Clinical Disorders and Diseases of the Skeletal

System

Cleft Lip/Palate Facial and oral malformations that occur very

early in pregnancy Results when there is not enough tissue in the

mouth or lip area, and the tissue that is available does not join together properly

Cleft lip – split or separation of the two sides of the upper lip

Cleft palate – split or opening in the roof of the mouth (hard or soft palate)

1 in 700 babies; 4th most common birth defect in the US

Cleft lip/palate cont. The cause is unknown May be linked to genetic and

environmental factors (drugs, exposure to viruses or chemicals)

Eating, speech, and dental problems could result

Often requires multiple surgeries to treat

Cleft Palate

Vertebral Column: CurvaturesScoliosis: abnormal lateral curvature of the

spine (occurs most often in the thoracic region)

Caused by a bone abnormality present at birth, abnormal muscles or nerves, trauma, or genetic

2-3% of Americans at age 16 (girls are more prone to developing the condition)

Diagnosed by screening exams, bone exam, and X-ray Treatments include braces or surgery (spinal fusion)

Scoliosis

Osteomalacia Softening of the bones due to a lack of

Vitamin D or a problem with the body’s ability to break down and use Vitamin D

Rickets - Children's form of osteomalacia

Causes – not enough Vitamin D; not enough exposure to sunlight or malabsortption of Vitamin D by the intestines

Symptoms - bone weakness, fractures that occur without real injury, and numbness

Treatments – Vitamin D, calcium, and phosphorus supplements

Bone loss outpaces bone regeneration

Bones weaken and lose mass

Bones become brittle and fractures occur more often

Found most often in women

Treatment may include; medication, diet changes, exercise

Osteoporosis

Osteoarthritis Degenerative joint disease Most common type of arthritis (21

million) Breakdown of cartilage in joints Mostly occurs in the weight bearing

joints, but it can occur anywhere Causes cartilage to become stiff and lose

its elasticity As cartilage deteriorates, tendons and

ligaments stretch, causing pain

OsteoarthritisSymptoms:•Joint aching and soreness•Pain after overuse or long periods of inactivity•Joint swelling•Fluid accumulation

Treatment: medication, physical therapy, surgery

Knee Replacement surgery Generally reserved for people over the

age of 50 with severe osteoarthritis Helps relieve pain & restore function in

severely diseased knee joints During surgery; a surgeon cuts away

damaged bone and cartilage from your femur, patella, and tibia and replaces it with an artificial joint made of metal alloys, high-grade plastics, and polymers

Fractures A crack or break in a

bone

Despite its mineral strength, bone can crack or even break if subjected to extreme loads, sudden impacts, or stresses from unusual directions

Types of Fractures Named according to their external

appearance, their location, and the nature of the crack or break in the bone.

Two general categories:1. Closed (simple) – fracture is internal2. Open (compound) – fracture projects

through the skin

Common fracture types (cont’d)

Common fracture types

Comminuted fractures

Spiral fractures

Figure 6–16 (4 of 9)

Figure 6–16 (7 of 9)

Greenstick fracture

Figure 6–16 (9 of 9)

Compression fractures

Depression fracture of the skull

Treatment of a Fracture Initial treatment for fractures of arms,

legs, hands, and feet include splinting the extremity in the position it is found, elevation, and ice.

Edema (or swelling)What does this have to do with splinting

and casting? Closed Reduction – manual realignment Open Reduction – surgically realignment

Steps in the Repair of a FractureStep 1 –

Immediately after the fracture, extensive bleeding occurs (blood vessels are broken).

A large blood clot, or fracture hematoma, soon closes off the injured vessels and leaves a fibrous meshwork in the damaged area.

The disruption of the circulation kills osteocytes (mature bone cells) around the fracture.

Dead bone soon extends along the shaft.

Steps in the Repair of a Fracture

Step 2 – The cells of the endosteum (cellular

layer) and periosteum undergo cell division and the daughter cells migrate into the fracture zone.

An external callus (hard skin) forms and encircles fracture

An internal callus organizes within the cavity and between the broken ends of the shaft

The broken ends have been temporarily stabilized

Steps in the Repair of a Fracture

Step 3 – Osteoblasts (bone building cells) replace

the central cartilage of the external callus with spongy bone

Calluses form a brace at the fracture site Spongy bone now unites the broken ends Fragments of dead bone are removed and

replaced If the fracture required a cast, it can be

removed at this stage

Steps in the Repair of a Fracture

Step 4 – Osteoclasts (remove and recycle bone

matrix) and osteoblasts continue to remodel the region of the fracture (4 months to 1 year)

When remodeling is complete, the bone of the calluses is gone and only living compact bone remains.

The bone could be slightly thicker and stronger than normal at the fracture site

Fracture repair

Fracture repair (cont’d)

Casts Holds a broken bone in place as it heals Help to prevent or decrease muscle

contractions Provide immobilization (the joints above

and below the area) Casts are made of plaster and fiberglass Typically worn for 6-8 weeks

Dislocation Separation of two bones where they meet

at a joint (no longer in normal position) Caused by a sudden impact to the joint May be hard to tell a dislocated bone

from a broken bone Generally take 3-6 weeks to heal Possible ligament damage can occur