differential diagnosis 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. Common symptoms include tenderness and swelling at the site of injury and the top of your foot. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. 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. It is interesting to note that the word chauffeur comes from the French for "someone who warms" the car engine. intra-articular glenoid fracture. Anterior cruciate ligament (ACL) avulsion fracture or tibial eminence avulsion fracture is a type of avulsion fracture of the knee. 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 transverse fracture 1.5-2 cm from tip of proximal tuberosity. Symptoms of a Lisfranc fracture depend on the severity of the injury. 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). Associations high risk of nonunion. 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 type 1: avulsion of the tip of the coronoid process It is also known as backfire fracture or lorry driver fracture 1. 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: 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 Examples of soft tissue injuries include: vascular 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. 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. Gross anatomy. 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. It is also known as backfire fracture or lorry driver fracture 1. extra-articular lover fracture (or Casanova fracture) Spinal fractures are usually the result of significant trauma to a normally formed skeleton or the result of trauma to a weakened spinal column. Epidemiology As the physiological closure of the physeal plate begins medially, the lateral (open) physis is prone to this type of fracture. CT or MR may be more sensitive than conventional radiographs for detection of avulsion injuries. These type of fractures are more common in children, especially aged 5-10 years, due to the elasticity of their bones. 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. Practical points Epidemiology Fractures of the sternum are seen in between 3-6.8% of all motor vehicle collisions 1. 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.. Sternal fractures occur in ~5% of blunt chest trauma with the manubrium being the most commonly injured part. Practical points. Classification. The superficial layer has variable attachments and crosses two joints while the deep layer has talar attachments and crosses one joint: transverse fracture 1.5-2 cm from tip of proximal tuberosity. 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. 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: As the physiological closure of the physeal plate begins medially, the lateral (open) physis is prone to this type of fracture. Trimalleolar fractures refer to a three-part fracture of the ankle. Pathology Nasal bone fractures, when isolated, are most commonly displaced fractures of one of the paired nasal bones. Having three parts, this is a more unstable fracture and may be associated with ligamentous injury. They may represent an isolated tendinous injury or occur in combination with an avulsion fracture of the dorsal base of the distal phalanx. Posterior cruciate ligament (PCL) avulsion fractures are a type of avulsion fracture of the knee that represent the most common isolated PCL lesion. Lateral malleolar fracture with deltoid injury OR bimalleolar OR trimalleolar fracture Bimalleolar fracture and right ankle dislocation on X-ray (anteroposterior). Strictly speaking, the fracture is misnamed and should more correctly be called "hangee" fracture. more: Jones 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 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. base of 5 th metatarsal fracture. Insufficiency fractures are a type of stress fracture, which are the result of normal stresses on abnormal bone. The fractures involve the medial malleolus, the posterior aspect of the tibial plafond (referred to as the posterior malleolus) and the lateral malleolus. Gross anatomy. 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. Epidemiology Fractures of the sternum are seen in between 3-6.8% of all motor vehicle collisions 1. Coronoid process fractures have been classified into three types within the Regan and Morrey classification system 1:. Vertical fracture through the distal tibial epiphysis (Salter-Harris III) with a horizontal extension through the lateral aspect of the physis. 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. Management depends not only on the type of fracture but also importantly on the functional status and living situation of the patient. Terminology. The ligament is composed of two layers. As the physiological closure of the physeal plate begins medially, the lateral (open) physis is prone to this type of 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. Vertical fracture through the distal tibial epiphysis (Salter-Harris III) with a horizontal extension through the lateral aspect of the physis. transverse fracture through diaphysis. CT or MR may be more sensitive than conventional radiographs for detection of avulsion injuries. 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. 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 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. transverse fracture through diaphysis. Males are affected more commonly than females with a median age of injury of 56 years. Having three parts, this is a more unstable fracture and may be associated with ligamentous injury. Posterior cruciate ligament (PCL) avulsion fractures are a type of avulsion fracture of the knee that represent the most common isolated PCL lesion. Most authors regard it as a type 4 Salter-Harris fracture. type 1: avulsion of the tip of the coronoid process Classification. type 1: avulsion of the tip of the coronoid process Radiopaedia.org, the wiki-based collaborative Radiology resource 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. 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