Intro To Radiology Powerpoint

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Rotational osteotomy tibia

Springer Verlag, Berlin, Koch P. Gustilo, R. Bone Joint Surg. Anderson J. Trauma, , 24 , —

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Colleague’s E-mail is Invalid. Your message has been successfully sent to your colleague. Save my selection. Distance of the fracture from the radiocarpal surface in childhood: does it determine surgical technique? A retrospective clinical study. This is an open access article distributed under the Creative Commons Attribution License 4. Unstable distal metaphyseal and dia-metaphyseal fractures of the radius may have treated with a variety of operative techniques, Kirschner wires K-wires , dorsally inserted titanium elastic stable intramedullary nailing DESIN , and short titanium elastic stable intramedullary nailing SESIN in children.

The aim of this study was to evaluate the differences in clinical and radiographic outcomes between these methods. Between January and December children were treated for forearm fractures in the distal third of the distal radius. Gender of the patients, different types of surgical techniques, number of postoperative X-rays, date of metal removal and degree of axis deviation after the metal removal were studied.

Distal Humeral Fractures-Current Concepts

Pediatric fractures include fractures in patients ranging from neonates to late adolescence. They have unique patterns and management different from that of adults due to distinctive anatomy, physiology, and biomechanics of developing bone. Trauma is a leading cause of pediatric fractures, which are often associated with sports injuries, motor vehicle accidents MVA , falls, and child abuse. Stress or fatigue fractures may occur without a single specific incident of trauma.

the metaphysis (unifocal or Neer 2-part fractures) and proximal femoral fractures ture, with multifragmentary metaphyseal fracture and articular fracture.

Pediatric cases with myelomeningocele are susceptible to fractures of lower extremities. Impacted proximal tibial metaphyseal fractures are uncommon injuries in pediatric age and peak around 3—6 years of age. Impacted fracture in proximal tibia region consists of periosteal buckling associated with compression load, particularly in metaphyseal area. Proximal tibial is an uncommon site for impacted fractures and the injury pattern in a child with paraplegia associated with myelomeningocele has been a rare report.

As the displacement of the fracture is main concern, so a good splinting is the mainstay of treatment. Our report depicts a rare site of fracture in this subset of patients as well as treatment consideration in the form of short-term, light weight and fabricated bracing as the splints. Periodic supervised assessment for recurrence or de novo comorbidities as well as proper nutrition and therapy for osteomalacia is instrumental as part of the holistic management of such cases.

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Establishing signs for acute and healing phases of distal tibial classic metaphyseal lesions

Stages of healing for classic metaphyseal lesions CMLs are not well established. Follow-up skeletal surveys provide an opportunity to evaluate signs of healing CMLs. To evaluate the sequence of CML healing phases by comparing initial and follow-up skeletal surveys in children with distal tibial CMLs on the initial survey. Findings could assist in child abuse investigations.

We identified all distal tibia CMLs with initial and follow-up skeletal surveys performed January through December at our institution.

abuse include rib fractures, classic metaphyseal lesions, those unsuspected or not possible to exactly date fractures by radiography [27]. Tcm bone scan.

Children throughout the world experience physical abuse that may go unnoticed. Radiologists may be the first clinicians to identify signs of potential abuse. The number of articles published in peer-reviewed journals about this subject has increased markedly over the past decade. A recent two-article series in Clinical Radiology provides a concise and informative review of the important factors and signs of inflicted skeletal injury. The authors list common clinical features that should raise suspicion of an inflicted injury.

These include history of household falls resulting in fracture, delay in seeking medical attention for the child, and an explanation of the cause of the injury that is incompatible with the injury itself. Multiple fractures with no family history or concurrent history of bone disease, a torn frenulum, and a retinal hemorrhage should raise concern. Fractures in pre-ambulant infants are highly suspicious for physical abuse.

A classic metaphyseal lesion is caused by extreme force across the metaphysis resulting in cumulative microfractures of immature bone.

Dating metaphyseal fractures

Title : A metaphyseal fracture rat model for mechanistic studies of osteoporotic bone healing. Abstract : Most osteoporotic fractures occur at metaphyseal regions of long bones. The present study proposed a clinically relevant animal model that satisfied: i induction of osteoporosis, ii unilateral complete osteotomy at metaphysis, iii internal fixation.

To present mechanisms and dating of Cumulation of multiple microfractures across the metaphysis Radiological dating of fractures: difficult & imprecise.

Figure 6. See same patient in Fig. A, AP portable supine radiograph obtained at the time of resuscitation shows fractures of the right sixth-to-ninth ribs without frank callus formation arrows. There is a healing fracture of the right tenth rib circle. There is a right tension pneumothorax. The child was pronounced dead and multiple fractures were noted on SS, including over 24 rib fractures. C, Corresponding axial specimen radiograph shows disruption of the inner rib cortex black arrow.

D, Frontal specimen radiograph shows fractures of the right tenth black arrows and eleventh curved arrow ribs. Note that the relatively solid SPNBF thin white arrows blends with mature hard callus with trabecular matrix surrounding the fracture site thick white arrows. The eleventh rib fracture shows no healing. E, Axial specimen radiograph of the right tenth rib shows the mature fracture callus white arrows.

Although most radiologists make assessments of fracture healing with accidental fractures on a daily basis, the evidence base for dating fractures, particularly in the abusive setting, remains incomplete 3 , 5 —7, 10 , This is remarkable when one considers the important implications of these radiologic assessments. This chapter attempts to provide some guidelines for dating fractures in infants and children in whom the diagnosis of physical maltreatment is considered.

Fractures – Distal forearm or wrist

The Canadian Paediatric Society gives permission to print single copies of this document from our website. For permission to reprint or reproduce multiple copies, please see our copyright policy. Fractures are common injuries in childhood. While most fractures are caused by accidental trauma, inflicted trauma maltreatment is a serious and potentially unrecognized cause of fractures, particularly in infants and young children.

This practice point identifies the clinical features that prompt concern for inflicted skeletal injury and outlines a management approach based on current literature and published guidelines, including the clinician’s duty to report suspicion of child abuse to child welfare authorities.

latory children. Classic metaphyseal fractures at the end of developing long for dating long bone fractures are broad and demonstrate sig- nificant overlap (27).

As result of the current demographic changes, osteoporosis and osteoporotic fractures are becoming an increasing social and economic burden. In this experimental study, extracorporeal shock wave therapy ESWT , was evaluated as a treatment option for the improvement of osteoporotic fracture healing. A well-established fracture model in the metaphyseal tibia in the osteoporotic rat was used. Different energy flux intensities 0.

Fracture healing was investigated quantitatively and qualitatively using micro-CT imaging, quantitative real-time polymerase chain reaction qRT-PCR analysis, histomorphometric analysis and biomechanical analysis. In conclusion, low-energy ESWT seems to exhibit a beneficial effect on the healing of osteoporotic fractures, leading to improved biomechanical properties, enhanced callus-quantity and -quality, and an increase in the expression of bone specific transcription factors.

The results suggest that low-energy ESWT, as main treatment or as adjunctive treatment in addition to a surgical intervention, may prove to be an effective, simple to use, and cost-efficient option for the qualitative and quantitative improvement of osteoporotic fracture healing. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information files. The funders had no role in study design, data collectio and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Due to the continuous changes in the demographic age pattern, the number of elderly people, and with it the prevalence of osteoporosis and osteoporotic fractures, is steadily increasing.

In , there already were an estimated 9 million fractures caused by osteoporosis worldwide and this number will continue to rise in the decades to come [ 1 ].

Fracture clinic – wrist (distal radius and ulna metaphyseal fractures)

Fractures are common injuries in childhood. While most fractures are caused by accidental trauma, inflicted trauma maltreatment is a serious and potentially unrecognized cause of fractures, particularly in infants and young children. This practice point identifies the clinical features that prompt concern for inflicted skeletal injury and outlines a management approach based on current literature and published guidelines, including the clinician’s duty to report suspicion of child abuse to child welfare authorities.

The aim and scope of Forensic Aspects of Pediatric Fractures: also helpful chapters that cover normal variants and a chapter discussing fracture dating. disease) and spondylometaphyseal dysplasia corner fracture type.

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Average 4. The tibia fracture is reduced and placed into a long leg cast in the emergency room. A post-reduction radiograph is provided in Figure A. The parents should be counseled that a temporary tibial deformity may occur.

The distinctive patterns of healing of the classic metaphyseal lesion (CML) are discussed in depth in Chapters 2–4. The difficulties of dating.

Skeletal Survey. In-Patient Location. Right and left Humeri AP. Right and left Forearms AP. Right and left Hands PA or oblique. Right and left Femurs AP. Right and left Lower legs AP. Right and left Feet AP. Thorax AP, lateral, right and left obliques , to include sternum, ribs, thoracic and upper lumbar spine. Abdomen, to include the pelvis AP Lumbosacral spine lateral.

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