Abigail Bergman

ISM-Period 1

Hook, William F. How to Ready x-Rays?, AOT, 2013.

• There are a total of 4 different shades in an x-ray. In order from darkest to lightest shade it is
gas, fat, water, and minerals. Soft tissue in an x-ray shows as a lighter gray, while bone shows
as white.
• Compare old films with new films to show changes in x-rays. Comparing left and right sides
are also important, especially in the chest, skull, and abdomen.
• If there are two water structures that come in contact with each other, it will cover the border
in the x-ray between the two systems.
• More obvious signs of foreign objects in the body is that they are mostly white in appearance
on the x-ray and you can usually make out the shape and determine the foreign body.
• A shaft view of a bone may not be enough to tell a fracture is there, so it is important to
always take multiple views of a bone to find any missed fractures during the shaft view.
• In order to find small hairline fractures, follow the outside structure of the bone until you see
any abnormal breakage or cracks.
• For any breakages that might be hard to tell, might need a CT-Scan to get a better view of the
fracture.
• Look for shortened bones, height differences, or rotation to help spot dislocations or gaps in
between joints that may point to a fracture.
• Getting post-op films will help determine the rate of healing and whether or not the fractured
has healed enough to be left alone and the splint/cast to be taken off.
• Screws, plates, or rods may be used to help hold together a fracture to help the healing process
and set the fracture so it may heal correctly.

This article goes in depth with each view of how to read an x-ray and how to spot
abnormalities, while also providing information about normality’s of an x-ray and not
misinterpreting an image.
 Abigail Bergman
ISM-Period 1

Watkins, T, et al. “CT for Determining the Results of Treatment of Fractures of the Wrist.” US

National Library of Medicine, July 1987, www.ncbi.nlm.nih.gov/pubmed/3495968.

• During a study, there were 13 patients tested under the CT scanner

• They were trying to prove that the CT is the best way to determine bone fractures.
• Out of these 13 patients, 4 had metal rods or screws, 7 were held with casting materials,
and the last 2 with slings.
• With these 13 patients, the CT scan was helpful while determining "bony union in the
presence of advanced osteoporosis.
• CT helps locate fractures that are perpendicular to the plane of the scan
• CT helps finding small bone fragments even with patients with osteoporosis
• CT scans make it possible to study Lister's tubercle, the bony part on the dorsal end of the
wrist.
• The cost of a CT scan can off-put patients and their families due to the lack of knowledge
of the very helpful machine. They question how important a picture may be for the
patients' health, while many times it can be detrimental to the healing process.
• With the use of the CT, doctors are able to more effectively diagnose a fracture, which
may lead to a longer immobilization time that will offset the patient's ability to participate
in normal, everyday activities.
• Since the CT is able to fine definite fractures, less doctor exams are necessary, therefore
lowering the cost of treatment with less orthopedic consultations.
• They had come to a conclusion that the new CT machine was indeed, worth the money
and that it correctly located and scanned bone fractures.

This article had very detailed analysis of the CT scan and how to correctly analyze the
effects of the CT scanner, while also informing future users about the pros and cons of
the machine.
 Abigail Bergman
ISM-Period 1

Beaty, JH. “Orthopedics.” The Royal Children's Hospital, 2010, www.rch.org.au/fracture-

education/references/.

• There are 3 phases of fracture healing.

• There is the first phase, the inflammatory phase which causes the formation of blood clots in
torn blood vessels.
• The swelling is a side-effect of the body sending different chemicals to the sight of injury that
are important for proper healing of the fractured bone.
• The second phase is the reparative phase which the phase in which the body starts to heal. The
bone forms a thick mass of calluses at the end of the bone that recruit new bone-healing cells to
form the new bone.
• The original callus at the end of the bone is soft, and after time it hardens to become a harder
callus that will eventually be replaced with bone.
• The hard callus is softer and weaker than actual bone, but it is better for the body than soft
callus as it can maintain harder hits, making for a faster healing time.
• The third and final phase is the remodeling phase in which the healed fracture and callus
respond to normal everyday activity. This is the longest phase and could take up to years to
complete. The external callus that was created during the second phase is removed and because
it is not needed anymore and it begins to look like normal bone in an x-ray.
• Children are much more malleable than adults because they have growth plates in their bones
that allow for much faster and permanent healing than adults.

This article allowed for better, in depth information about children vs. Adults in bone healing.