![]() Computed Tomography scan can be useful for displaced or angulated fractures, complex intra-articular fractures, vertebral, and pelvic fractures.Oblique views are also helpful for detecting subtle spiral fractures where the AP and lateral views are normal, yet a fracture is strongly suspected.Īnkle AP mortise view is helpful since it includes distal tibia, distal fibula, talus, and proximal metatarsals. Oblique views are helpful for fully disclosing the nature and extent of many fracture patterns, especially when the injury involves the ankle, elbow, hand (especially for scaphoid fracture), or foot. ![]() It isvaluable to obtain comparison views of the contralateral side, especially if there is suspected physeal injuries which may have very subtle radiographic abnormalities.Īnteroposterior (AP) and lateral views are the most common. Radiographs should include the joints immediately proximal and distal to a fractured long bone. X-Rays: At minimum, two views are obtained, taken at 90-degree angles.Evidence of neurovascular compromise necessitates urgent, often operative, orthopedic treatment. Assessment of two-point discrimination is probably the best test of sensory function. Check the integrity of pulses and speed of capillary refill, as well as testing sensory and motor function. Checking neurovascular function distal to the injury is essential in evaluating any child with a potential fracture.Pain on motion and limitation of motion signal the need for further examination. Observe the spontaneous movement, attempts to get the patient to voluntarily move the involved part through its expected range, and passive movement. Palpation and assessment of active and passive motion: localized swelling and tenderness on palpation are significant findings and should alert the examiner to the likelihood of an underlying fracture.Comparison with the opposite extremity and measurement of circumference can be very helpful when findings are subtle. Evaluate the overlying skin and soft tissues for swelling, ecchymosis, abrasions, punctures, and lacerations. Visual inspection: Gross position of the extremity allows you to appreciate for presence or absence of deformity, distortion or abnormal angulation, and longitudinal shortening.Another possible complication is compartment syndrome, a painful condition resulting from the expansion of enclosed tissue and that may occur when a body part is immobilized in a cast. Open fractures may lead to bone infections, which delay the healing process. Recovery is complete when there is no bone motion at the fracture site, and x rays indicate complete healing. A non-union fracture may result when a fracture does not heal, such as in the case of an elderly person or an individual with medical complications. ![]() Healing time varies from person to person with the elderly generally needing more time to heal completely. Realignment has been shown to be much more difficult after six hours. If determined necessary by a physician, the fractured site should be manipulated, realigned, and immobilized as soon as possible. Fractures can normally be cured with proper first aid and appropriate aftercare. Causes and symptomsįractures involving joint surfaces almost always lead to some degree of arthritis of the joint. An example of segmental alignment is when the arm bone fractures in two separate places, with displacement of the middle section of bone. Segmental fragmented positioning occurs if fractures in two adjacent areas occur, leaving an isolated central segment. An avulsed fragment occurs when bone fragments are pulled from their normal position by forceful muscle contractions or resistance from ligaments. A displaced bony fragment occurs from disruption of normal bone alignment with deformity of these segments separate from one another. Angulated fragments result in pieces of bone being at angles to each other. ![]() Overriding is a term used to describe bony fragments that overlap and shorten the total length of a bone. An impacted fracture is characterized as a bone fragment forced into or onto another fragment resulting from a compressive force. Fragments of bone that maintain their normal alignment following a fracture are described as being non-displaced. Comminuted fractures have two or more fragments broken into small pieces, in addition to the upper and lower halves of a fractured bone.
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