Fracture and Bone Healing (2) PDF

C o ll e g e Abnormal fracture healing o f 4- Delayed union: M e callus formation and bony union occur but at a slower than d normal rate ic i n e 5- Nonunion: – Fracture callus formation is interrupted or incomplete and ‫ك‬ ‫ل‬ the bone ends are joined by non-osseous repar...

C o ll e g e Abnormal fracture healing o f 4- Delayed union: M e callus formation and bony union occur but at a slower than d normal rate ic i n e 5- Nonunion: – Fracture callus formation is interrupted or incomplete and ‫ك‬ ‫ل‬ the bone ends are joined by non-osseous reparative tissue ‫ية‬ (fibrocartillagenous tissue) ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬  Abnormal fracture healing 6- Pseudoarthrosis (false joint) If a nonunion persists, the dicine – malformed ‫كلية الطب‬ callus undergoes cystic degeneration, and the luminal surface may become lined by synovial-like cells. The space between the fractured bone ends may contain fluid C o ll e g o e Pathological fracture f M e d ic i n e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ C o ll g e Pathological fracture e A pathological fracture describes a fracture occurring either o spontaneously or after insignificant injury through an area of f M abnormal bone. e d ic Causes: i n 1- Metabolic bone disease (osteoporosis) e – 2- Paget disease ‫ك‬ 3- Tumors: such as a benign or malignant tumour. ‫ل‬ ‫ية‬ 4- Simple bone cyst ‫ا‬ 5- Metastatic carcinoma and myeloma ‫ل‬ 6- Infection ‫ط‬ ‫ب‬ dicine – ‫كلية الطب‬ Osteonecrosis (Avascular Necrosis)  Osteonecrosis (Avascular Necrosis) Definition: Osteonecrosis refers to infarction (ischemic necrosis) of trabecular bone and marrow cells. The cortex is usually not affected due to collateral blood dicine – ‫كلية الطب‬ supply. Peak incidence occurs 30s to 50s years The symptoms depend on the location and extent of infarct. Typically, subchondral infarcts cause pain. C o ll e Osteonecrosis (Avascular Necrosis) g e o f Causes of bone ischemia: M Vascular injury (trauma, vasculitis) e d Drugs (corticosteroids) ic i Systemic disease (sickle cell crisis) n e Radiation – ‫ك‬ ‫ل‬ - In about 25% of cases, the cause is unknown ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬  Osteonecrosis (Avascular Necrosis) The three suspected mechanisms causing osteonecrosis: Mechanical disruption of vessels Thrombotic occlusion Extravascular compression dicine – ‫كلية الطب‬ Loading… Avascular necrosis most commonly affects the ends of long bones (femur, humerus), knees, shoulders, ankles, jaw The classical sites are: o Head of femur o Neck of talus o Waist of the scaphoid C o ll e g e o f M e d ic i n e – ‫ك‬ ‫ل‬ ‫ية‬ ‫ا‬ ‫ل‬ ‫ط‬ ‫ب‬ Femoral head with a subchondral, wedge-shaped pale yellow area of osteonecrosis (arrow).  Resources https://www.youtube.com/watch? v=X8pouA7I2jw&ab_channel=nabilebraheim Robbins and Cotran PATHOLOGIC BASIS OF dicine – ‫كلية الطب‬ DISEASE, Chapter 26 - Bones, Joints, and Soft Tissue Tumors, 1273 to 1292