Fractures & Repair

Male vs. Female PelvisFemale Structure (All related to female pelvis functioning as a birth canal):• Iliac bones more flared• Angle of pubic arch greater• > distance b/t ischial

spines• Sacral curvature shorter

& wider• Bones lighter

Osteopenia/Osteoporosis• In early adulthood, the activity of osteoblasts &

osteoclasts are about equal• Bone is constantly being remodeled• In late adulthood, the balance shifts & osteoclasts

start tearing more bone down• In females, the lack of estrogen enhances the ability

of osteoclasts to absorb bone. • Since the osteoblasts (the cells which produce bone)

are not encouraged to lay down more bone, the osteoclasts win and more bone is lost than is produced.

Symptoms of Osteoporosis• Trabeculae are lost & spaces develop in bone• Spaces fill in with fibrous & fatty tissue• “Fragility fractures” result

• • Loss of bone density

• Loss of bone mass

Risk Factors for Osteoporosis

• Post-menopausal females• Genetics• Low dietary calcium• Lack of weight-bearing exercise• Smoking • Drinking alcohol• Recent weight loss• Caucasian or Asian women with slight build• Older age

Diagnosis & Treatment of Osteoporosis

• Both diseases are assessed by measuring BMD (bone mineral density)

• Osteopenia is defined as 1 to 2.5 standard deviations below the mean for BMD

• Osteoporosis is a BMD of at least 2.5 std. dev. below the mean

• Medication (biophosphonates 1X weekly or monthly) to build bone

• Weight-bearing exercise 30 min. daily• 1.000-1,500 mg daily of Ca• 200 IU Vit D

Disorders of the Skeletal System

• Of the vertebral column:kyphosis – an exaggerated thoracic curvature (rounded shoulders & hunchback)scoliosis – abnormal lateral curvature pf the vert. columnlordosis – accentuated lumbar curvature

Disorders of the Vert. Column

• • • Kyphosis

• Scoliosis Lordosis→

Osgood-Schlatter Disease • commonly seen in a

growing child and adoles-cent

• this is b/c the bones are typically growing faster than the muscles and tendons, so they have a tendency to become tight.

• most often seen in preteen and teenage boys from 9 to 13 years old.

• occasionally diagnosed in girls ages 8 to 13.

Osteogenesis Imperfecta• Commonly called “Brittle Bone Disease”• The classic symptoms include:• weak bones, which makes them susceptible to fractures• usually below average height • blue tint to the whites of their eyes (blue sclera) • multiple bone fractures • early hearing loss• loose joints (hypermobility) and flat feet• the development of poor teeth• bowed legs and arms• the severity of the disease varies greatly

Osteogenesis Imperfecta (OI)