Avulsion Fx img unt6 ppt

Avulsion Fracture:

Avulsion Fracture By Utsav Brahmbhatt 6/18/2011

Description of Dysfunction:

Description of Dysfunction An avulsion fracture is a type of fracture in which part of the bone is broken off or “avulsed” from the rest of the bone. 1 The word “avulsion” literally means “tearing.” Avulsion fractures are typically caused when so much force is exerted on a tendon or ligament that it pulls away, tearing off a chunk of bone along the way.

Signs/Symptoms and Incidence:

Signs/Symptoms and Incidence In many cases, people have a tough time getting an avulsion fracture, because their muscles send signals to the body telling them to stop before they hurt themselves. A thletes, who push through such signals, are at risk of avulsion fractures. So are children, because their growing bones will break before their young tendons and ligaments will . 2 In a basic avulsion fracture, an x-ray of the site reveals that a small piece of bone has been torn away.

Diagnosis/Prognosis and Tx:

Diagnosis/Prognosis and Tx By resting the affected area, icing it periodically, and using anti-inflammatory drugs to keep down inflammation and infection, the avulsion fracture can be treated. Sometimes, however, a large piece of bone is removed, or the bone is significantly dislocated and clearly visible on radiographic image . In these instances, surgery is required to address the fracture. When surgery is performed on an avulsion fracture, the goal is to reattach the piece of bone which has been torn away, and to address the associated torn ligament or tendon. Recovery periods can be lengthy for more serious avulsion fractures, as any trauma to the area can cause the fracture to recur, or make it worse, two outcomes which are most definitely undesirable.

Impact on Function:

Impact on Function Children and athletes in particular tend to be at risk of re-damaging avulsion fractures by getting back into training too soon. 1 With children, if they are performing rigorous activities which is causing trauma, the bone will be only handle to a certain extent before it is avulsed, due to the immature state, the bone will give away before the tendon depending on the activities performed. Avulsion fractures can also occur from disease or pathology.

Role of Imaging:

Role of Imaging In case of avulsion fracture, it is very important to get a radiographic image, which is best choice in this case to know the extent of the avulsed bone to better treat the patient with the physical therapy treatments and see the rate of healing in the patient as they progress for their return to function.

Image:

Image http://radpod.org/wp-content/uploads/2007/05/calcaneal_avulsion.jpg

Findings/Discussion:

Findings/Discussion As per an additional imaging, I would like use a T1 and T2 MRI images in frontal and sagittal planes to get the extent of edema/effusion to better conservatively design the PT treatment protocol. Patients with avulsion fractures are going to experience pain whenever contracting or lengthening the surrounding musculature. This is going to cause a significant gait disturbance, particularly during the heel off phase of a gait (ankle plantar flexion ). The patient will initially have significant pain during weight bearing as well. Until the inflammation has resolved and the bony fragment is reattached, the patient is going to experience a good deal of pain with most ankle movement. 3

Refrences:

Refrences http ://www.wisegeek.com/what-is-a-avulsion-fracture.htm Accessed June 20, 2009. McNaughton GW, Thomas L. Spontaneous Avulsion Fracture Of The Calcaneus. SMJ 2006 51(3): 50 JF Norfray , LF Rogers, GP Adamo , HC Groves, and WJ Heiser . Common calcaneal avulsion fracture. American Journal of Roentgenology , Vol 134, Issue 1, 119-123

Questions:

Questions Why do you suppose adolescent athletes are most commonly diagnosed with avulsion fractures ? What coupled forces would produce the most torque at the Achilles tendon to cause an avulsion fracture?