Musculoskeletal Function
Risk factors: age, activity, environment
Athletic injuries- usually soft tissue
o Contact sports increase risk of neck, bone injuries
Diving is most common sport for injuries
Soft tissue injuries
o Contusion: skin intact- hemorrhage = ecchymosis (color change
of the bruise; purple with oxygen with red blood; blue, green, and
yellow indicate deoxygenation)
Bruise, vessels break apart underneath the skin
Goes away when all the debris has been picked up by
the scavengers
o Hematoma: local large bleeding underneath the skin- skin intact
although may break open with increase pressure
Pooling
Subungual Hematoma: bleeding underneath the nail
o Laceration: break in multiple layers of the skin; can be planned,
intentional
o Abrasion:- multiple superficial interruptions on the skin
Skin is open and can see blood
Variations in Normal Growth and Development
Torsional deformities
o In-toeing and out-toeing
o Internal and external tibial torsion
o Internal and external femoral torsion
Genu varum (bowlegged) and genu valgum
REVIEW: Hereditary and Congenial Deformities
Congenital dysplasia of the hip
Foot deformities (clubfoot)
o Talipes varus: foot inverted at heel
o Talipes valgus: foot everted at hell
o Talipes equinus: plantarflexion, toes lower than heel
o Talipes calcaneus: dorsiflexion, heel below toes
Spine Curvatures
Scoliosis: lateral curvature of the spine; left to right
o Measure by degrees of curvature
o Patient can benefit from brace
Lordosis: lumbar region is has an anterior rotation or curvature
Kyphosis: cervical spine that has anterior curvature of the cervical
Fractures
Classification
, o Transverse: across
o Oblique: diagonal All have trouble
o Spiral with healing!
o Comminuted: multiple pieces
o Segmental
o Butterfly
o Impacted: one bone impacts into another
Greenstick: children’s growth plates
Healing of Bone Fractures
Hematoma Form, 2-3 days, Signal Cellular Activity, Clotting
o Localized pooling of blood at the area of fracture
o Fracture: a bone that has been separated from the piece of bone,
there will be a distance between the end broken pieces- this is
where the hematoma form
o Body tells the brain that there is an injury (signaling cellular
activity) when then sends fiber and collagen
Callus Formation- Sticky, Osteoblasts (bone building), 3-4 weeks- distal
to fracture so forms bridge
Bony callous formation- ossification (harden)- bridge complete- mature
cells replace
Remodeling- callus resorbed
o If patient doesn’t remodel, extra callus (extra edging of the
bone), they rub up against the nerve endings, sharp pain with
movement
Treatment: surgery to shave off the extra bone
Impaired healing- age, medications, disease, stress at site, circulatory
problems, poor nutrition
REVIEW: Treatment of Fractures
Reduction
Immobilization
Preserve Function
Complications of Fractures
Fracture blister- fluid accumulation inside the area of the break
o Cells can not grow and replace
o Surgery to drain the fluid
Compartment syndrome- increase fascial pressure in limited space so
circulation is compromised, cell death which is very pain (ORTHOPEDIC
EMERGENCY!)
Fat embolism syndrome- can move to respiratory distress/failure,
cerebral dysfunction, petechiae
Bone Infections
Risk factors: age, activity, environment
Athletic injuries- usually soft tissue
o Contact sports increase risk of neck, bone injuries
Diving is most common sport for injuries
Soft tissue injuries
o Contusion: skin intact- hemorrhage = ecchymosis (color change
of the bruise; purple with oxygen with red blood; blue, green, and
yellow indicate deoxygenation)
Bruise, vessels break apart underneath the skin
Goes away when all the debris has been picked up by
the scavengers
o Hematoma: local large bleeding underneath the skin- skin intact
although may break open with increase pressure
Pooling
Subungual Hematoma: bleeding underneath the nail
o Laceration: break in multiple layers of the skin; can be planned,
intentional
o Abrasion:- multiple superficial interruptions on the skin
Skin is open and can see blood
Variations in Normal Growth and Development
Torsional deformities
o In-toeing and out-toeing
o Internal and external tibial torsion
o Internal and external femoral torsion
Genu varum (bowlegged) and genu valgum
REVIEW: Hereditary and Congenial Deformities
Congenital dysplasia of the hip
Foot deformities (clubfoot)
o Talipes varus: foot inverted at heel
o Talipes valgus: foot everted at hell
o Talipes equinus: plantarflexion, toes lower than heel
o Talipes calcaneus: dorsiflexion, heel below toes
Spine Curvatures
Scoliosis: lateral curvature of the spine; left to right
o Measure by degrees of curvature
o Patient can benefit from brace
Lordosis: lumbar region is has an anterior rotation or curvature
Kyphosis: cervical spine that has anterior curvature of the cervical
Fractures
Classification
, o Transverse: across
o Oblique: diagonal All have trouble
o Spiral with healing!
o Comminuted: multiple pieces
o Segmental
o Butterfly
o Impacted: one bone impacts into another
Greenstick: children’s growth plates
Healing of Bone Fractures
Hematoma Form, 2-3 days, Signal Cellular Activity, Clotting
o Localized pooling of blood at the area of fracture
o Fracture: a bone that has been separated from the piece of bone,
there will be a distance between the end broken pieces- this is
where the hematoma form
o Body tells the brain that there is an injury (signaling cellular
activity) when then sends fiber and collagen
Callus Formation- Sticky, Osteoblasts (bone building), 3-4 weeks- distal
to fracture so forms bridge
Bony callous formation- ossification (harden)- bridge complete- mature
cells replace
Remodeling- callus resorbed
o If patient doesn’t remodel, extra callus (extra edging of the
bone), they rub up against the nerve endings, sharp pain with
movement
Treatment: surgery to shave off the extra bone
Impaired healing- age, medications, disease, stress at site, circulatory
problems, poor nutrition
REVIEW: Treatment of Fractures
Reduction
Immobilization
Preserve Function
Complications of Fractures
Fracture blister- fluid accumulation inside the area of the break
o Cells can not grow and replace
o Surgery to drain the fluid
Compartment syndrome- increase fascial pressure in limited space so
circulation is compromised, cell death which is very pain (ORTHOPEDIC
EMERGENCY!)
Fat embolism syndrome- can move to respiratory distress/failure,
cerebral dysfunction, petechiae
Bone Infections
