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A 12 year old boy is brought into the ER with a broken right arm from…

- - - - Osteomalacia is a condition in which calcium salts are not adequately deposited into the bone. Results in soft, weak bones and pain upon bearing weight.
- - - - His diet would have to change quickly to one with vast amounts of calcium. Accompanied by vitamin D to help his body properly absorb the calcium. Not a junk food based diet.
      - If the boy's epiphyseal plate was damaged in the compound break, that could directly affect the length of his right arm completely. It could become shorter than his left at an older age due to the cartilage not being able to calcify to increase length of the long bones.
      - The boy is young and still growing and has suffered severe fractures. As long as his epiphyseal plates stay mainly in tact, and his diet improves, he should heal fully with the help of healthcare providers.
- - - - Appositional Growth; The cartilage-forming cells in perichondrium secrete matrix against external face of existing cartilage. -New matrix laid down on SURFACE of cartilage.
      - Interstitial Growth; Chondrocytes within lacunae divide and secrete new matrix; expanding cartilage from within. -New Matrix made WITHIN matrix.
      - (Hardened cartilage is NOT the same as bone)
    - - Interstitial growth requires the presence of epiphyseal cartilage in the epiphyseal plate. Epiphyseal plate maintains constant thickness.
      - Long bones grow lengthwise by interstitial (longitudinal) growth of the epiphyseal plate. Bones increase thickness through appositional growth. Bones stop growing during adolescence.
  - - - Endosteum: delicate connective tissue membrane covering internal bone surface. Covers trabeculae of spongy bone. Lines canals that pass through compact bone.
      - Periosteum: a white, double-layered membrane covering external surfaces except joints. Fiberous layer: outer layer of dense irregular connective tissue. Anchoring points for tendons and ligaments.
    - - Compact Bone: dense outer layer on every bone that appears smooth and solid.
      - Spongy Bone: made up of a honeycomb of small, needle-like or flat pieces called trabeculae. (Open spaces between trabeculae are filled with yellow or red bone marrow.)
        
        Spongy Bone makes up the ends of our long bones while compact bone makes up the rest. Although these two come together to make the entirety of our bones, are bones are not solid all the way through. They come together to make a hollow center called the Medullary cavity, which contains bone marrow used to make new blood cells.
  - - - Viatamin D which enhances calcium absorption from gastrointestinal tract.
      - Vitamin C which is needed for collagen formation.
      - Calcium and phosphate for calcification