The Significance of Minor Bone Injuries

Abstract

In fractures, injury to the ligaments and muscles is often equal in importance to the bone damage and compels us to view the fracture as part of a complex injury and not solely as trauma to bone. Berridge and Bonnin (1944), in discussing the radiographic examination of the ankle joint, express the view that it is clinically certain that ligamentous damage is as serious as bony injury and that further application of X-ray technique can demonstrate ligamentous injury. In many cases of minor fractures it is evident that the importance of the damage to the soft tissue actually outweighs the bone injury and anybody who has been in touch with medical problems of sport, such as injuries due to boxing, ski-ing, or football, will know that torn ligaments may prove far more incapacitating than a straightforward fracture. There are various radiographic techniques to show injury to the ligaments, such as radiography of a joint under strain or arthrography. Ordinarily X-ray reports on certain bone injuries may be amplified simply by inferring from the type and site of fracture which actual ligament has been damaged, and whether the ligamentous lesion is of greater consequence than the trivial bone trauma shown on the film. These fractures are commonly described as chip fractures or detachments of a small bone flake.