1. Trauma Trauma to the musculoskeletal system may affect bone, cartilage, muscles and joints.

To each of these structure, trauma may cause immediate damage and late changes. a. Fractures A fractures is defined as a break in the continuity of a bone. Fractures can be classified according to several fractures (table 6.11). based on the extent of the break, fractures are classified as complete or incomplete. A complete fracture breaks the bone all the way through. While with incomplete fracture the bone is broken but stays as one piece. Fractures are also classified as open (previously called compound) if the skin is broken and closed (previously called simple) when the skin at the site of fracture is not broken. The fracture pattern depends on the mechanism of injury. Compression load produces a compaction or oblique fracture. Bending load has a tendency to produce a flat transverse fracture. However, bending load on one side is associated with compression on the other side, which may affect the pattern of the fracture. Torsional force tends to produce a spiral fracture. Other classification are based on the number of bone pieces, the direction of the fracture line, and other factors (table 6.11). pathological fractures occur at the sites at the preexisting abnormalities that weaken bone. A minimal force that usually would not cause the fracture of a normal bone may produce a pathological fracture. A transchondral fracture (osteochondritis dissecans) represents fragmentation and separation of portion of cartilage or cartilage bone. This type is most prevalent in adolescent and occurs typically in the head of the femur, ankle, kneecap, elbow, and wrist. The role of scintigraphy in fracture diagnosis is limited to cases of radiologically occult fractures and fractures of the small bone of the hands and feet. Stress Fractures. Stress fractures are due to repeated stress, each episode of which is less forceful than required to fracture the bony cortex. The stress fracture is not as thought due to repeated traumatic microfractures. It is a focal area of increased bone turnover secondary to the repeated stress. The process starts with resorption of cavities before being coupled to an osteoblastic response to replace the absorbed bone. The process the rarefaction is faster than the osteoblastic process and will progress if the individual continues with stressful activity and trauma. Complete fracture through the zone of rarefaction may occur. If this occurs in normal bones, the resulting fractures are called fatigue fractures, while if they occur on abnormal bones, as in osteoporosis,