Bone Growth and Fractures Flashcards by Kambi Ben-Ejeteh

What happens in the cessation of bone growt?

Growth in height ceases at the end of puberty
Growth in length ceases, cell proliferation slows and plate thins
May leave a line visible in the x ray

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What happens to sex steroids during the cessation of bone growth?

Sex steroids stimulate growth spurt but promote closures of epiphyseal plates

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What happens to the epiphyseal plate during cessation of bone growth?

Plate is invaded by blood vessels epiphyseal and diaphysial vessels unite

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What is a primary ossification centre?

Found in the diaphysis of long bones
Appears before birth
Responsible for forming the central part of the bone

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What is a secondary ossification centre?

Found in the epiphyses of long bones
Appears after birth during childhood
Responsible for the growth of bone ends and the formation of epiphyseal plates

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What is an example of a pathological disease and defect if the resting zone in the epiphyseal plate?

Disease:
Diastrophic dysplasia -
Defect:
Defective collagen synthesis/ processing of proteoglycans

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What are the examples of pathological disease of the growth zone in the epiphyseal plate?

Achondroplasia
Malnutrition
Irradiation Injury
Gigantism

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What happens during achondroplasia?

Deficiency in cell proliferation and/or matrix synthesis

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What happens during gigantism?

Increased cell proliferation

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What are some examples of pathological disease and defects that occur in the hypertrophic zone of the epiphyseal plate?

Disease:
- Rickets (children)
- Osteomalacia (adults)
Defect:
- Insufficiency of calcium or phosphate for normal calcification

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What does normal growth and development of bone require?

Calcium
Phosphorus
Vitamins A, C and D
Balance between growth hormone, thyroid and parathyroid hormones, oestrogen and androgens

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Where is cortical? compact bone found?

Shaft of long bones

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Where is cancellous/ Trabecular bone found?

Ends of long bones, vertebral bodies, flat bones

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Why is the structure of cortical/ compact bone?

Concentrically arranged lamellae - Haversian systems

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What is the structure of cancellous/ Trabecular bone?

Meshwork of trabuculae with intercommunicatoing spaces

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What is the function of cortical/compact bone?

Mechanically strong

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What is the function of cancellous/trabecular bone?

Metabolic

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Describe the periosteum of cortical/ compact bone?

Thick

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Describe the periosteum of cancellous/Trabecular bone?

Thin

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Describe the Turnover of cortical/ compact bone?

Slow

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Describe the turnover of cancellous/ trabecular bone?

Rapid

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Describe the Blood Supply of cortical/ compact bone?

Slow

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Describe the Blood supply of cancellous/ Trabecular bone bone?

Rich

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What are the fracture patterns of cortical/compact bone?

Study These Flashcards

Direct or indirect violence may result in deficitsat the fracture siteleading to non-union.

What are the fracture patterns of cancellous/trabecular bone?

Honeycomb structure fails as the result of compression (e.g. a fall from height compacts the bone)

What are the mechanisms of injury in terms of direction of force?

- Direct vs Angular - Rotational - Compression

What does imaging show in fractures

- Site of bones involved - Clues on soft tissue injury - Clues on energy transfer - Pathological bone - Paediatric bone

What clues on energy transfer does imaging show?

- Wide displacement - Comminuted - Multiple fracture sites

What is a fracture?

A complete or incomplete break in a bone

What is a displaced fracture?

Bone breaks into two or more pieces and moves out of alignment.

What is a non-displaced fracture?

the bone breaks but does not move out of alignment.

What is a closed fracture?

The skin is not broken

What is open fracture?

the bone has broken through the skin – this is a medical emergency and you should be seen in the emergency or urgent care department immediately.

What is avulsion fracture?

when a fragment of bone is separated from the main mass.

What is buckled fracture?

or impacted fracture), ends are driven into each other; commonly seen in arm fractures in children.

What is comminuted fracture?

the bone breaks into several pieces.

What is compression/wedge fracture?

usually involves the bones in the back (vertebrae).

What is a greenstick fracture

an incomplete fracture in which the bone is bent; occurs most often in children.

What is a linear fracture?

The break is parallel to the bone’s long axis.

What is an oblique fracture?

the break has a curved or sloped pattern.

What is a pathological fracture?

caused by a disease that weakens the bones.

What is a spiral fracture?

one part of the bone has been twisted at the break point.

What is a stress fracture?

A hairline crack

What's a transverse fracture?

the broken piece of bone is at a right angle to the bone’s axis.

What does fracture healing depend on?

The activity of the cells of the poeriosteum

What are bone remodelling units?

- Consist of osteoclasts and osteoblasts - Keep adult bone mass relatively constant in. the face of developmental, physiological and physical demands

How long does healing take and what does it depend upon?

- Takes 2-20 weeks for healing depending on: - Severity and position of the fracture - Age of the patient

What are the phases of fractures and callus formation?

1. Reactive phase 2. Reparative Phase 3. Remodelling Phase

What is the reactive phase?

- Fracture and inflammatory phase - Fibroblasts in the periosteum proliferate to form granulation tissue around the fracture site

What happens during the reparative Phase?

- Callus formation - osteoblasts quickly form woven bone, to bridge the gap - Woven bone is weak as the collagen fibres are arranged irregularly - Lamellar bone laid down - collagen organise ointment regular sheets to give strength and resillience

What happens during the remodelling phase?

- Remodelling by osteoclasts to restore original bone shape

What does the mechanical environment drive?

ifferentiation of either osteoblastic (stable enviroment) or chondryocytic (unstable environment) lineages of cells

What does enchondral ossification convert?

soft callus to hard callus (woven bone). Medullary callus also supplements the bridging soft callus.

What does VEGF production lead to?

new vessel invasion, newly formed bone (woven bone) is remodeling via organized osteoblastic/osteoclastic activity.

What is Wolff's law?

bone remodels in response to mechanical stress

What are piezoelectric changes?

bone remodels is response to electric charges

What is conservative treatment?

- Simple fracture with low risk of non-union - Dependent on natural healing process - +/- immobilisation - Rehabilitation

What happens during intervention?

- Fractures with limb threat or risk of non union - Augment natural healing with replacement or strengthening - +/- immobilisation - Rehabilitation

Bone Growth and Fractures Flashcards

(58 cards)