What is a Pathological Fracture ?
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Conditions & Disorders of the Skeletal System

Introductory Note: Knowledge of the structure and function of bones and aspects of skeletal system generally are essential parts of training in human biology, medicine and associated health sciences. This page is intended to include the detail required for most Basic / First Level Courses in many therapies, and some ITEC Diplomas.

This page is divided into the following sections:

  1. Types of Fractures
    and their causes - see also types of fractures

  2. Postural Deformities
    see also curvature of the spine
  3. Other Skeletal Conditions
    and their causes and effects.


1. Types of Fractures (and their causes)

A fracture is breakage of a bone, this breakage may be complete or incomplete.

The following table summarises six common types of fracture. For more detail see the page about types of fractures.

1.

Simple

A clean break of the bone with little or no break in the overlying skin.

2.

Greenstick

An incomplete break of the bone in which part of the outer shell (cortex) remains intact.
This occurs particularly in children, who have more flexible bones than adults.

3.

Compound (also known as "Open")

A broken bone that pierces the overlying skin.

4.

Cominuted

A fracture in which the bone is broken into more than two pieces.
A crushing force is usually responsible and there is extensive injury to surrounding soft tissues is common.

5.

Impacted

A fracture in which the bones involved are driven into each other.

6.

Complicated

A broken bone that also involves damage to other organs - in addition to broken bone(s) and possibly also broken skin. An example is a broken rib that punctures a lung.

See also pathological fractures.

2. Postural Deformities

1.

Kyphosis

Excessive outward curvature of the spine, causing hunching of the back.

2.

Lordosis

Inward curvature of the spine.
Some lordosis in the lumbar and cervical regions of the spine is normal.
Exaggerated lordosis may occur in adolescence - possibly as a result of faulty posture, or due to disease affecting the vertebrae and spinal muscles.

3.

Scoliosis

Lateral (sideways) deviation of the spine.
Scoliosis may be caused by congenital or acquired abnormalities of the vertebrae, muscles, and/or nerves.
Treatment may involve the use of spinal braces and, in cases of severe deformity. surgical correction by fusion or osteotomy.

For more about postural deformities see the pages about the vertebral column and curvatures of the spine.

3. Other Skeletal Conditions (and their causes and effects)

Condition

 

Cause

 

Effect

Arthritis

 

Over 200 diseases may cause arthritis, including:

 

Swelling, warmth, redness of the overlying skin, pain, restriction of motion.

Inflammation of one or more joints

 

osteoarthritis
rheumatoid arthritis
gout
tuberculosis, and other infections.

Osteo Arthritis

 

Osteo-arthritis is due to wear of the articulatory cartilage, and may lead to secondary changes in the underlying bone.
It may be primary, or it may occur secondarily to abnormal load to the joint or damage to the cartilage from inflammation or trauma.

 

The joints are painful and stiff with restricted movement. Osteoarthritis is recognized on X-ray by narrowing of the joint space (due to loss of cartilage) and the presence of osteophytes, osteosclerosis, and cysts in the bone.

Degenerative joint disease

 

Rheumatoid Arthritis

 

Rheumatoid Arthritis is a disease of the synovial lining of joints: The joints are initially painful, swollen, and stiff and are usually affected symmetrically.
(Onset can be at any age, and these is considerable risk of severity. Women are at greater risk. Rheumatoid arthritis is an autoimmune disease, and most patients show presence of rheumatoid factor in their serum*.)

 

As the disease progresses the ligaments supporting the joints are damaged and there is erosion of the bone, leading to deformity of the joints. Tendon sheaths can be affected, leading to tendon rupture.

(The second most common form of arthritis, after osteo arthritis)

 

Bone Cancer

 

Bone cancer may occur as a secondary cancer from, for example, prostate cancer

 

Damage to stem cells (the cause of leukaemia).

 

Gout

 

Gout is caused by a defect in uric acid balance in the metabolism - resulting in an excess of the acid and its salts (urates) which then accumulate in the bloodstream and joints, respectively.

 

Gout can result in attacks of acute gouty arthritis, chronic destruction of the joints, and deposits of urates (tophi) in the skin and cartilage - especially of the ears.
The excess urates also damage the kidneys, in which stones may form.

 

Osteoporosis

 

Infection, injury and synovitis can cause localized osteoporosis of adjacent bone.
Generalised osteoporosis is common in the elderly, and in women often follows the menopause. It is also a feature of Cushing's disease and prolonged steroid therapy.

 

Bones that are brittle and liable to fracture.

Loss of bone tissue.

 
 
 
 

Rickets

 

Rickets is a childhood condition caused by insufficient vitamin D and Calcium

 

Bow legs.

Childhood disease

 
 

* Serum (blood serum) is similar to blood plasma except that it lacks fibrinogen and some other substances that are used in the coagulation process.

This is the end of this page about the skeletal disorders. Information about the structure and functions of bones, cranial and facial bones and bones of the feet and hands are also included on this website.

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