Lecture 10 Musculoskeletal Growth/Injury and Repair

Question 1

Ligament attaches ____ to____

Answer 1

Bone to Bone

Question 2

What are the stages of healing of a ligament rupture

Answer 2

Haemorrhage
Proliferative phase
Remodelling

Question 3

When would conservative treatment be an option for a ligament rupture

Answer 3

Partial
No instability
Poor candidate for surgery

Question 4

When would operative treatment be an option for a ligament rupture

Answer 4

Instability

Expectation (sportsmen)

Question 5

Do tendons have a blood supply

Answer 5

No

Question 6

Achilles tendon is a _____of a tendon

Answer 6

Degeneration

Question 7

Quervain’s Stenosing Tenovaginitis is a _____ of a tendon

Answer 7

Inflammation

Question 8

What is Enthesopathy?

Answer 8

Inflammation at insertion to bone

Question 9

What is Osgood Schlatter’s Disease

Answer 9

Inflammation of insertion of patellar tendon into anterior tibial tuberosity
Occurs in adolescent active boys

Question 10

What is the cure for Osgood Schlatter’s Disease

Answer 10

Cure is rest, no serious damage

Question 11

What is avulsion

Answer 11

Failure at insertion

Forced flexion of finger

Question 12

What is the conservative treatment of avulsion

Answer 12

Retraction tendon

Question 13

What is the operative treatment of avulsion

Answer 13

• Reattachment tendon- Through bone

* Fixation bone fragment

Question 14

How do you investigate Achilles tendon rupture

Answer 14

o Positive Simmonds’s (squeeze) test- no plantar flexion

o Palpable tender gap

Question 15

What is cortical bone

Answer 15

Compact structure
Diaphysis
Less biologically active
Contain blood vessels on centre

Question 16

What is cancellous bone

Answer 16

Spongey bone
Designed to take load
Metaphysis
Site of longitudinal growth
Very biologically active

Question 17

What is a fracture

Answer 17

Break in structural continuity of bone

Question 18

Why do bones fail

Answer 18

High energy transfer in normal bones
Repetitive stress in normal bones
Low energy transfer in abnormal bones (osteoporosis, osteomalacia, metastatic tumour)

Question 19

Describe the stage 1 of healing after a fracture

Answer 19

1. Haematoma and fibrin clot
2. Platelets, neutrophils, monocytes, macrophages
3. Fibroblasts
4. Mesenchymal & Osteoprogenitor

Question 20

Describe the stage 2 of healing after a fracture

Answer 20

1. Soft callus

2. Pain and swelling subside

Question 21

Describe the stage 3 of healing after a fracture

Answer 21

1. Hard Callus

2. Conversion of cartilage to woven bone

Question 22

Describe the stage 4 of healing after a fracture

Answer 22

1. Conversion of woven bone to lamellar bone