12 year old boy with a bone fracture, elbow appears broken, and part of the bone in the upper arm appears to be protruding from the skin. Found fragments of bone in the wound. Also the child is lactose intolerant.

Anatomy of Long

Epiphysis

Diaphysis

tubular shaft

runs proximal and distal of bone

hollow region

Called medullary cavity

filled with yellow marrow

walls of the diaphysis composed of dense and hard compact bone.


wider section at each end of the bone

filled with spongy bone.

Red marrow fills the spaces in the spongy bone

epiphysis meets the diaphysis at the metaphysis

narrow area that contains the epiphyseal plate

Growth plate

bone stops growing in early adulthood

cartilage is replaced by osseous tissue

epiphyseal plate becomes an epiphyseal line.

Forming, Growth, Remodeling of bones

Osteocyte

Regulates Bone Health

Boss Man

Osteoclast

Osteoblast

Shaves on bone

Macrophage

(builds bone) lays down osteoids

which are mostly collagen

Protein(organic)

Osteoid

which attracts inorganic

Stages of bone Healing

Calcium

Medullary

Bone is composed of small cells

In Matrix of collagen cells

the periosteum forms the outter Surface of bone

collagen fibers lay on rings of Lamella

in opposite direction

Elasticy and flexibility

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Hemotopoises

blood cell production

occurs in red bone marrow (CT)

stem cells form red, and whitee blood cellsalso platelets

proximal and distal

articular cartilage

Hematoma Formation

endosteum lines the medullary cavity

fibrous layer and cellular layer

-mass of clotted blood forms at fracture site

-torn blood vessels hemorrhage

-site becomes swollen, painful, and inflamed

Fibrocartilaginous Callus Formation

-fibrocartilaginous callus forms

-granulation tissue/soft tissue forms a few days after fracture

-capillaries grow into tissue and phagocytic cells (WBCs) begin cleaning derbis

fibroblasts secrete collagen fibers that connect broken bone ends

Bony Callus Formation

-new bone trabeculae appears in fribrocartilaginous callus

-fibrocartilaginous callus converts into bony/hard callus

-bone callus begins 3-4 weeks after injury and continues until firm union is formed 2-3 months later

Bone Remodeling

Open Reduction

-excess material on bone shaft exterior and in the medullary cavity is removed

-compact bone is laid down to reconstruct shaft walls

surgery is required to align bones... screws, plates, and rods may be used to hold bones in place


Factors of Healing Time

reduction in which fractured bones are realigned by manipulation rather than surgery

nonsurgical

-painful

-age
-if patient is smoker...

oxygen provides energy to heal but smokers have a decreased level of oxygen

Inorganic part:Calcium Phosophate (what our bone is made of)

proliferation zone

hypertrophic zone

calcification zone

the line in the adult bone that stoops growth

disc of hyline cartilage

that grow during childhood

ossification zone

side of the epiiphyseal plate facing the epiphisis contains resting cartilage

Eli. proximal to the resting cartilage area are arranged form the earliest stage of growth

to region where bone is replacing the cartilage

Long one is Endochondral

Mesynchyme

Aerolar dense

12 year old vitamin D defficient

Classification of bone fractures

simple: closed fracture

compound: open fracture

transverse: straight across

spiral: often from twisting

comminuted fracture: more than two pieces

impacted fracture: one fragment driven into another

greenstick fracture: incomplete fracture with splintering

oblique fracture

Vitamin C deficient

Poor diet

brittle bone from lack of nutrients

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compound fracture

humerous and epicondile

olecranon

medial condyle

boy was running and fell

scapula and clinical area

younger children have smaller bones than adults

if treated properly it should heal well and keep growing