Orthopedic Flashcards
(8 cards)
Zones in growth plate/ physis [Epi to Meta]
Zone 1 - of reserve cartilage / reserve cell
Zone 2 - of proliferation
Zone 3 - of hypertrophy
Zone 4 - of mineralisation
Zone 5 - of ossification
Periosteum
2 layers - inner CAMBIUM [Osteogenic potential] and outer FIBROUS [provides attachment for muscles]
Attached to the bone via SHARPEYS FIBRES [Denser at meta and lesser at dia]
Is not present at - Joint, Sesamoid bones
Constituents of bones
- Matrix = Cells + Protein = OSTEOID
- Osteoblast [Bone formation]
- Osteoclast [Bone resorption]
- Osteocyte [Quiescent blast / Silent cell]
- Protein - Type I Procollagen - Minerals
. Ca - hydroxy apatite
. Phosphate - Water [5-7%]
OSTEOID + MINERALS = BONE
Markers of
A. Osteoblastic activity
B. Osteoclastic activity
A. Type I procollagen, Bone specific Alkaline Phosphatase, Osteocalcin and Osteonectin
B. Hydroxylated lysine and proline, TRAP [Tartarate Resistant Acid Phosphatase], Sialoproteins, N and C chains of telopeptidases
- Normal Vagus deformity of elbow
- Normal neck Shaft angle in hip
- Normal valgus deformity at the knee joint
- 5° - 15°
- 120° - 135°
- 6° - 8°
Condensation in cancellous part of bone
Trabeculae
Rickets of Prematurity
Rickets in premature babies, as transfer of minerals from mother to child happens In 3rd trimester, these babies do not get it.
Rickets
- Symptoms
. Bow leg / Knock knees. - Signs
. Craniotabes [Ping pong skull] [Earliest Manifestation]
. Rachitic rosary
. Harrisons sulcus
. Pectus carinatum
. Coxa vara of hip and bowing of femur
. Windswept deformity of legs - Investigation
. Deficiency of ca/po4/Vit D
. X-ray : Splaying and Fraying of metaphysis - Treatment
. Mineral supplements
. Brace support - MERMAID SPLINT - Monitoring of Rx
. Radiological assessment : Appearance of white line in metaphyseal area that denotes proper mineralization
. Metabolic assessment : Decreasing trend of Elevated Alkaline Phosphatase to Normal level.
