COMMON

BONE
FRACTURES
UPPER LIMB FRACTURES
LOWER LIMB FRACTURES
PELVIC FRACTURES
SPINAL FRACTURES
 UPPER LIMB FRACTURES
1.SHOULDER DISLOCATIONS
2.CLAVICLE FRACTURES
3.ACROMIO-CLAVICULAR JT INJURY
4.HUMERUS FRACTURES
5.ELBOW FRACTURES
6.ELBOW DISLOCATIONS
7.FOREARM FRACTURES
8.WRIST FRACTURES -COLLE'S ,SMITH'S
9.CARPAL DISLOCATIONS
10.HAND FRACTURES

1.SHOULDER DISLOCATIONS

ANTERIOR DISLOCATION :COMMON

POSTERIOR :VERY RARE

ANTERIOR DISLOCATION : AP SHOULDER :

DIAGNOSTIC FEATURE:
HUMERAL HEAD LOCATED BENEATH THE
COROCOID PROCESS

ASSOCIATED INJURY:
HILL SACH'S LESION :
# OF POSTEROLATERAL HUMERAL HEAD
BANKARD'S LESION :
# INFERIOR PART OF THE GLENOID

CLAVICLE FRACTURE :
VIEWS : AP VIEWS – STRAIGHT AND
CRANIALLY ANGLED- # OF MID 1/3 IS COMMON

ACROMIO-CLAVICULAR JOINT INJURY:

AKA – SHOULDER SEPARATION

DEGREE OF INJURY : DISLOCATION TO

SUBLUATION

AP VIEW:
NORMAL AC JOINT
1.5MM WIDE
2.UNDERSURFACE OF ACROMION AND
CLAVICLE FORMS AN UNINTERRUPTED ARC

DIAGNOSIS :

AP STRESS VIEW , WITH THE PATIENT

HOLDING 6 – 9 KG IN EACH HAND
I – INCOMPLETE DISRUPTION – WIDENING OF
AC JOINT
II – COMPLETE DISRUPTION OF AC LIGAMENTS
AND PARTIAL DISRUPTION OF CORACO-
CLAVICULAR LIGAMENTS -
ELEVATION OF CLAVICLE LESS THAN THE
COMPLETE SHAFT WIDTH OF THE ACROMION.
III – COMPLETE DISRUPTION OF AC AND CC
LIGAMENTS
INCRESED DISTANCE BETWEEN SUPERIOR
SURFACE OF CORACOID AND UNDER
SURFACE OF THE CLAVICLE
NORMAL CORACOCLAVICULAR DISTANCE IS
1.1-1.2 CMS
 HUMERUS

NECK : AP AND AXILLARY VIEWS

#MOST COMMONLY AT THE SURGICAL NECK
ASSOCIATED WITH SEPARATION OF THE
GREATER TUBEROSITY
 HUMERAL SHAFT FRACTURE

AP VIEW :
SHOWS ANGULATED AND OVER RIDING
FRAGMENTS DUE TO MUSCULAR
CONTRACTION ON THE INDIVIDUAL
FRAGMENTS

ELBOW JOINT :

FRACTURES :
SUPRACONDYLAR FRACTURE:
ELBOW LATERAL VIEW:
DETECTION BY DRAWING A LINE ALONG THE
Supracondylar fracture humerus

ANTERIOR SURFACE OF THE HUMERUS

CALLED ANTERIOR HUMERAL LINE.
THIS LINE SHOULD PASS THROUGH THE
MIDDLE 1/3 OF THE HUMERUS
IF NOT , THEN SIGNIFIES SUPRA CONDYLAR
FRACTURE WITH DISPLACEMENT OF THE
DISTAL FRAGMENT
abnormal anterior humeral line

RADIAL HEAD FRACTURE:

OBLIQUE VIEW OF ELBOW : SHOWS FRACTURE
LINE. AP AND LATERAL MAY NOT ALWAYS
SHOW
SECONDARY SIGNS OF FRACTURE:
FAT PAD SIGNS: ANTERIORAND POSTERIOR
FAT PAD SIGN.
ANTERIOR FAT PAD:
NORMALLY SEEN AS A FUSIFORM LUCENCY
ANTERIOR TO THE DISTAL PART OF THE
HUMRUS ON LATERAL VIEW OF ELBOW. IN
RADIAL HEAD FRACTURE , THIS GETS
DISPLACED SUPERIORLY AND DISPLAYS THE
“SAIL SIGN”
POSTERIOR FAT PAD SIGN : NORMALY NOT
SEEN. SEEN ONLY WITH FRACTURE AND
EDEMA OR EFFUSION OF THE ELBOW JOINT

FAT PAD SIGN INDICATES ELBOW JOINT

EFFUSION OR HEMARTHROSIS WITH RADIAL
HEAD FRACTURE

RADIAL HEAD DISLOCATION:

AP VIEW : RADIOHUMERAL LINE – LINE
DRAWN THROUGH SHAFT OF RADIUS PASSES
THROUGH THE HEAD OF THE RADIUS AND THE
CENTER OF THE CAPITELLUM
RADIAL HEAD DISLOCATION ALMOST ALWAYS
ASSOCIATED WITH FRACTURE OF THE ULNA
 ELBOW DISLOCATION

POSTERIOR AND LATERAL DISLOCATIONS OF

RADIUS AND ULNA
IN RELATION OT HUMERUS
# OF ULNAR CORONOID IS PRESENT

xray elbow AP VIEW showing elbow dislocation

OLECRANON # - SEEN ON LATERAL VIEW.
FRACTURE FRAGMENT IS PULLED UP
MUCULAR CONTRACTION
# CAPITELLUM – LINEAR OR OSTEOCHONDRAL
INJURIES
SEEN ON MRI , XRAYS NOT OF MUCH USE

FOREARM FRACTURES:
ALMOST ALWAYS , BOTH BONES OF FOREARM
ARE ALWAYS #ED OR ONE FRACTURED AND
OTHER DISLOCATED

MONTEGGIA # DISLOCATION : PROXIMAL

ULNA FRACTURE AND ANTERIOR

DISLOCATION OF RADIAL HEAD

GALEZZI # DISLOCATION :DORSALLY

ANGULATED DISTAL RADIUS FRACTURE AND
DISTAL RADIOULNAR JOINT DISLOCATION
WRIST
PA AND LATERAL VIEWS USED FOR DIAGNOSIS
CARPAL INJURY – MULTIPLE VIEWS ARE
NECESSARY
AGE : CHILDREN AND > 40 YRS – DISTAL
RADIAL FRACTURE
YOUNG ADULTS – SCAPHOID FRACTURE IS
COMMON
SCAPHOID # UNCOMMON BEFORE 12 YRS AND
AFTER 40 YEARS

COLLE'S FRACTURE :
DISTAL FRACTURE OF THE RADIUS WITH
DORSAL DISPLACEMENT OF THE DISTAL
FRACTURE FRAGMENT

SMITH'S FRACTURE OR REVERSE COLLE'S

FRACTURE:
DISTAL RADIAL FRACTURE WITH VOLAR
DISPLACEMENT OF THE DISTAL FRACTURE
FRAGMENT

BARTON'S FRACTURE :
FRACTURE OF THE VOLAR LIP OF THE DISTAL

RADIUS

REVERSE BARTON'S FRACTURE :

FRACTURE OF THE DORSAL LIP OF THE DISTAL
RADIUS

HUTCHINSON'S OR CHAUFFER'S CRANK

HANDLE FRACTURE
FRACTURE OF RADIAL STYLOID

INDIRECT SIGN : PRONATOR QUADRATUS FAT

PAD SIGN .SEEN IN DISTAL FOREARM
FRACTURES AND DISLOCAIONS

CARPAL BONE FRACTURES

SCAPHOID FRACTURE : MOST COMMON
CARPAL BONE FRACTURE
BEST VIEW : PA VIEW IN MAXIMUM ULNAR
DEVIATION
MOST ARE DISPLACED TRANSVERSE
FRACTURES THROUGH MIDDLE OR WAIST OF
THE SCAPHOID.
SCAPHOID RADIOGRAPH SHOULD BE TAKEN 7 –
10 DAYS AFTER ORIGINAL TRAUMA BY WHICH
TIME OSTEOCLASIS WOULD HAVE WIDENED
THE FRACTURE LINE and MADE THE
FRACTURES VISIBLE.

MRI OR SERIAL SCINTIGRAPHY:

SINCE THESE MAY BE INVISIBLE ON PLAIN
FILM IN THE EARLY PERIOD FOR ONE WEEK.

AVASCULAR NECROSIS OF THE DISTAL

FRAGMENT OCCURS DUE TO VASCULAR
DISRUPTION

EARLY DETECTION CAN BE DONE WITH MRI

(LOW SIGNAL IN BOTH T1 AND T2 WEIGHTED
IMAGES)
AND SKELETAL SCINTIGRAPHY
CT AND XRAY ONLY USEFUL IN THE LATER
COURSE AND IT APPEARS DENE DUE TO
SCLEROSIS

TRIQUETRUM FRACTURE :
SECOND MOST COMMON FRACTURE
LATERAL VIEW FOR DETECTION:
SHOWS AVULSED FRAGMENT FROM THE
DORSAL SIDE AT THE SITE OF ATTACHMENT
OF THE RADIOCARPAL LIGAMENT

HAMATE # : INVOLVES HOOK AND THE DORSAL

SURFACE

TRAPEZIUM FRACTURE:
SEEN AS VERTICAL FRACTURE IN THE
LATERAL ASPECT OF THE BONE

CARPAL DISLOCATIONS:
RESULTS FROM LIGAMENTOUS DISRUPTION
THE LIGAMENTS SURROUNDING THE LUNATE
PROVIDE STABILITY FOR THE CARPUS

SCAPULOLUNATE DISLOCATION:
SIMPLEST AND MOST COMMON
SCAPULOLUNATE LIGAMENT DISRUPTION
1. WIDENING OF SCAPULOLUNATE SPACE ON
THE PA RADIOGRAPH - TERRY THOMAS SIGN
NORMAL INTERCARPAL DISTANCE IS ABOUT
2MM, > 4MM IS ABNORMAL – TERRY THOMAS
SIGN POSITIVE

BEST SEEN ON ULNAR DEVIATED ANTERIOR

VIEW

2.ROTATION OF SCAPHOID – ON IT'S AXIS –

BRINGS THE DISTAL POLE END ON
3.SIGNET RING SIGN
ROTATION CAUSES PROJECTION OF THE
DISTAL POLE OVER THE WAIST

PERILUNATE DISLOCATION:
DISRUPTION OF SCAPHO-LUNATE , LUNO
CAPITATE,LUNO-TRIQUETREL LIGAMENTS

LATERAL VIEW : LUNATE RETAINS IT'S

ALIGNMENT WITH THE RADIUS , WHEREAS
THE REST OF THE CARPAL BONES AND HAND
SHIFT DORSALLY

PA VIEW :
LUNATE ROTATES AND BECOMES WEDGE
SHAPED

ASSOCIATED # : SCAPHOID #, CAPITATE #

LUNATE DISLOCATION:

DISRUPTION OF
RADIOLUNATE ,
SCAPHOLUNATE,
LUNOCAPITATE,
LUNOTRIQUETREL LIGAMENTS

SO ON LATRAL FILM LUNATE DISLOCATES

ANTERIORLY AND TILTS SO THAT IT'S DISTAL
ARTICULAR SURFACE FACES THE PALM

THE ALIGNMENT BETWEEN LUNATE AND

RADIUS IS DISRUPTED AND THE REST OF THE
CARPUS MAINTAINS IT'S RELATIONSHIP

PA VIEW : SIMILAIR TO PERILUNATE

DISLOCATION
 HAND FRACTURES
BOXER'S FRACTURE:
FRACTURE OF THE 4TH AND 5TH METACARPAL
WITH INVOLVEMENT OF THE MIDSHAFT OR
BASE.
BENNETTE'S FRACTURE :
# OF FIRST METACARPAL BONE BASE
INTRA ARTICULAR

UNSTABLE
DISTAL FRAGMENT IS DISTRACTED BY THE
UNOPPOSED ACTION OF ABDUCTOR
POLLICIS LONGUS

ROLANDO'S FRACTURE:
COMMINUTED # OF THE BASE OF THE FIRST
METACARPAL
STABLE FRACTURE
NO DISPLACEMENT OF DISTAL FRAGMENT AS
IT IS COMMINUTED

GAME KEEPER'S THUMB

DISRUPTION OF THE ULNAR COLLATERAL
LIGAMENT OF THE MCP JT

RADIOLOGICALLY OCCULT UNLESS

ASSOCIATED WITH AVULSION FRACTURE
OF THE BASE OF THE PROXIMAL PHALANX

VIEWS WITH THUMB RADIALLY STRESSED

WILL DEMONSTRATE RADIAL DEVIATION
AT THE MCP JT

USG , MRI DEMOSTRATES TORN LESION

AND POTENTIAL ENTRAPMENT WHICH IS
TERMED STENER LESION

PHALANX #:
1.VOLAR PLATE AVULSION OF THE DIP,PIP
SEEN ON LATERAL FILM

2.BASEBALL FINGER, MALLET FINGER AND

DROP FINGER
HYPERFLEXION OF THE DIP WITH DISRUPTION
OF THE DEEP COMPONENT OF THE EXTENSOR
TENDON

LATERAL RADIOGRAPH:
AVULSION FRAGMENT MAY BE SEEN AT THE
DORSAL ASPECT OF DIP
THE DIP SHOWS FLEXION DEFORMITY

PELVIC FRACTURES

CLASSIFICATION :
STABLE INJURIES
UNSTABLE INJURIES

LATERAL COMPRESSION FORCES – B/L

FRACTURE OF SUPERIOR and INFERIOR PELVIC
BONES
AP COMPRESSION – DISRUPTION OF SI JOINT
and PUBIC SYMPHYSIS
OPEN BOOK INJURY :
WHEN B/L SI JT + SYMPHYSIS PUBIS ARE

DISRUPTED

MALGAIGNE COMPLEX:
FRACTURE OF MEDIAL ILIUM OR SACRUM + #
OF SUPERIOR OR INFERIOR RAMI ON THE
IPSILATERAL SIDE + SUPERIOR DISPLACEMENT
OF IPSILATERAL HEMI PELVIS

STRADDLE INJURY :LANDING ON HARD

OBJECT-
# IN THE ISCHIAL AND PUBIC RAMI , B/L
SUPERIOR DISPLACEMENT OF MEDIAL
FRAGMENTS
URETHRAL INJURY COMMON

TRANSVERSE FRACTURE OF SACRUM:

FALL ON THE BUTTOCK
LATERAL FILM IS DIAGNOSTIC
INSUFFICIENCY FRACTURES : IN ELDERLY ,
OSTEOPOROTIC BONE
SEEN IN SACRAL ALA
DIFFICULT TO IDENTIFY ON PLAIN FILM
BECAUSE OF SUPER IMPOSED BOWEL SHADOW

SKELETAL SCINTIGRAPHY : HONDA SIGN ,

INCRESED ACTIVITY IN THE SHAPE OF “H”
ACCOMPANIED BY # OF BODY OF PUBIS

LOWER LIMB FRACTURES

FEMORAL NECK FRACTURES
1.SUBCAPITAL #
NON DISPLACED , IMPACTED FRACTURES
DIFFICULT TO IDENTIFY ON RADIOGRAPHS
CAUSES AVASCUAR NECROSIS OF FEMORAL
HEAD
MRI AND SCINTIGRAPHY USED FOR DIAGNOSIS
2.INTER TROCHANTERIC FRACTURE
COMMINUTED #
DO NOT CAUSE AVN
PLAIN FILM – AP , FROG AP AND LATERAL
VIEWS USED FOR DIAGNOSIS

3.SUB TRACHANTERIC #
FREQUENTLY PATHOLOGICAL
TRANSVERSLY ORIENTED
ASSOCIATED WITH METASTASES,
PAGET'S ,MYELOMA

4.ISOLATED FRACTURES
A.GREATER TROCHANTER :COMMON IN
ELDERLY
B.LESSER TROCHANTER : PATHOLOGICAL #
EXCLUDE METASTASES

DISLOCATIONS OF THE HIP

POSTERIOR DISLOCATIONS :
COMMON
ASSOCIATED WITH # OF POSTERIOR PART OF
THE ACETABULUM
XRAYS – DEMONSTRATE THE FRACTURE
CT – SHOWS FRACTURES INSIDE AND OUTSIDE

JOINT SPACE

FRACTURES OF FEMORAL SHAFT

XRAYS – SUFFICIENT FOR DIAGNOSIS
THE JOINTS ABOVE AND BELOW SHOULD ALSO
BE INCLUDED IN THE FILM AS THEY ARE
ASSOCIATED WITH DISLOCATIONS OF THE
JOINTS AND #S
FRACURES CAN BE DISPLACED , IMPACTED ,
COMMINUTED ,DISTRACTED
HEAVY BLOOD LOSS O UPTO 2 L CAN OCCUR
SWIFTLY CAN CAUSE MORTALITY
 KNEE FRACTURES AND
DISLOCATIONS
XRAY VIEWS : AP , LATERAL,OBLIQUE VIEWS
MRI FOR ASSOCIATED SOFT TISSUE INJURIES
CT FOR DETECTING COMMINUTED
FRAGMENTS OR AVULSION FRAGMENTS

SUPRACONDYLAR # OF FEMUR :
USUALLY EXTENDS INTO THE INTRA-
CONDYLAR AREA VERTICALLY FORMING
INTRA-ARTICULAR COMPONENT
SEEN CLEARLY ON PLAIN FILM AP VIEW.
AP DISPLACEMENTS CAN BE SEEN ON LATERAL
VIEW

LATERAL TIBIAL PLATEAU FRACTURE

MOST COMMON FRACTURE AROUND THE KNEE

BEST SEEN ON OBLIQUE VIEWS
NON DISPLACED # DIFFICULT TO DETECT
MRI /CT HELP DETECT THESE EASILY

SEGOND FRACTURE:
AVULSION FRACTURE OF LATERAL MARGIN OF
TIBIAL PLATEAU
ASSOCIATED WITH ACL AND LATERAL
COLLATERAL LIGAMENT TEAR

FRACTURES OF PATELLA
LINEAR FRACTURE
TRANSVERSE FRACTURE:
D/D BIPARTITE PATELLA XRAY # PATELLA
1.BIPARTITE PATELLA HAS SMOOTH EDGES
2.BIPARTITE PATELLA HAS OSSIFICATION
CENTERS IN EACH PART LOCATED
SUPEROLATERALLY
3.BIPARTITE PATELLA ARE B/L IN 80% OF
CASES

OSTEOCHONDRAL #:
SITE: ARTICULAR SURFACE OF PATELLA OR
FEMORAL CONDYLES
MRI USED FOR DETECTION
T2W – HIGH SIGNAL IN THE FRACTURE LINE
AS FLUID INTERPOSES BETWEEN FRACTURE
LINE OF THE CARTILAGE

PATELLO FEMORAL DISLOCATION:

MOST COMMON DISLOCATION IN THE KNEE
DIFFICULT TO DETECT ON PLAIN
RADIOGRAPHS
LATERAL DISLOCATION OF PATELLA :DUE TO
VALGUS FORCE + MEDIAL BLOW TO THE
PATELLA
DISRUPTION OF MEDIAL PATELLAR
RETINACULUM
MEDIAL PATELLAR - # / CONTUSION
LARGE FEMORAL CONDYLE - # / CONTUSION
LARGE EFFUSION PRESENT
MRI BEST FOR DIAGNOSIS AS PATIENTS MAY
RELOCATE PATELLA MANUALLY

LOWER LEG #
FRACTURES OF DISTAL END OF TIBIA AND
FIBULA
XRAY – AP , LATERAL

TIBIA – STRESS FRACTURE

DIAGNOSED WITH MRI AND SCINTIGRAPY

MORE EASILY THAN WITH XRAYS WHERE THE
SUBTLE CHANGES SUCH AS THICKENING OF
CORTEX ,PERIOSTEAL REACTION

BUMPER FRACTURE – FRACTURE OF SHAFT OF

TIBIA DUE TO INJURY FROM AUTO MOBILE
BUMPER

ANKLE INJURIES:
MOST COMMON – EXTERNAL ROTATION OF
FOOT RELATIVE TO LEG
RESULTS IN SPIRAL OR OBLIQUE FRACTURE
OF LATERAL MALLEOLUS
AVULSION OF THE DELTOID LIGAMENT
MEDIALLY
INTERNAL ROTATION OF FOOT RELATIVE TO
LEG – INVERSION INJURY – TRANSVERSE
FRACTURE OF THE LATERAL MALLEOLUS
OBLIQUE FRACTURE OF THE MEDIAL
MALLEOLUS
LIGAMENTOUS DISRUPION
AVULSION FRACTURE – FRAGMENT - DISTAL
TO TIP OF MALLEOLUS
IF LIGAMENTS RUPTURE AT THE MID PORTION
WE SEE ONLY SOFT TISUE SWELLING AND NO
RADIOLOGICAL FEATURE
MRI – BEST FOR ASSESSMENT OF ANKLE
INJURIES

TRIMALLEOLAR FRACTURE :
FRACTURE OF 1. MEDIAL MALLEOLUS
2.LATERAL MALLEOLUS 3. POSTERIOR LIP OF

THE DISTAL TIBIA

PILON FRACTURE :
IMPACTION OF THE DOME OF THE TALUS
AGAINST PLAFOND
COMMINUTED FRACTURE OF THE DISTAL
TIBIAL JOINT SURFACE

FOOT FRACTURES

HIND FOOT :
TALUS DISLOCATION : USUALLY ANTERIORLY
AVN OF TALAR DOME : # OF TALAR NECK /
CAPSULAR DISRUPTION
OSTEOCHONDRAL FRACTURES OF THE
DOMEOF THE TALUS DUE TO IMPACTIO
FRACTURE
MRI USED FOR DIAGNOSIS

FRACTURES OF CALCANEUM:
COMPRESSIVE FORCE CAUSE #
COMINUTEDFRACTURE OF THE CALCANEUM –
FLATENNING OF THE SUBTALAR PORTION OF
THE BONE
NORMAL BOEHLER'S ANGLE WHICH IS 20 – 40
DEGREES IS REDUCED FURTHER
SPECIAL VIEWS FOR CALCANEAL FRACTURES
INCLUDES .HARRIS VIEW - AXIAL VIEW OF
HEEL .
BEST IS TO STUDY WITH CT SCAN
ESPECIALLY CORONAL CT IS BEST IN
EVALUATING THE SUBTALAR JOINT

ASSOCIATED FRACTURES:
CALCANEAL FRACTURES ARE ASSOCIATED
WITH FRACTURES OF THE LUMBAR SPINE
FRACTURES WITHOUT CHANGE IN BOEHLER
ANGLE
OCCURS IN ANTERIOR PROCESS, POSTERIOR
TUBEROSITY OR LATERAL MARGIN OF THE
BONE
STRESS FRACTURES ARE COMMON IN THE
TUBEROSITY

MIDFOOT , FOREFOOT:
MOST COMMON # HERE IS THE AVULSION
INJURY ON THE DORSAL SURFACE OF THE
NAVICULAR

LISFRANC'S FRACTURE :
FRACTURE – DISLOCATIONS AT THE COMMON
TARSOMETATARSAL JOINT
SEEN IN DIABETICS , TRAUMA
2 TYPES:
A.HOMOLATERAL : ALL THE METATARSALS AR
SHIFTED LATERLLY
B.DIVERGENT :FIRST METATARSAL SHIFTS
MEDIALLY AND THE REMINDER OF THE
FOREFOOT SHIFTS LATERALLY
NORMAL ALIGNMENTS BEST SEEN ON OBLIQUE
VIEWS

MARCH FRACTURE :
STRESS FRACTURE OF THE METATARSALS
SEEN IN SOLDIERS AND RUNNERS

SEEN AS PERIOSTEAL NEW BONE FORMATION

ALONG THE SHAFTS OF THE 2ND , 3RD AND 4 TH
METATARSALS

AVULSION FRACTURE OF THE BASE OF THE

FIFTH METATARSAL
OCCURS DUE TO INVERSION INJURY
TRANSVERSE FRACTURE
TO BE DIFFERENTIATED FROM THE NORMAL
ACCESSORY OSSIFICATION CENTER AT
LATERAL ASPECT OF THE BASE OF THE FIFTH
METATARSAL WHICH IS LONGITUDINAL AS
OPPOSED TO THE FRACTURE WHICHIS
TRANSVERSE

JONES' FRACTURE:
EXTRAARTICULAR FRACTURE OF THE
PROXIMAL ASPECT OF THE FIFTH
METATARSAL
 SPINAL FRACTURES

COMPRESSION FRCTURES OF THE SPINE

CHARCTERISED BY 1.ANTERIOR WEDGE
DEFORMITY OF THE VERTEBRAL BODY
2.DEPRESSION LIMITED TO THE VERTEBRAL
END PLATE ESPECIALLY THE SUPERIOR END

PLATE

BAND OF SCLEROSIS IDENTIFIED UNDER THE

VERTEBRAL END PLATE
RETROPULSION OF THE FRACTURED FRAGMNT
POSTERIORLY CAN CAUSE CORD
COMPRESSION

THIS IS MOST COMMONLY SEEN AS TEAR DROP

FRACTURE OF THE CERVICAL SPINE AND
BURST FRCTURE IN THE THORACO LUMBR
JUNCTION

FRACTURES DISLOCATION
THE LOWER CERVICAL SPINE AND THORACO
LUMBAR JUNCTION COMMONLY INVOLVED
UPPER VERTEBRAL BODY DISLOCATED
ANTERIOR TO THE LOWER VERTEBRAL BODY

THE FRACTURE COMPONENT IS AN ANTERIOR

WEDGE FRACTURE OF THE LOWER
VERTEBRAL BODY INVOLVING LAMINAE ,
FACET AND SPINOUS PROCESS

IN CERVIAL SPINE ALTERNATIVELY THERE

MAY BE DISRUPTION OF THE CAPSULE OF THE
FACET JOINT AND INTERSPINOUS LIGAMENT
WITHOUT FRACTURE
THE RESULT CAN BE SUBLUXATION OR
DISLOCATION

CERVICAL SPINE FRACTURES

POSTERIOR OR NEURAL ARCH FRACTURE
MOST COMMON FRACTURE
COMPRESSION OF ARCH BETWEEN C2 AND
OCCIPUT
B/L
NON DISPLACED

HANGMAN'S FRACTURE
FRACTURE OF THE NEURAL ARCH OF C2
FRACTURELINE IS OBLIQUE ON LATERAL
FILM
DISLOCATION OF C2 ON C3
BUT NEURO INVOLVEMENT UNUSUAL
ODONTOID FRACTURES
MOST COMMON AT THE BASE OF THE
ODONTOID
SOFT TISSUE ANTERIOR TO ATLANTO AXIAL
JOINT
TYPE 1 – TIP – SUPEROLATERAL PART OF THE
DENS TIP
TYPE 2 – BASE
TYPE 3 – SUPERIOR PART OF THE BODY OF THE
VERTEBRA C2 . CT – BEST FOR DIAGNOSIS
ANTERIOR TILT OF ODONTOID ON LATERAL
FILM IS HIGHLY SUGGESTIVE OF FRACTURE