Radiology Techniques Overview

With or without contrast enhancement, CT scans provide detailed views of a specific plane of the bone.
Can identify soft tissue tumors or injuries to ligaments and tendons.
Used to pinpoint the location and extent of fractures in challenging areas for evaluation.

Uses magnetic fields, radio waves, and computers to depict changes in soft tissues like muscles, tendons, cartilage, nerves, and fat.
Contrast material can be used to enhance the visibility of anatomical structures.

Detects metastatic and primary bone tumors, osteomyelitis, and some fractures and aseptic necrosis.
A bone-seeking isotope is injected 2-3 hours before the scan.
The scan measures the distribution of the isotope, revealing bone metabolism.
Increased uptake indicates primary skeletal disease (osteosarcoma), metastatic bone disease, inflammatory skeletal disease (osteomyelitis), and fractures that are not healing as expected.

Direct visualization of joints for diagnosis and treatment of tears, defects, and disease processes.
Performed in the Operating Room under local or general anesthesia.
Saline is injected to enlarge the joint space for better visualization.
Symptoms: pain, joint contour changes, limb length alterations, and loss of range of motion.

Can be acute (sprains, strains, dislocations, fractures) or chronic and gradual from repetitive use (tendinitis, stress fractures).

Complete or incomplete disruption in the continuity of bone structure.
Defined by type, extent, and appearance.
Occur when bone is subjected to stress exceeding its capacity.
Can affect adjacent structures, leading to soft tissue edema, hemorrhage, joint dislocations, ruptured tendons, severed nerves, damaged blood vessels, and organ damage.

Based on location (proximal, midshaft, distal), type, degree of break, appearance, position and alignment of fragments, stability, and open or closed nature.

Avulsion: bone fracture resulting from strong tendon or ligament pulling.
Spiral: fracture twisting around the bone shaft.
Depressed: fragments driven inward, common in skull and facial bone fractures.
Impacted: one bone fragment driven into another.
Pathologic: fracture through diseased bone, occurring spontaneously or with minimal trauma.
Simple: contained fracture, no skin disruption.
Stress: fracture caused by repeated loading of bone and muscle.

Immobilization of the limb (support above and below the fracture).
Splints minimize soft tissue damage, pain, and bleeding from fragment movement.
Open fracture: cover the wound with a sterile dressing, do not attempt reduction.
Handle fractured extremity minimally.

Reduction: restoration of bone fragments to correct alignment and position.
Closed Reduction: non-surgical manual realignment, immobilized by traction, casting, external fixation, splints or braces.
Open Reduction: surgical correction with incision, uses internal fixation (ORIF) like wires, screws, pins, plates, rods, or nails.
Immobilization: after reduction, to maintain the alignment until union occurs.
External Immobilization: bandages, casts, splints, continuous traction, external fixators.
Internal Immobilization: metal implants.
Traction: devices applying pulling force on the fractured extremity for realignment with counter-traction in the opposite direction.
- Skin Traction: short-term, for 48-72 hours until skeletal traction or surgery. Tape, boots, splints applied directly to the skin with 5-10 pounds of weight.

Performed at the most distal point with successful healing potential.
Determined by adequate circulation and functional usefulness.
Doppler, blood pressure, and transcutaneous PaO2 aid in level determination.
Goal is to conserve as much extremity as possible, with preservation of knee and elbow joints preferred.

Focus on wound healing to achieve a nontender residual limb with healthy skin for prosthetic attachment.
Gentle handling, compression dressings to manage edema, and aseptic techniques are crucial for healing.

Compression bandage applied after surgery for soft tissue support, edema reduction, faster healing, pain management, and residual limb shrinkage.
Proper stump bandaging shapes the limb for prosthesis fitting.

Preoperative:
- Reinforce already taught information to patient and family.
- Understand amputation level, dressing type, and planned prosthesis.
- Educate about post-operative exercises, including upper extremity exercises.
- Discuss post-operative nursing care and expectations.
- Explain phantom limb sensation and pain.
Postoperative:
- Very individualized based on health, reasons for amputation, and age.
- Emphasis on prevention and detection of complications.
- Monitor for signs and symptoms of hemorrhage, including vital signs and dressing assessment.
- Employ sterile technique to minimize infection risk.