Acute Orthopedics

&
Basic Musculoskeletal Imaging
PART 10
Clinical Medicine III
PAST 543
Summer 2015

MISC.
Linda Metzger, BS, MPA, PA-C

Cervical Spine Fractures

Mechanism of Injury

Excellent Website:
https://www.med-ed.virginia.edu/courses/rad/cspine/mechanism1.html
Has tests impeded in lecture interesting & easy to read & fun.
Go to HOME page and there are other x-ray reviews.

Thoracic Spine Fractures

Mechanism of Injury
Flexion-compression = Wedge fx
Axial-compression = Fall from height = Burst fx
Flexion-distraction = Seatbelt = Chance fx (& associated abdominal injuries)

www.aaos.org
Types of Spinal Fractures
There are different types of spinal fractures. Doctors classify fractures of the thoracic and lumbar spine based upon pattern of
injury and whether there is a spinal cord injury. Classifying the fracture patterns can help to determine the proper treatment. The
three major types of spine fracture patterns are flexion, extension, and rotation.
Flexion Fracture Pattern
Compression fracture. While the front (anterior) of the vertebra breaks and loses height, the back (posterior) part of it does
not. This type of fracture is usually stable and rarely associated with neurologic problems.
Axial burst fracture. The vertebra loses height on both the front and back sides. It is often caused by a fall from a height and
landing on the feet.
Extension Fracture Pattern
Flexion/distraction (Chance) fracture. The vertebra is literally pulled apart (distraction). This can happen in accidents such as
a head-on car crash, in which the upper body is thrown forward while the pelvis is stabilized by a lap seat belt.
Rotation Fracture Pattern
Transverse process fracture. This fracture is uncommon and results from rotation or extreme sideways (lateral) bending, and
usually does not affect stability.
Fracture-dislocation. This is an unstable injury involving bone and/or soft tissue in which a vertebra may move off an adjacent
vertebra (displaced). These injuries frequently cause serious spinal cord compression.

Fight Bite
extensor tendon infection

VS

Tenosynovitis
flexor tendon infection
aka: pyogenic flexor tenosynovitis
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Osteomalacia
after physeal closure
rickets
prior to physeal closure
A defect in mineralization of osteoid matrix caused by
inadequate calcium and phosphate.
Doubtful that this population heals fractures well or quickly.
www.orthobullets.com

Arthritis

Rheumatoid arthritis
RA usually affects the joints on both sides of the body equally.
The most commonly affected joints are:
Wrists, fingers, knees, feet and ankles
Joint symptoms may include:
Morning stiffness, lasting more than 1 hour, is common
Joint pain is often felt on the same joints on both sides of the body
Over time, joints may lose their range of motion and may become
deformed.

Osteoarthritis
People with osteoarthritis may experience the following symptoms:
Pain and stiffness in the joints
Pain that becomes worse after exercise or pressure on the joint
Rubbing, grating or crackling sound when a joint is moved
Morning stiffness
Pain that causes sleep disturbances.
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Why are anterior shoulder

dislocations more common than
posterior shoulder dislocations?
Anterior dislocations = 95-98% of shoulder dislocations.
The reason is that the muscular and ligamentous support anterior to the
humeral head is much less robust than the substantial muscular and bony
support afforded posteriorly by the rotator cuff and scapula.
Anterior shoulder dislocations may be divided into the following four types:
Subcoracoid
Subglenoid
Subclavicular
Intrathoracic

Any other questions?

Email me at: BonePA2003@gmail.com

Really, I dont mind questions. It keeps me
learning, too. But, give me some time to answer
you.

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