BIOL241 – AP1 20 pts
NAME: Nathaniel Hanson
Read through the case histories presented below. Determine what type of fracture has occurred and label the type of fracture (open/closed, depressed/comminuted/transverse/spiral/
epiphyseal plate/pathological/etc.). Identify the bone where the fracture has occurred.
CASE HISTORY #1
The patient, a 28 y.o. male, presents to the local hospital complaining of right wrist pain. He reported while playing football in the park with friends, he fell backwards but had his right arm, hand and fingers extended to break his fall. He landed on his outstretched hand. He states he now has severe pain whenever he tries to move his thumb or tries to grip something. He thought he originally sprained his wrist but the marked pain with movement is very debilitating.
(Hint: this is the most commonly fractured bone in the wrist).
Vital signs are stable.
Plain films and CT scan were performed.
WHAT TYPE OF FRACTURE DO YOU SUSPECT AND WHERE?
I suspect that he fractured his scaphoid bone, the most commonly fractured carpal bone located at the base of the thumb, which would explain the pain he is experiencing when he tries to move his thumb. It is a closed fracture, as the skin is unpenetrated. It could be complete or incomplete, as well as displaced or nondisplaced.
CASE HISTORY #2
A 73 y.o. male presented to the emergency room with left leg pain and lacerations to the left thigh area. There was a hard white structure sticking out from the skin in his thigh that measured about 1” in length. The patient stated he had fallen off the roof, landing on his feet before falling backward onto his buttocks on the soft ground.
Vital signs are stable.
Plain films were performed.
WHAT TYPE OF FRACTURE DO YOU SUSPECT AND WHERE?
The patient fractured his left femur. The fracture is open and complete, evidenced by the penetration of skin in his thigh. Due to the patient’s age, it is very possible that this could be a comminuted fracture which is common in the elderly as their bones are more brittle.
CASE HISTORY #3
A 10 y.o. female presents to the hospital emergency room holding her left forearm with her right hand. She is in mild discomfort and is guarding any movement of her left wrist or hand. Her mother stated she was playing softball in a local tournament when she collided with a teammate sliding stiff-armed into home plate where she contacted with the plate. The patient stated she felt immediate pain in her left forearm. There is mild to moderate swelling along the distal end of the left forearm.
Vital signs are stable. Additionally, there were visible abrasions to the skin of the forearms.
Plain films and CT scan were performed.
WHAT TYPE OF FRACTURE DO YOU SUSPECT AND WHERE?
I suspect that the patient has experienced a distal fracture of the radius. As there is no penetration of the skin, it is a closed fracture. It could be displaced or nondisplaced, and she would need to be further assessed to determine if her ulna was fractured as well. It is possible that it is a greenstick fracture given the relative flexibility of bones in patients of this age.
CASE HISTORY #4
The patient, an 89 y.o. female with a history of breast cancer and is currently undergoing chemotherapy, presented to the hospital emergency room. She stated she was standing and about to open up an umbrella when she got out of balance and landed on her right hip. She experience limitations of right hip movement and persistent pain.
Vital signs are stable.
Plain films and CT scan were performed.
WHAT TYPE OF FRACTURE DO YOU SUSPECT AND WHERE?
I suspect a fracture of the proximal femur. Due to the patient’s age and the fact that she is currently undergoing chemotherapy, it is probable that the patient is experiencing increased bone resorption resulting in osteopenic bones. This would explain how the fracture could occur from minimal trauma. Closed, displaced, and possibly comminuted fracture due to the patient’s age and brittle bones.
CASE HISTORY #5
A 12 y.o. athletic male presents to the hospital emergency room with pain in the lower right leg and the inability to bear weight on the right foot. The patient stated that he was playing soccer with his friends in a local park. While running to meet the ball, he stepped into a depression on the grassy field but had to abruptly turn to meet the ball. He felt immediate pain in his lower right leg and could not stand or bear weight on the right side.
Vital signs are stable. There are no apparent contusions or abrasion evident but the right lower leg reveals moderate edema.
Plain films were performed.
WHAT TYPE OF FRACTURE DO YOU SUSPECT AND WHERE?
I suspect that the patient has fractured the tibia of his right leg. The excessive twisting forces applied to the tibia, compounded by having stepped into a depression on the field, have caused a closed spiral fracture.
Anatomy & Physiology I BIOL241
