Fracture Classifications Flashcards

Questions and Answers

What is a medial oblique?

medial oblique

What is the mechanism of injury for Rowe's Calcaneal Fracture Type IIA?

Fall from height

Fracture of the anterior calcaneus

Violent contraction of the gastrocnemius-soleus

Direct trauma to the posterior superior calcaneal tuberosity (correct)

What is the mechanism of injury for Rowe's Calcaneal Fracture Type IIB?

Direct trauma

Fall from height

Violent contraction of the gastrocnemius-soleus (correct)

None of the above

What is the mechanism of injury for Rowe's Calcaneal Fracture Type III?

Fall from height with heel in varus or valgus Signup and view all the answers

What is the best X-ray view for Rowe's Calcaneal Fracture Type III?

lateral oblique and calcaneal axial Signup and view all the answers

What is the most common extra-articular calcaneal fracture?

Rowe's Calcaneal Fracture Type III Signup and view all the answers

Match the Essex-Lopresti fracture types with their descriptions:

Type 1 = Tongue fracture (vertical fracture line) without STJ involvement Type 2 = Joint depression fracture (horizontal fracture line) with STJ involvement Signup and view all the answers

What is the mechanism of injury for First Metatarsalphalangeal Joint Dislocation?

All of the above Signup and view all the answers

What must you rule out with First Metatarsalphalangeal Joint Dislocations?

Sesamoid fracture or osteochondral lesion Signup and view all the answers

What classification system is used for First Metatarsalphalangeal Joint Dislocations?

JAHSS Classification Signup and view all the answers

Describe Jahss Type 1 dislocation.

Dorsal dislocation of the proximal phalanx and sesamoids with the intersesamoidal ligament intact. Usually not reducible by closed technique. Signup and view all the answers

Describe Jahss Type II A dislocation.

Dorsal dislocation of the proximal phalanx and sesamoids with rupture of the intersesamoidal ligament. Signup and view all the answers

What is the anatomy of Lisfranc's Joint?

2nd metatarsal recessed between medial and lateral cuneiforms - keystone. Lisfranc's ligament is a strong dorsal ligament from the base of the 2nd to the medial cuneiform. Signup and view all the answers

What is a common mechanism of injury for Lisfranc injuries?

A crushing force or a torsional force with the foot in plantarflexion. Signup and view all the answers

What type of dislocation is more common, dorsal or plantar of the Lisfranc ligament?

Dorsal dislocation Signup and view all the answers

What are circulatory compromise risks associated with Lisfranc injuries?

Lateral plantar artery with type C injuries. Signup and view all the answers

What is the most common navicular fracture?

Dorsal cortical avulsion. Signup and view all the answers

What classification system is used for navicular fractures?

Watson-Jones Classification. Signup and view all the answers

What is a Jones fracture?

A fracture at the proximal shaft, within 1.5 cm from the tuberosity. Signup and view all the answers

Fractures of the fifth metatarsal within 1.5 cm of the tuberosity may require up to 20 weeks of nonweight-bearing immobilization and may still result in nonunion.

True Signup and view all the answers

What is the most common type of tarsus fractures?

Calcaneal fractures. Signup and view all the answers

What classification system is used for intra-articular calcaneal fractures?

Essex-Lopresti Signup and view all the answers

Study Notes

First Metatarsalphalangeal Joint Injuries

Hyperextension injuries can result in dislocations, often from motor vehicle accidents or falls from height.
Always rule out sesamoid fractures or osteochondral lesions with dislocations.
The JAHSS Classification system is utilized for categorizing dislocations.

JAHSS Classification Types

Type 1: Dorsal dislocation of the proximal phalanx and sesamoids, intersesamoidal ligament intact; usually not reducible.
Type II A: Dorsal dislocation with rupture of intersesamoidal ligament.
Type II B: Dorsal dislocation with transverse fracture of the sesamoids.

Lisfranc's Joint Anatomy

The second metatarsal serves as a "keystone" between medial and lateral cuneiforms.
Lisfranc's ligament is a strong dorsal ligament linking the base of the second metatarsal to the medial cuneiform.
There is no ligamentous attachment between the first and second metatarsal bases.

Mechanisms of Lisfranc Injuries

Dorsal dislocations are more prevalent due to stronger plantar ligaments.
Direct injuries occur from crushing forces, while indirect injuries often involve torsional forces with the foot in plantarflexion.

Diagnostics for Tarsometatarsal Fractures

Initial assessment includes X-rays, ideally taken in weight-bearing or partial weight-bearing positions.
CT and MRI are used for subtle fractures; MRI helps evaluate soft tissue involvement.

Lisfranc Classification Systems

QUENU & KUSS: Divides dislocations into types A (homolateral or total), B (isolateral or partial), and C (divergent).
HARDCASTLE Classification: Covers the severity and type of Lisfranc injuries from homolateral to divergent configurations.

Complications of Lisfranc Injuries

Potential issues include circulatory compromise, especially affecting the lateral plantar artery, infection, Sudeck's atrophy, degenerative joint disease, and exostosis formation.

Osteochondral Lesions of the Talus

Other names include transchondral fracture and osteochondritis dissecans.
Predominantly occur at the medial border (posterior third) and lateral border (anterior third) of the talus.

Talar Fractures and Classifications

Most common navicular fracture is dorsal cortical avulsion.
The Watson-Jones Classification categorizes navicular fractures into three types based on the region and nature of the injury.

Hawkins' Classification of Talus Neck Fractures

Group I: Non-displaced fractures; low AVN risk.
Group II: Displaced fractures; moderate AVN risk.
Group III: Severely displaced fractures with high AVN risk.
Group IV: Complete involvement of multiple joints with very high AVN risk.

Fifth Metatarsal Fractures

Uncomplicated avulsion fractures are the most common and usually heal well.
A Jones fracture is a serious injury requiring careful management due to its tendency for complications like nonunion.

Calcaneal Fractures

The most common tarsus fracture type, with a high incidence of intra-articular involvement.
Mechanism of injury often involves falls from height; critical radiographic angles include Bohler's and Gissane's angles for evaluation.

Rowe Classification for Calcaneal Fractures

Different types categorize fractures based on their anatomical location and intra or extra-articular nature.
Type III is the most common extra-articular calcaneal fracture.

Aseptic Necrosis of Bone

Caused by blood supply interruption, leading to avascular necrosis.
Recognition is crucial within 6-8 weeks, with radiographic signs indicating prognosis.

Treatment for Osteochondral Lesions

Non-weight bearing below-the-knee casting is standard until revascularization occurs.
Options include procedures like talectomy, triple arthrodesis, and ankle fusion surgeries.

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Description

Explore key concepts related to First Metatarsalphalangeal Joint dislocations in this set of flashcards. Each card covers mechanisms of injury, differential diagnoses, and classification systems essential for understanding these injuries. Test your knowledge and enhance your comprehension of fracture classifications.