Introduction to the Radiology of
Fractures and Related Injuries
Matthew Cham
Medical Student
University of Rochester
School of Medicine & Dentistry
Presentation material for educational purposes only. All rights reserved. © 1999 URMC Radiology.
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Introduction to the Radiology of
Fractures and Related Injuries
Types: location and mechanisms of injury
! Classifications and grading
! Radiologic vs. Clinical features
! Variants
!
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Types of Fractures
!fig4-19p.tif.0
Incomplete vs Complete
Greenspan 1992
!
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Simple
Fractures
!fig4-20p.tif
Alignment &
displacement
of fragments
Greenspan 1992
!
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Greenspan 1992
!fig4-21p.tif
Simple Fractures
! Directions of the fracture lines
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Greenspan 1992
!FIG4-22p.TIF
Other terms: fracture line not seen
! Impaction, depression, and compression
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Greenspan 1992
!FIG4-24p.TIF
Uncommon fractures
! Stress and pathologic etiologies
Presentation material for educational purposes only. All rights reserved. © 1999 URMC Radiology.
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Greenspan 1992
!FIG4-25p88.TIF
Fractures involving the growth plate
! Salter-Harris Classification
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Injuries of non-articulating joints
!fig5-25-67p.tif
!
Acromioclavicular & coracoclavicular separation
Sprain or tears in the AC and (or) CC ligaments, resulting in AC
separation with inferior displacement of the scapula and extremity
Greenspan 1992
!
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Anterior dislocation of the humeral head
!FIG5-25p.TIF
!
Depression
fractures
Hill-Sacks
& Bankart
lesions
Greenspan 1992
!
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Proximal Humeral
Fractures
!FIG5-22ap88.TIF
Classification by
location and extent
of displacement
Greenspan 1992
!
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Greenspan 1992
!fig5-22bp.tif
Fracture-dislocation of the humeral head
! Classification by anatomic location and displacement
Presentation material for educational purposes only. All rights reserved. © 1999 URMC Radiology.
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Distal Humeral Fractures
5-58ap.TIF
Muller Classification of Extra-articular extension
Greenspan 1992
!
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Distal
Humeral
Fractures
! Muller
Greenspan 1992 !5-58bp.TIF
Classification of
intra-articular
extension
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Dislocations
Posterior
elbow
!1237-02.tif
!
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Radial Head
fracture
Mason
Classification
I = undisplaced
II = displaced
III = comminuted
5-63p.TIF
IV = dislocated
Greenspan 1992
!
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Olecranon
Fractures
!
Horne-Tanzer
Classification
IA = Oblique proximal 3rd
IB = Transverse proximal 3rd
IIA = Oblique middle 3rd
IIB = Transverse middle 3rd
Greenspan 1992
5-69p.tif
III = Oblique distal 3rd
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Fractures of
the forearm
Monteggia
fracturedislocations
Bado classification of fractures
of the proximal ulna:
I = with anterior radial
dislocation
II = with posterior radial
dislocation
III = with lateral radial
dislocation
IV = with anterior radial
dislocation and fracture
Presentation material for educational purposes only. All rights reserved. © 1999 URMC Radiology.
Greenspan 1992 5-74p.TIF
!
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Fractures of
the forearm
!
Colles fracture
Greenspan 1992
6-11p.TIF
Fractures to the distal
radius, usually with lateral or
dorsal displacement of the
distal fragment
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Fractures of the forearm
Smith fractures (reverse Colle’s fractures)
Fractures of the distal radius with volar displacement
and angulation of the distal fragment
Type 2
Type 3
6-18p.tif
Type 1
Greenspan 1992
!
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Fractures of the wrist
Scaphoid fractures
Second most common injury
of the upper limb
Greenspan 1992
!FIG6-32p.TIF
Greenspan 1992 Handp88.tif
!
normal scaphoid bone
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Fractures of the hand
! Bennett fracture-dislocation
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Greenspan 1992
Greenspan 1992
!fig6-65p.tif
Intra-articular fracture of the proximal end of the first metacarpal, with
dorsal and lateral dislocation of the distal segment.
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Greenspan 1992
7-27p.TIF
Fractures of the Proximal Femur
! Intra- and Extracapsular fractures
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Blood supply of the femoral head
7-28p.tif
Interruption of this blood supply
secondary to intracapsular fracture
may lead to osteonecrosis
Greenspan 1992
!
Presentation material for educational purposes only. All rights reserved. © 1999 URMC Radiology.
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Fractures of the Proximal Femur
Impaction of the femoral neck into the femoral head
Normal
Greenspan 1992 1233-02p.tif
!
Impaction
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Posterior column
fx of acetabulum
!1241-01p.TIF
!
Acetabular fracture (
)
Posterior dislocation of the
femoral head
6015p88.tif
!
patient 1
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patient 2
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6014p88.tif
Anterior dislocation of the femoral head
6013p88.tif
patient C
patient C
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Greenspan 1992 8-21p.TIF
Fractures of the distal femur
! Supracondylar, condylar, and intercondylar extension
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Fractures of the
distal femur
Greenspan 1992
6043p88.tif
intercondylar fracture
6044p88.tif
!
lateral view
AP view
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Summary
!
simple vs. comminuted fractures
!
stress and pathologic fractures
!
intra- vs. extra-articular involvement
!
dislocation vs. separation
!
depression fractures and associated lesions
!
effects of fractures on blood supply
Presentation material for educational purposes only. All rights reserved. © 1999 URMC Radiology.
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