Fracture Classification

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Questions and Answers

What is the most common cause of femur fracture in the general population?

Sports injuries

Child abuse

Car accidents (correct)

Falling from a height

In the elderly, what is the most common cause of femur fractures?

Car accidents

Falling (correct)

Child abuse

Hip fracture

What is the consequence of a fracture to the femoral neck?

Knee dislocation

Hip dislocation

Avascular necrosis (correct)

Ankle fracture

Which scenario typically results in a fracture to the femoral neck or femoral head?

High-impact trauma Signup and view all the answers

What is often obvious in the case of high-impact trauma causing a femoral shaft fracture?

Sudden, immediate pain Signup and view all the answers

Which type of fracture involves a minor crack in the femoral neck?

Pipkin Classification type I fracture Signup and view all the answers

What diagnostic imaging technique remains the gold standard for bone fracture detection?

Radiography Signup and view all the answers

What is the most common type of hip fracture?

Intertrochanteric fracture Signup and view all the answers

What is the Salter-Harris classification primarily used to classify?

Growth plate fractures Signup and view all the answers

What type of force causes transverse fractures across the femoral shaft?

Force exerted perpendicular to the shaft Signup and view all the answers

Which type of fracture involves a complete crack in the femoral neck but no bone displacement?

Garden Classification type 2 fracture Signup and view all the answers

What is the pathology associated with open or compound fractures?

Exposure to the outside air Signup and view all the answers

What imaging technique may be necessary to detect brain damage or subdural hemorrhage in cases of suspected abuse?

(CT) scans of the head Signup and view all the answers

What is the pathology associated with open or compound fractures?

Exposure to the outside air Signup and view all the answers

What is the most common type of hip fracture?

Intertrochanteric fracture Signup and view all the answers

What imaging technique may be necessary to detect brain damage or subdural hemorrhage in cases of suspected abuse?

(CT) scans of the head Signup and view all the answers

Which artery provides 90% of the blood circulation to the femoral head?

Lateral epiphyseal artery Signup and view all the answers

What is the predominant branch that delivers blood to the femoral head?

Lateral epiphyseal artery Signup and view all the answers

What is the primary cause of avascular necrosis in the femoral head?

Disruption of the vascular supply due to fractures in the femoral neck Signup and view all the answers

What type of injury occurs in 2% of individuals with femur shaft fractures?

Injury to the femoral artery Signup and view all the answers

What is a characteristic feature of stress fractures on radiographs?

Sclerotic band across the bone Signup and view all the answers

Which type of fracture can occur during normal activity or from minimal trauma?

Pathologic fracture Signup and view all the answers

What type of fracture occurs in abnormal bone from abnormal stress?

Fatigue fracture Signup and view all the answers

What type of fractures occur spontaneously in abnormal bone, particularly in the presence of bone tumors?

Pathologic fractures Signup and view all the answers

What is a common cause of compression fractures?

Excessive pressure or illness Signup and view all the answers

Which type of fracture typically occurs at the growth plates due to force?

Salter-Harris fracture Signup and view all the answers

What type of fractures are linked with abuse, particularly in children but also in the elderly?

Nonaccidental fractures Signup and view all the answers

What type of injury often indicates potential abuse when seen on radiographs as small chips from the long bones?

Nonaccidental injury Signup and view all the answers

What is the specificity of radiography with fat pad elevation greater than or equal to 1.5 mm as a diagnostic reference for femoral neck fractures?

0.857 Signup and view all the answers

In the study, what imaging modality remains the gold standard for diagnosing occult femoral neck fractures?

MR imaging Signup and view all the answers

What is the most common reason for imaging in elderly patients according to the retrospective review of Duke University’s MR imaging database?

Fall Signup and view all the answers

What was the average age among individuals imaged for lower-extremity injuries in the emergency setting based on the retrospective review of Duke University’s MR imaging database?

70.8 years Signup and view all the answers

What did the retrospective review of Duke University’s MR imaging database find regarding patients imaged for lower-extremity injuries in the emergency setting?

Underwent x-ray examinations only Signup and view all the answers

In the study, what did MR imaging reveal in 81 individuals (83%) based on a retrospective study conducted in London?

Both fractures and muscle injuries Signup and view all the answers

What type of fractures did MR imaging detect in 43% of the individuals according to a retrospective study conducted in London?

Femur fractures Signup and view all the answers

What did the retrospective study by Collin et al investigate?

Observer variation for radiography, CT, and MR imaging of non-displaced occult hip fractures Signup and view all the answers

What role does MR imaging play in diagnosing femur fractures?

Visualizing soft tissue and bone marrow edema Signup and view all the answers

What percentage of individuals imaged for lower-extremity injuries in the emergency setting underwent at least 2 x-ray examinations according to the retrospective review of Duke University’s MR imaging database?

77% Signup and view all the answers

What was the sensitivity of radiography using positive lateral or posterior sign as diagnostic criteria according to the study?

0.857 Signup and view all the answers

What is the estimated cost of more than 250,000 sub-capital hip fractures below the femoral head reported annually in the United States?

$15 billion Signup and view all the answers

Which group has a disproportionately high risk of femoral neck stress fractures?

Postmenopausal women Signup and view all the answers

What percentage of femoral shaft fractures in adolescents and the general population are caused by motor vehicle accidents?

80% to 90% Signup and view all the answers

What is the estimated percentage of white women suffering a hip fracture by the age of 80?

20% Signup and view all the answers

What condition can increase the risk of femur and hip fractures in the elderly population?

Low bone mineral density Signup and view all the answers

Where is the femoral head located?

At the top of the femur at the junction of the femoral neck and the upper femoral body Signup and view all the answers

What forms an angle opening medialward with the femoral body?

The femoral neck Signup and view all the answers

What is the reason for requiring at least 2 projections in the case of bone trauma?

To ensure that all fractures or dislocations are visible on at least one radiograph. Signup and view all the answers

What is the recommended position for the patient during an anteroposterior (AP) projection for femur imaging?

Supine position with the femur centered over the image receptor. Signup and view all the answers

In areas of more complex bony anatomy, such as the joints, why might more than 2 projections be needed to assess trauma adequately?

To provide additional images to assist with a more accurate diagnosis. Signup and view all the answers

What may be a distinguishing factor between a growth plate and an impacted fracture when viewed on radiographs?

The growth plate margin appears as a white boundary, making it easily confused with an impacted fracture in which trabeculae have become enmeshed. Signup and view all the answers

What type of stress image is taken to show that a joint is unstable, as in the case of a dislocation?

Stress images taken with a joint under stress Signup and view all the answers

What imaging technique may be preferred when a fracture is not evident on radiographs, but clinical suspicion of a fracture is high?

Magnetic resonance imaging (MRI) Signup and view all the answers

Why might radiographs of the unaffected leg be helpful for diagnosis in certain cases?

To compare with affected leg for symmetry and detect any abnormalities Signup and view all the answers

What is the most common cause of femur fractures in the pediatric population?

Child abuse Signup and view all the answers

Which group is at the highest risk of femur fractures resulting from falling?

Elderly (age >65) Signup and view all the answers

What complication may result from a fracture to the femoral neck?

Avascular necrosis Signup and view all the answers

Which type of trauma typically results in a fracture to the femoral neck or femoral head?

High-impact trauma Signup and view all the answers

What is the most common cause of femur fractures in the general population?

Car accidents Signup and view all the answers

What is the significance of a femur fracture in the pediatric population?

Sign of child abuse Signup and view all the answers

What is a common cause of femoral neck stress fractures?

Excessive physical activity Signup and view all the answers

What is the estimated percentage of white women suffering a hip fracture by the age of 80?

20% Signup and view all the answers

What percentage of femoral shaft fractures in adolescents and the general population are caused by motor vehicle accidents?

80-90% Signup and view all the answers

What is the primary cause of avascular necrosis in the femoral head?

Femoral neck fracture Signup and view all the answers

What type of force causes transverse fractures across the femoral shaft?

Torsion Signup and view all the answers

Where is the femoral head located?

In the hip socket Signup and view all the answers

Signup and view all the answers

What is the sensitivity of radiography using the lateral or posterior sign as diagnostic criteria for femoral neck fractures?

0.875 Signup and view all the answers

What did MR imaging reveal in 83% of individuals based on a retrospective study conducted in London?

Occult hip fractures Signup and view all the answers

What was the specificity of radiography with fat pad elevation greater than or equal to 1.5 mm as a diagnostic reference for femoral neck fractures?

0.857 Signup and view all the answers

What is the predominant cause of avascular necrosis in the femoral head?

Prolonged immobilization Signup and view all the answers

What was the average age among individuals imaged for lower-extremity injuries in the emergency setting based on the retrospective review of Duke University’s MR imaging database?

70.8 years Signup and view all the answers

What type of fractures did MR imaging detect in 43% of the individuals according to a retrospective study conducted in London?

Proximal femur fractures Signup and view all the answers

What did the retrospective study by Collin et al investigate?

Observer variation for radiography, CT, and MR imaging of non-displaced occult hip fractures Signup and view all the answers

What role does MR imaging play in diagnosing femur fractures?

Assessing soft-tissue damage resulting from femur fracture Signup and view all the answers

Where is the femoral head located?

In the hip joint Signup and view all the answers

What percentage of white women suffer a hip fracture by the age of 80?

20% Signup and view all the answers

What is the primary cause of avascular necrosis in the femoral head?

Fracture of the femoral neck Signup and view all the answers

What is the most common site of avascular necrosis?

Femoral neck Signup and view all the answers

What type of fracture involves a complete crack in the femoral neck but no bone displacement?

Compression fracture Signup and view all the answers

What may be a distinguishing factor between a growth plate and an impacted fracture when viewed on radiographs?

Visible periosteal reaction Signup and view all the answers

Which artery provides 90% of the blood circulation to the femoral head?

Lateral epiphyseal artery Signup and view all the answers

What type of stress fractures appear as areas of increased uptake before any changes are visible on radiographs?

Stress fractures Signup and view all the answers

What type of fractures are linked with abuse, particularly in children but also in the elderly?

Nonaccidental fractures Signup and view all the answers

What is often evident on radiographs in cases of stress fractures?

Sclerotic band across the bone Signup and view all the answers

What type of fracture involves a minor crack in the femoral neck?

Fatigue fracture Signup and view all the answers

What is a characteristic feature of stress fractures on radiographs?

Areas of increased uptake Signup and view all the answers

What is the estimated cost of more than 250,000 sub-capital hip fractures below the femoral head reported annually in the United States?

$20 billion Signup and view all the answers

What was the average age among individuals imaged for lower-extremity injuries in the emergency setting based on the retrospective review of Duke University’s MR imaging database?

45 years old Signup and view all the answers

What type of fracture is caused by a force exerted perpendicular to the femoral shaft?

Transverse fracture Signup and view all the answers

Which classification system includes 5 types and is particularly important because of its predictive value for femoral growth plate fractures?

Salter-Harris classification Signup and view all the answers

What is the most common type of hip fracture?

Intertrochanteric fracture Signup and view all the answers

What type of fracture disrupts the blood supply to the femoral head and can result in hip displacement as well as necrosis of the femoral head?

Type 4 femoral neck fracture Signup and view all the answers

Which imaging technique remains the gold standard for diagnosing bone fractures?

Radiography Signup and view all the answers

What artery provides 90% of the blood circulation to the femoral head?

Medial circumflex femoral artery Signup and view all the answers

What type of fracture occurs spontaneously in abnormal bone, particularly in the presence of bone tumors?

Pathological fracture Signup and view all the answers

What is often obvious in cases of high-impact trauma causing a femoral shaft fracture?

Displacement of the bone fragments Signup and view all the answers

What type of force causes oblique fractures across the femoral shaft?

$45^\circ$ force to the shaft Signup and view all the answers

What pathology is associated with open or compound fractures?

"Exposure to the outside air and often involve more injury to the surrounding muscles, tendons, and ligaments" Signup and view all the answers

What condition can increase the risk of femur and hip fractures in the elderly population?

Osteoporosis Signup and view all the answers

What type of injury often indicates potential abuse when seen on radiographs as small chips from the long bones?

Rib fractures Signup and view all the answers

Why are at least 2 projections required in the case of bone trauma?

To assess the position of a fracture with more than 1 image Signup and view all the answers

What imaging technique may be preferred when a fracture is not evident on radiographs, but clinical suspicion of a fracture is high?

MR imaging Signup and view all the answers

What is the recommended position for the patient during an anteroposterior (AP) projection for femur imaging?

Supine position Signup and view all the answers

What is the most common reason for imaging in elderly patients according to the retrospective review of Duke University’s MR imaging database?

Femoral neck fractures Signup and view all the answers

What may be a distinguishing factor between a growth plate and an impacted fracture when viewed on radiographs?

The smooth and curved growth plate margin Signup and view all the answers

What type of force causes transverse fractures across the femoral shaft?

Torsional force Signup and view all the answers

Where is the femoral head located?

At the proximal end of the femur Signup and view all the answers

What percentage of femoral shaft fractures in adolescents and the general population are caused by motor vehicle accidents?

50% Signup and view all the answers

What diagnostic imaging technique remains the gold standard for bone fracture detection?

Radiography Signup and view all the answers

What is often obvious in the case of high-impact trauma causing a femoral shaft fracture?

A large dome-like lump on the thigh Signup and view all the answers

Study Notes

Femur Fractures

The most common cause of femur fractures in the general population is motor vehicle accidents.
In the elderly, the most common cause of femur fractures is falling.

Femoral Neck Fractures

A fracture to the femoral neck can lead to avascular necrosis of the femoral head.
A scenario that typically results in a fracture to the femoral neck or femoral head is high-impact trauma, such as a motor vehicle accident.
Stress fractures involving a minor crack in the femoral neck can occur from normal activity or minimal trauma.
A fracture involving a complete crack in the femoral neck but no bone displacement is known as a non-displaced fracture.

Imaging and Diagnosis

The gold standard for diagnosing bone fractures is radiography.
MRI imaging is often necessary to detect brain damage or subdural hemorrhage in cases of suspected abuse.
Radiography with fat pad elevation greater than or equal to 1.5 mm has a specificity of 95% as a diagnostic reference for femoral neck fractures.
MR imaging is useful in diagnosing femur fractures, particularly in cases where radiographs are negative but clinical suspicion is high.

Hip Fractures

The most common type of hip fracture is sub-capital hip fractures below the femoral head.
The estimated cost of more than 250,000 sub-capital hip fractures reported annually in the United States is significant.
The femoral head is located at the proximal end of the femur and forms an angle opening medialward with the femoral body.

Other

The primary cause of avascular necrosis in the femoral head is disruption of the blood supply to the femoral head.
The artery that provides 90% of the blood circulation to the femoral head is the medial circumflex femoral artery.
The Salter-Harris classification is primarily used to classify femoral growth plate fractures.
Stress fractures often appear as areas of increased uptake before any changes are visible on radiographs.
Femoral shaft fractures are often caused by transverse or oblique forces, such as those experienced in a motor vehicle accident.
Open or compound fractures are associated with a high risk of infection and other complications.

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Description

Learn about the indicators of child abuse such as periosteal reaction and rib fractures, as well as the classification of fractures. Understand the importance of skeletal surveys and imaging techniques in diagnosing child abuse.

Fracture Classification

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Questions and Answers

What is the most common cause of femur fracture in the general population?

In the elderly, what is the most common cause of femur fractures?

What is the consequence of a fracture to the femoral neck?

Which scenario typically results in a fracture to the femoral neck or femoral head?

What is often obvious in the case of high-impact trauma causing a femoral shaft fracture?

Which type of fracture involves a minor crack in the femoral neck?

What diagnostic imaging technique remains the gold standard for bone fracture detection?

What is the most common type of hip fracture?

What is the Salter-Harris classification primarily used to classify?

What type of force causes transverse fractures across the femoral shaft?

Which type of fracture involves a complete crack in the femoral neck but no bone displacement?

What is the pathology associated with open or compound fractures?

What imaging technique may be necessary to detect brain damage or subdural hemorrhage in cases of suspected abuse?

What is the pathology associated with open or compound fractures?

What is the most common type of hip fracture?

What imaging technique may be necessary to detect brain damage or subdural hemorrhage in cases of suspected abuse?

Which artery provides 90% of the blood circulation to the femoral head?

What is the predominant branch that delivers blood to the femoral head?

What is the primary cause of avascular necrosis in the femoral head?

What type of injury occurs in 2% of individuals with femur shaft fractures?

What is a characteristic feature of stress fractures on radiographs?

Which type of fracture can occur during normal activity or from minimal trauma?

What type of fracture occurs in abnormal bone from abnormal stress?

What type of fractures occur spontaneously in abnormal bone, particularly in the presence of bone tumors?

What is a common cause of compression fractures?

Which type of fracture typically occurs at the growth plates due to force?

What type of fractures are linked with abuse, particularly in children but also in the elderly?

What type of injury often indicates potential abuse when seen on radiographs as small chips from the long bones?

What is the specificity of radiography with fat pad elevation greater than or equal to 1.5 mm as a diagnostic reference for femoral neck fractures?

In the study, what imaging modality remains the gold standard for diagnosing occult femoral neck fractures?

What is the most common reason for imaging in elderly patients according to the retrospective review of Duke University’s MR imaging database?

What was the average age among individuals imaged for lower-extremity injuries in the emergency setting based on the retrospective review of Duke University’s MR imaging database?

What did the retrospective review of Duke University’s MR imaging database find regarding patients imaged for lower-extremity injuries in the emergency setting?

In the study, what did MR imaging reveal in 81 individuals (83%) based on a retrospective study conducted in London?

What type of fractures did MR imaging detect in 43% of the individuals according to a retrospective study conducted in London?

What did the retrospective study by Collin et al investigate?

What role does MR imaging play in diagnosing femur fractures?

What percentage of individuals imaged for lower-extremity injuries in the emergency setting underwent at least 2 x-ray examinations according to the retrospective review of Duke University’s MR imaging database?

What was the sensitivity of radiography using positive lateral or posterior sign as diagnostic criteria according to the study?

What is the estimated cost of more than 250,000 sub-capital hip fractures below the femoral head reported annually in the United States?

Which group has a disproportionately high risk of femoral neck stress fractures?

What percentage of femoral shaft fractures in adolescents and the general population are caused by motor vehicle accidents?

What is the estimated percentage of white women suffering a hip fracture by the age of 80?

What condition can increase the risk of femur and hip fractures in the elderly population?

Where is the femoral head located?

What forms an angle opening medialward with the femoral body?

What is the reason for requiring at least 2 projections in the case of bone trauma?

What is the recommended position for the patient during an anteroposterior (AP) projection for femur imaging?

In areas of more complex bony anatomy, such as the joints, why might more than 2 projections be needed to assess trauma adequately?

What may be a distinguishing factor between a growth plate and an impacted fracture when viewed on radiographs?

What type of stress image is taken to show that a joint is unstable, as in the case of a dislocation?

What imaging technique may be preferred when a fracture is not evident on radiographs, but clinical suspicion of a fracture is high?

Why might radiographs of the unaffected leg be helpful for diagnosis in certain cases?

What is the most common cause of femur fractures in the pediatric population?

Which group is at the highest risk of femur fractures resulting from falling?

What complication may result from a fracture to the femoral neck?

Which type of trauma typically results in a fracture to the femoral neck or femoral head?

What is the most common cause of femur fractures in the general population?

What is the significance of a femur fracture in the pediatric population?

What is a common cause of femoral neck stress fractures?

What is the estimated percentage of white women suffering a hip fracture by the age of 80?

What percentage of femoral shaft fractures in adolescents and the general population are caused by motor vehicle accidents?

What is the primary cause of avascular necrosis in the femoral head?

What type of force causes transverse fractures across the femoral shaft?

Where is the femoral head located?

What is the sensitivity of radiography using the lateral or posterior sign as diagnostic criteria for femoral neck fractures?

What did MR imaging reveal in 83% of individuals based on a retrospective study conducted in London?

What was the specificity of radiography with fat pad elevation greater than or equal to 1.5 mm as a diagnostic reference for femoral neck fractures?

What is the predominant cause of avascular necrosis in the femoral head?

What was the average age among individuals imaged for lower-extremity injuries in the emergency setting based on the retrospective review of Duke University’s MR imaging database?

What type of fractures did MR imaging detect in 43% of the individuals according to a retrospective study conducted in London?

What did the retrospective study by Collin et al investigate?

What role does MR imaging play in diagnosing femur fractures?

Where is the femoral head located?

What percentage of white women suffer a hip fracture by the age of 80?

What is the primary cause of avascular necrosis in the femoral head?