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Musculoskeletal Imaging 6 min read

How to describe a fracture

Learning objectives

  • Build a complete fracture description from six elements
  • Communicate displacement and angulation unambiguously
  • Know which features escalate urgency

Step-by-step approach

  1. 1

    Bone and site

    Name the bone and the segment: proximal/middle/distal third, metaphysis, diaphysis, or epiphysis; intra- vs extra-articular.

  2. 2

    Pattern

    Transverse, oblique, spiral, comminuted, segmental, avulsion, impacted — the pattern encodes the mechanism.

  3. 3

    Displacement

    Described by where the DISTAL fragment has gone, as a percentage of bone width where useful.

  4. 4

    Angulation

    Direction the apex points, or the tilt of the distal fragment — say which convention you're using. Dorsal angulation of the distal radius = Colles-type.

  5. 5

    Joint involvement and special features

    Intra-articular extension, dislocation, open fracture, and in children the physis (Salter-Harris).

  6. 6

    The second fracture

    Rings (pelvis, mandible, forearm) break in two places. Found one? Look for the other.

Common mistakes

  • Vague descriptions ('broken wrist') that force the surgeon to re-read the film
  • Missing the second fracture in ring structures
  • Overlooking subtle impacted fractures — look for sclerotic bands

Summary checklist

  • Bone + site
  • Pattern
  • Displacement
  • Angulation
  • Articular involvement
  • Second fracture?

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