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Bahan Dr. Noverial SP - OT PDF
Bahan Dr. Noverial SP - OT PDF
Marko Macura, MD
Orthopaedic trauma surgeon
systematic x-ray interpretation
fracture nomeclature
A
◦ Adequacy, Alignment
B
◦ Bones
C
◦ Cartilage
S
◦ Soft Tissues
ABCs approach applies to every x-ray image!
Adequate views:
• Min. 2 views—AP & lateral
(except maybe children)
• 3 views even better (oblique view)
• Sometimes more (i.e. Brodin’s)- CT is better
Swelling posterior to
the joint
Suspect hairline
fracture- not clearly
visible on x-ray
(A) alignment
(B)bones- fracures 2.,3. & 4. metacarpals
Frxs of diaphyses 2.-4th. metacarpals.
Cave!: jewelery (ring)- should always be
removed (oedema-constriction)
Medical terminology describing fractures.
Better
communication with orthopaedic and
trauma surgeons.
Fracture description
• Open/closed fracture
• Anatomic location
• Fracture line shape
• Interfragmentary position
• Neurovascular status
Describe to the surgeon open/closed fx
Closed fx
• Simple, noncomplicated fx
• No skin wounds at or near fracture site
Open fx
• Complicated fracture (fractura complicata)
• Skin wound- bony fragment may protrude
• Open fxs are often comminuted & dislocated
Surgical emergency
Immediate surgical treatment required
Stop the bleeding
treatment
• IV antibiotics
• Tetanus vaccine
• Treat pain
• Surgical debridement (excision, irrigation) & fx
reduction
Describe anatomic fracture location
Left/right side
Which bone?
Location within the bone:
• Proximal/middle/distal part
• Bone is divided into 1/3 or epi-, meta-, diaphysys
• Propagation of fx into a joint?
Closed fracture of left distal femur