fractures through the ages

Question 1

what are the coral like meshwork structures within bone called?

Answer 1

trabecular meshwork

Question 2

what is the main inorganic component of bone where calcium is

Answer 2

calcium phosphate in a chemical arrangement known as calcium hydroxyapatite

Question 3

what cohorts of people are most at risk of osteoporosis

Answer 3

post menopausal women

amputee cohorts- lost muscle insertions and load so hips become very osteoporotic

Question 4

what is the first line of treatment for osteoporosis and how does it work?

Answer 4

bisphosphonates
kill osteoclasts so reduce bone resorption and there is more osteoclast remodelling so bone density gets stronger
half life of 7 years

Question 5

what is another line of treatment for osteoporosis?

Answer 5

denosumab
inhibits osteoclast formation, function and survival
monoclonal antibody that binds to the RANK ligands on osteoclasts which prevents it from binding to the receptor on osteoblasts and getting activated

Question 6

what age do you lay down the most of your bone?

Answer 6

most calcium is laid down in the pre pubescent period

exercise should be done in pre pubescent period to make bones strong and drink lots of milk

Question 7

how do fractures heal?

Answer 7

callus formation
week 1- blood pouring in to bone, contained by soft tissue forming a haematoma.
within the haematoma you get all the pro inflammatory molecules which stimulate healing
the blood clot forms into a soft callus which stabilises the fracture
4-16 weeks - callus is calcified and gets harder. this is woven bone- not normal strength
then the disorganised bone will get refined- the parts with not much load will dissolve down and the parts with more stress gets stronger - Wolfs law

Question 8

what are the different types of fracture?

Answer 8

spiral fracture- broken by a twisting force
diagonal/ oblique- compression fracture
butterfly fracturet- direct hit
transverse fracture- tension/ pulling fracture