BONES AND JOINTS

Total number of bones =206

Total number of muscles =700
Both bones and muscles =50% of body weight
FUNCTIONS

 Bones : protection and support

 Joints: movement
 FRACTURES

 Definition : break in the bone

 Reason :Trauma
 MCQ: who described it?
 Hippocrates [14 century B.C]
 Who will treat?
Doctors [orthopedicians]
Traditional bone setters
FRACTURE
TYPES OF FRACTURES
Green stick fractures
break is incomplete leaving one
cortex intact
young bones of children
Closed fracture
no communication with outside
CLOSED FRACTURE
TYPES OF FRACTURES

Open fracture
communication with outside
compound fracture
serious condition[infectious]
OPEN FRACTURE
TYPES OF FRACTURES

Pathological fracture
Weak bone → fracture
↑
Trivial violence
e.g : parathyroidism
TYPES OF FRACTURES

Stress fracture
Repeated minor stresses → fracture
↑
Long period

Birth fracture
During delivery
MECHANISM OF FRACTURE

 Direct violence
 Indirect violence
 Torsion
HEALING OF BONES IN FRACTURE

Three phases
 Inflammatory
 Reparative phase
 Remodelling phase
 Inflammatory phase
Fracture
↓
Break of bone
↓
Break of blood vessels
↓
Leakage of blood
↓
Fill the gap[haematoma]

Duration:1-2 days
HEALING OF BONES IN FRACTURE
Reparative phase
*Granulation tissue formation[callus
formation]
*bridge the gap
*duration:8-12 days
HEALING OF BONES IN FRACTURE

Remodelling phase

By muscular and weight bearing stresses

Moulding
Duration:1 year
PHYSIOTHERAPY AND REHABILITATION

Complication of fracture
wasting of muscles
Stiffness of joints
COMPLICATIONS OF
FRACTURES
Physiotherapy → Therapeutic exercises
↓
To make limbs work normal
Who will do ? → physiotherapist
Who will supervise → Orthopaedic surgeon
DISLOCATION OF JOINTS

Definition: Total displacement of the

articular end of the bone from the
joint cavity
CLASSIFICATION

1.Congenital
2.Traumatic
3.Pathological
4.Paralytic
CONGENITAL DISLOCATION

*From birth
*Reason:Genetic factors
*Teratogenic disorder
CONGENITAL DISLOCATION
TRAUMATIC DISLOCATION

*serious violence
*shoulder , elbow , hip
PATHOLOGICAL DISLOCATION

*diseases
*e.g: tuberculosis
PARALYTIC DISLOCATION

*damage to nerves
*muscle imbalance
*e.g: poliomyelitis
 ARTHRITIS

 Definition: Inflammation of all the

components and structures of the joints

Involves : synovium , articular

surfaces , capsule
 ARTHRITIS

Reasons :
Diet
Psycho-somatic illness
Infections
Diseases
Metabolic abnormalities
 ARTHRITIS

Types
1.Infective arthritis
2.Rheumatic arthritis
3.Osteoarthritis
4.Metabolic arthritis
 INFECTIVE ARTHRITIS
Staphylococcal
Streptococcal
Gonococcal
Rheumatic
Smallpox
Tuberculosis
Syphilitic
Damage joints ----- pain
RHEUMATIC ARTHRITIS

*Auto-immune origin
*Reason : unknown antigen
*Inflammation of synovial membrane
*Localized to musculoskeletal system
*Affects mainly connective tissue
 OSTEOARTHRITIS
*Degenerative condition
*Ageing joints
↓
Progressive and localized degeneration
of the articular cartilage
↓
At later stage , cartilage eroded ,
exposing sclerosed bone.
METABOLIC ARTHRITIS
*Inborn error of purine metabolism
[GOUT]

“deposition of sodium urate crystals

{uric acid}on the articular cartilage ,
synovial membrane,periarticular
tissues
*pain , swelling ,reddening of joints
 BONES
Calcium and vitamin D
↓
Essential for bone growth and structure
maintenance

*Calcium --- stones of the bone

*vitaminD --- Increases absorption and
deposition
*Bone contains 98% of body calcium
*Mineralization-building the bone with
calcium
 RICKETS

Deficiency of vitamin D
↓
No stones available for construction
[defective mineralisation]
 RICKETS

*Bowed legs
*Knock knees
*Pigeon chest
*Broadening of wrist and ankles
*Protuberant abdomen
 RICKETS

Reason: poverty→nutritional deficiency

↓
Rickets[nutritional]
Age: below 4 years
 RICKETS

Source: cod and shark liver oil

Prevention : pregnant mother

 OSTEOMALACIA

*Deficiency of calcium and vitamin D

in adults
*Characteristics : Bone pain ,
Tenderness,
Brittleness {bone}
 ORTHOPAEDICS

“branch of science which deals with

disorders of the bones and joints”
 ORTHOPAEDICS

*includes
Plaster cast
Manipulation under anesthesia
Surgical and neurological examination,
Traction procedure,
Splinting and use of appliances.
PLASTER CAST
COMPLICATIONS OF
FRACTURES