Fractures through the ages Flashcards
What are trabeculae? how do they change with age?
Cross connection within the bones.
start as nice and thick and get thin-with much air n the as you get ilder
What composes bones?
balance of matrix and cells
matrix-organic (type 1 Collagen, PLS, proteins) and inorganic (ca + P (Hydroxy-appatite)
Cells-Osteoclasts, blasts, cytes and progenitors
Describe the process of normal bone turnover?
Osteoclasts digests bones neraly constantly-then osteoblasts precurors enter the gap and start filling with osteoid tissue
Mineralisation of the tissue,and osteocyte sit there
-> resting-> repeat cycle
when goes wrong-DEXA test to identify oestoporosis–which can cause a lot of fracture
What are treatment options of Osteoporosis?
Bisphosphonates-inactvates and kill osteoclasts —> cannot give to amputee osteoporosis
Also have 7 years half life-reduce turnover in general-micro-fractures accumulate-> cause very atypical fracture (like right through femur) -which dont repair well
Desonumab-Anti RANKL Ab
RANKL is produced by osteoblasts and differentiate/actuvate osteoclasts. Desonumab stops activation of osteoclasts –short half life and doesnt stop all
Who tend to have oesteoporosis?
post menoposal Elderly and young amputees (30yo) (back to Wolff’s law-dont load the bone properly and their limps become very osteopenic)
How dangerous are hip fractures?
NOF-most common fragility fracture-50% die within 30 days of fracture
usually also a signs of general declining health
How can you help prevent hip fractures?
Exercise-Wolffs
Peak bone mass (natrually) peaks in adolescence –> then flattens out from these and drops later
so need to try and peak out as high as possible (exercise, calcium, vit D, etc)-because always flattens out
If youve had inadequate environemental factors-peak lower-and then when it drops risk of fractures increases a lot
Describe bone healing process?
healing by callous-especially if movement at fracture (not absolute stability)
week 1 start with heamatoma-blood pouring in + inflammation
Week 2/3-start being replaced by soft callous-cells lay down cartilage like structure-lump out of bone
then 4-16-hard callus-start hardening, calcification of cartilage-forms woven bone-disorganised-and not as strong (as stress hasnt been present)–then remodelling beyond that-and from woven goes back to normal shape
in children, much much faster
What are fracture patterns and what can they tell you?
Patterns depend on how the bone was broken and with how much force
Spiral pattern-usually twisting lik
Oblique-Compression
Butterfly-direct hit
Transverse-pulling
Greenstick fracture-peadiatric-crack outwards but not snap
ofc all the soft tissue can have
