Anatomy And Physiology

Anatomy Physiology

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Human bones have the ability to heal themselves however depending on the severity of damage to the bone if there is no professional/medical assistance in the early stage of some types of broken bones then healing will occur with Deformity. Deformity then causes reduced function and of course does not look good.

The medical term for broken bone is Fracture.
A Fracture is defined as a complete or incomplete break in a bone resulting from application of excessive force.

Types of fractures

By observation
Open - This means either the skin is closed/not lacerated
Closed - the skin is opened/lacerated, the bone may be seen.

By Xray
Transverse- linear/horizontal break in bone
Greenstick- bone is bent like when trying to break a green twig occurs in children whose bones are not fully callcified
Comminuted - break has 3 or more fragments of bone

Healing occurs in 3 stages

1.Reactive Phase this is from time of injury to about 3 weeks

- Inflammatory phase - this is time of pain. A large blood clot is formed around the broken pieces of bone,like hugging the two broken ends together
- Granulation tissue formation- then the blood cells begin to die and special tissue producing cells called fibroblasts make a meshwork with the small blood vessels in area to form granulation tissue.

2. Repair Phase occurs 3 weeks to 12 mths but at about 12 weeks bone is formed in the callus bridging the gaps of fragments.

- Callus formation- this occurs inside the clot. cells called chondroblasts and osteoblasts from the outer covering of the bone begin to multiply from both pieces until they unite with each other filling the space with soft mesh-like bone.
- Lamellar bone deposition- mineriseled deposits occur here and during this process blood vessels also position themselves in the bone tissus. Then the gap between is closed

3. Remodeling Phase takes 1-2 years to achieve normal architecture.

- Remodeling to original bone contour - bone continues to harden by action of cells called osteoclasts and the osteoblasts and starts to get its original

Factors that promote healing

cessation of smoking -studies show decreased bone healing in smokers.
calcium rich healthy diet
regulated weight bearing of injured limb.
estrogen therapy may be suggested for older women.

Medical treatment
the aim is to prevent or treat infection to bone or surrounding tissue and promote proper healing.

1.Pain relief

-keeps The two pieces together for correct positioning,preventing deformity and for faster healing. This is done by use of splint, slings, casts,traction surgically placing pins/wires.

With the non-use of muscles during healing especially in older persons stiffness and weakness occurs as a result of atrophy thus physiotherapy will be necessary- muscle strengthening exercises

Complications of a fracture

-deformity if not treated properly.
-clot in lung artery-pulmonary embolism usually only from leg fractures.
-compartment syndrome- excessive swelling of injured muscle can reduce blood flow -depriving muscle of oxygen and cause damage to the muscles.
-temporary loss of function of limb.

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