Case Study – Packet 4
1. What is meant by a “complete, comminuted, intertrochanteric fracture of the right hip? a. A complete fracture is when the entire bone impacted is fractured. A comminuted fracture is when the bone breaks shatters into many pieces. Intertrochanteric refers to the top part of the femur. So, a complete, comminuted intertrochanteric fracture is the upper most part of the femur is completely shattered. A comminuted fracture is common in older people, so this fracture is normal for someone Margaret’s age. (Marieb, Elaine N.R., Ph.D. “5/The Skeletal System.” Essentials of Human Anatomy & Physiology. San Francisco: Pearson Education, 2006/ 137. Print.) 2. Draw a picture of what you think Margaret’s fractured femur looks like b.
3. The radiologist reports signs of osteoporosis. How is osteoporotic bone different from regular bone? c. Osteoporotic bone differs from regular bone because it has a lower bone mass and a loss of bone tissue, which can lead to weak, fragile bones. Osteoporosis is known to affect elderly women more often than men. Since our bones stop gaining density at the age of 25, it is important to continue to build strong bones after that time. Compared to regular bones, osteoporotic bones look thinner and have bigger pores. (Shiel, William C., JR. “Osteoporosis Picture Slideshow: Are Your Bones At Risk?” Www.MedicineNet.com. MedicineNet, Inc 1996-2012. Web.) 4. Why do bones become osteoporotic in some people? (What, specifically, is happening in the bones themselves?) d. Bones become osteoporotic in some people because the bone density stops forming. At a certain age, bones stop evolving. At that point, it is important to exercise and consume all the vital vitamins our body needs to remain strong. When bones begin to lose their density, there is a chance of osteoporosis occurring. When bones become osteoporotic, they start to thin out and the pores in the bones grow larger. This makes the bones turn weak and fragile, re-enforcing the idea that people with osteoporotic bones are more likely to suffer more serious fractures than those that do not have osteoporosis. 5. Describe the changes that a broken bone undergoes as it is healing. e. When a bone breaks or fractures, the first step of the healing process is inflammation. Lasting for a few days, the inflammation occurs because the blood channels are disturbed. This is known as hematoma – bleeding within tissue. Damaged bone tissue dies, and releases a chemical called Cytokines, which initiates the healing process. Osteoclasts then begin to remove dead bone cells. The blood from the fractured bones begins to form a blood clot, which acts as the first link between the fragment pieces. Fibroblasts then begin to lay down new tissue a few days after the fracture occurs. The Soft Callus begins a few days after the bone was broken. The Fibroblast cells that were present during the inflammation stage are responsible for making Cartilage and Fibrocartilage. Fibrocartilage is a spongy material that fills in the space between fractured pieces of the bone. The fibrocartilage will not strengthen too much, and it is weak, so it is extremely important that there is very little movement when this part of the process is taking place. For another two – three weeks, the Soft Callus transforms into woven bone. This process is the most time consuming, taking anywhere from six – twelve weeks to fully finish. Hard Callus is aided by calcium and phosphate being released into the cartilage tissues. The next part of the healing process is the Fracture Union. Bone remodeling begins ones the fractured bone has come back together. The shape of the bone is not the same as it was originally, but over time Osteoclasts remove unnecessary parts, which Osteoblasts lay down bone where needed. (PhysioRoom. “Bone Fracture Healing Explained”...