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Uncovertebral jt
- Jt of luschka
- C3-6
- Guides flex/ext, limits SB
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High risk factors that mandates a radiograph
- 1. age >= 65
- 2. Dangerous mechanism
- ----fall down stair
- ----axial loading
- ----high speed auto accident
- ----RV
- ----bike collision
- 3. Paraesthesia C/S stenosis
- ----compress SC
- ----B/B changes
- ---- weakness, tingling in legs
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Low risk factors for radiograph
- 1. simple rear end MVA (whiplash)
- 2. sitting position in ED
- 3. ambulatory at any time
- 4. delayed onset of neck pain
- 5. absence of midline C/S tenderness
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inflammatory phase
time blood vessels ruptured causing bleeding and clotting forming hematoma
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Reparative phase
- 7-14 days
- hematoma invaded w/ capillaries to allow osteogenic cells from periosteum and endostium to form callus
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Remodeling phase
- Clinically united
- Fx line still visible but evidence of maturing callus
- Cast removed
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Last bone healing phase
- 60 mo
- Complete union
- Callus reabsorbed and replaced by mature bone
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Compression plates
- ORIF
- Compression helps approximate broken ends and facilitate bone growth so don’t have to be fixated as long
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Malunion
Fx heals in bad position bc of bad reduction/ fixation or PT
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Delayed union
Fx takes twice as long to heal due to poor fixation/ poor blood supply/ infection
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Non-union
Fx hasn’t healed in 6-9 mo
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Best view to identify cervical fx
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Odontoid fx
- Due to violent upper C/S flexion
- Possible breach of transverse or alar ligaments
- May demonstrate torticollis, hoarseness, c2 NR
- Odontoid view radiograph
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Rust sign
- Pt holds weight of head in their hands
- Means fx, don’t touch pt
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