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PATHOPHYSIOLOGY

Modifiable Risk Factors:


Cigarette smoking
Low body weight
Low calcium intake
Alcoholism
Recurrent falls
Inadequate physical activity
Poor health/frailty

Non-modifiable Risk Factors:


Hx of fractures as an adult
Hx of fractures in first degree
relative
Female sex
Advanced age

TRAUMA
Stress placed on the bone excees the capacity
of the bone to absorb it
Bone breakage
Blood vessel disruption

Ecchymosis

Jaundice

RBC Hemolysis

intraosseous blood flow

Bleeding around the site & into


the surrounding soft tissues

Ischemia
Bone cell death

Pain

prostaglandin,
bradykinin, serotonin

Intense inflammatory reaction


Histamine, serotonin, bradykinin,
C3a, C5a, LTC4, LTD4, PGI2, PGE2,
PGD2, PGF2,

Warmth & redness

Vasodilation, vascular
permeability

TXA2, PAF, IL-1, TNF-,


LTB4
Fibrin clot formation &
acts as a new network
upon w/c new cells can
adhere to

True bone replaces callus


& is slowly calcified

Callus/ immature new bone


formation

Osteoprogenitor cells
osteoclastic activity

Stress on the opposing side of the broken


bone accelerates osteoclastic activity

blood flow to injured area


Accumulation of phagocytic cells
Phagocytosis & removal of dead cell debris

Fixation, traction

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