Test yourself: Fracture general principles
Case Study 1.
A 36-year-old woman fell on her right hand. There is pressure pain and functional limitation at the level of the MCP-I joint.
An X-ray is made (fig. 1).
Figure 1. AP image (a) and lateral image (b) of dig-I in the right hand.
Abnormal joint articulation of the MCP-I joint. The proximal phalanx of dig-I has been dislocated towards dorsoradial.
There is no fracture.
Luxation of MCP-I in the right hand.
♦ Figure 1. Answer: Luxation of MCP-I in the right hand.
Case Study 2.
A 7-year-old boy jumped from a gate (one meter high). He doesn't want to stand on his leg and is in much pain.
An X-ray of his left ankle is made (fig. 2).
Figure 2. AP image (a) and lateral image (b) of the left ankle.
- Fracture line in distal tibia with a spiral orientation. The fracture line does not continue into the ankle joint and the fracture fragments are virtually anatomical.
- There is a lytic lesion at the level of the fracture. The lesion is lobed, sharply delineated and extends in the cortical direction. Think of non-ossifying fibroma (NOF) or fibrous dysplasia.
Pathological extra-articular spiral fracture in the distal tibia.
♦ Figure 2. Answer: pathological extra-articular spiral fracture in the distal tibia.