Snap Crack

Owww - Poor Bone Density!!!

This is old age - be careful - it can sneak up on you at any time.

So, old person + slip and fall = Complex fracture through the distal left femoral metadiaphysis, displaced posterior to proximal femur, multiple free butterfly fragments*.

*Butterfly fragment - a wedge-shaped shard of bone from the shaft of one of the long bones. This injury occurs at the apex of the fracture force and is a subtype of a comminuted fracture.

Conga Line

This 80 y/o won't be doing the conga anytime soon.

Comminuted left hip intertrochanteric fracture.
Medial superior and inferior pubic rami fracture.

Fall Back

60-year old woman fell backwards off of a 6 foot high stone wall.

Trimalleolar fracture with dislocation pre and post films.

You can see on the medial side where the fibula was sticking through her skin.

Contact Sports

I'm getting really sick of x-raying little ( 7-10y/o) kids injured in contact sports. This little boy was playing tackle football and he was wearing all the right protective equipment. It wasn't a pick-up game in someones backyard.
His parents were surprised that he had a broken femur. "It was just a little kid. (that tackled their son and broke his femur)" the dad said.
When you go to a Mighty Midgets' (or whatever their team is called) game and there's an ambulance and paramedic crew parked on the sideline it indicates that this might be a dangerous sport.

This is the fifth femur fx on a child under 10 that I have done in the last 2 months.

Down Fall

This patient fell 15 feet from a roof and broke his radius and ulna. Another tech did the x-rays (and hung this first one upside down).

The bones are so crushed that this lateral looks almost like an AP.

Ouch Eww

Nicely dislocated finger on a 50ish woman. "Caught finger in sweater and fell over onto hand." Ouch! It looked really messed up from the outside too. I felt like telling the woman to take a pic of it with her cell phone. She could show it to her friends. The 4th digit was almost perpendicular to her other fingers! So weird.

El Bow

Saturday was a dislocated elbow night. Two in one night - how often does that happen?


This pt was very, very drunk. They gave her 8 of morphine and she was still writhing around on the cart. She also threatened to murder me if I touched her elbow and it hurt her. I couldn't really do a lateral (or an AP or anything that looked right), but I tried and she didn't kill me, so fairly successful.
This next pt dislocated and fractured his radius. He also wanted to kill me. The student I was working with said he looked like he was going to punch me when I was positioning his arm. Hey- if you come to the ER, you're in a lot of pain and you want x-rays done, it might hurt. Boo hoo. Would you rather not know what is wrong with you?
He wouldn't let me move his arm for the AP, so the x-ray below was done with tube/film angle magic. I was pretty close to AP all things considered.
Then I spent an hour in surgery workin' the C-arm.
And ta da- post op films. Looks a lot better, right? (ignore the yellow arrow-it's not pointing at anything)

Gimme Gimme

This little 3 year old child had a tantrum and pulled a candy machine over. It fell on their leg and broke the femur in two.

Ouch!

Mister Twister

Older man water skiing. Hmmm, ouch?
I know! I know! My lateral sucks! But he wouldn't even let me touch his leg, so I worked with what I had. Next time...more tube angle. And if you don't know what I'm talking about....these pics are perfectly AWESOME!!

Cracked Up

Man vs. Truck.

Truck wins.

I'm pretty proud of my nice cross-table laterals. This was ordered as an ankle, but I decided to do more of a Tib/Fib after I saw how much damage there was on his ankle. In the last pic you can see that there are some spiral fractures. I've seen fractures like that spiral from ankle to knee.

For a 20-something he has horrible bone density. Too much soda? More calcium!

I also did an AP Tib/Fib, but I'm too lazy to copy it.