Mariana McAlpine 12/8/12
446-01 Mrs.Corrado
Case Study – Packet 4
1. What is meant by a “complete, comminuted, intertrochanteric fracture of the right hip? a. A complete fracture is when the entire bone impacted is fractured. A comminuted fracture is when the bone breaks shatters into many pieces. Intertrochanteric refers to the top part of the femur. So, a complete, comminuted intertrochanteric fracture is the upper most part of the femur is completely shattered. A comminuted fracture is common in older people, so this fracture is normal for someone Margaret’s age. (Marieb, Elaine N.R., Ph.D. “5/The Skeletal System.” Essentials of Human Anatomy & Physiology. San Francisco: Pearson Education, 2006/
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Effects of Extended Bed Rest- Immobilization and Inactivity. http://www.ncbi.nlm.nih.gov/books/NBK27213.) 8. What risk factors does Margaret have for osteoporosis? h. Because Margaret has such a long history of smoking, she is more likely to encounter many more problems with her bones. Smoking is known to release hormones that lead to the break down of bones. Smoking damages blood vessels, causing the circulation of blood and oxygen to be hindered. This makes the bone healing process that much harder for Margaret because her body has to fight numerous things to begin healing itself. Sedentary is a word used to describe those that sit more often than move around. Since Margaret is sedentary, she places excess stress on her skeleton, causing her bones to endure more pain. Margaret’s lifestyle suggests that she is a likely candidate for osteoporosis. 9. What bones are most vulnerable to osteoporosis and why? i. When discussing osteoporosis, the bones that automatically come to mind are the wrist, spine, and hip. Certain parts of the vertebral column are also common osteoporotic bones. In the vertebral column, the upper lumbar, lower thoracic, and cervical vertebrae are usually the bones that end up becoming osteoporotic. 10. Specifically describe how each of these medications works to treat Margaret’s condition. j. Oral Calcium Supplements are used to prevent and treat low blood calcium levels for people that do not get enough
Given the above considerations, Margaret's osteoporotic femurs are vulnerable to fracture because of (A) the loss of spongy bone in the epiphyses and (B) the thinning of the bony collar in the diaphysis.
This is where the skin does not break at the site of the fracture, and is the most common type of fracture
Osteoporosis if often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have the disease until their bones become so weak that sudden strain, bump, or fall causes a fracture or a vertebra to collapse. Collapsed certebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis or stooped posture. Certain people are more likely to develop osteoporsis than others. Factors that increase the likelihood of developing osteoporosis are called "risk factors." The following risk factors have been identified: Being female thin and/or small frame, Advanced age, a family history of osteoporosis Postmenopause, including early or surgically enduced menopause. Abnormal absence of menstral period, anorexia, nervosa, or bulimia. A diet of low in calcium use of certain
There are two types of osteoporosis that have been identified which are primary and secondary. Osteoporotic bones are thin and brittle and are prone to fracture. The bone loss involves both compact and spongy bone. In type I osteoporosis, which occurs typically in postmenopausal women, spongy bone loss predominates, occurring most prominently in the vertebrae and distal radius (Gueldner, Burke, Smiciknas-Wright, 2000). Major complications of type I osteoporosis are crush fractures of the vertebral bodies and the distal end of the radius. Type II, or old-age, osteoporosis is characterized by a proportional loss of compact and spongy bone of the long bones (Gueldner, Burke, Smiciknis-Wright). The most serious fractures of old age are those of
Type I osteoporosis (postmenopausal osteoporosis) generally develops in women after menopause when the amount of estrogen in the body greatly decreases. This process leads to an increase in the resorption of bone (the bones loses substance). Type I osteoporosis occurs in 5% to 20% of women, most often between the ages of 50 and 75 because of the sudden postmenopausal decrease in estrogen levels, which results in a rapid depletion of calcium from the skeleton. It is associated with fractures that occur when the vertebrae compress together causing a collapse of the spine, and with fractures of the hip, wrist, or forearm caused by falls or minor accidents. As the disease progresses, other characteristics show up: compression of the vertebrae resulting
Fragility fracture is occasionally the first presentation of osteoporosis. The incidence of osteoporosis-related fractures has been reported to increase with age and over 50% of the incidents occurring in menopausal women aged > 75 years. Vertebral column and hip are the most common site of fracture contributing to a significant morbidity and mortality in the elderly. Additionally, patients with a history of a fracture have a higher chance of encountering future fractures (Anders et al. 2007).
For instance, imagine tripping over an object and as you fall gently hit the ground, your hip breaks. Others include mild stress like bending over or coughing. This disease commonly occurs in the spine, wrist, or hip and is known to effect all genders and races, though is seen more in Asian and Caucasian women as well as women past menopause. Symptoms of osteoporosis include: Back pain – caused by a collapsed vertebra or fracture, loss of height, stooped fracture, and a bone fracture that happens more easily than expected. Many factors play in the cause of developing this particular disease, such as aging and the use of tobacco and alcohol. Another factor of developing this disease depends on how much bone obtained in an individual’s youth. An intake of
Due to increasing number of elderly population the number of hip fractures are increasing worldwide. The growth of elderly population is more seen in Asia, Latin America, the Middle East and Africa than in Europe and North America. The incidence rates of hip fractures are different from population to population, As the population ages, worldwide, the mean age of hip fractures is also increasing. Studies have shown hip fractures are around two times more common in female than they are in male; this phenomenon is due to women’s lower bone mass and density comparing in
You then tend to experience more breaks or fractures with falls or simple maneuvers of the body. The breaks usually occur in the hip, wrist, ribs or spine. Something as simple as bending over or coughing generally can cause a fracture. Sadly most cases of osteoporosis isn’t diagnosed until this occurs. Osteoporosis can be either classified as primary or secondary. Primary factors that are attributed to Osteoporosis, as stated above, would be old age or bone resorption issues that have taken pace with in the body. Also, this disorder can be experienced by men and women typically of Caucasian or Asian descent, but can also be experienced by other races.
Common fractures that occur in the spine, hips, and wrist are frequently related to osteoporosis. Sometimes mild stressors such as coughing or bending over may cause a fracture of brittle and weakened bones related to osteoporosis. Bone is live tissue that is continuously damaged and repaired.
A fracture is a broken bone. Some of the most common causes of fractures are car accidents, falls, and sports-related inuries. There are several options for treating a fracture. Open fracture treatment is when the fracture site is surgically opened or exposed. This can be with or without manipulation and with or without skeletal traction. One type of open fracture treatment is internal fixation with a fixation device. In this type of treatment the doctor repositions or "reduces" the pieces of broken bone into normal alignment. Then screws and/or metal plates are used to connect the broken bone. It may also be necessary for the doctor to insert rods through the center of the bone. Another type of treatment is open fracture treatment. With closed fracture treatment, the fracture site is not surgically opened or removed. The different methods for closed fracture treatment. These include casting, traction, and an external fixation device. Casting is used to stabilize a broken bone and keep broken bone pieces from moving during healing. The cast is usually made from fiberglass or plaster. Traction can be used stabalize the injured area. With traction the muscles and tendons around the bone are stretched. The traction is controlled by a pulley and weights system in a metal frame above the bed. In exteranal fixation
Pathophysiological Explanation of Diagnosis The sub-trochanteric fracture, take place in the proximal region of the femur. This portion is located between the lesser trochanter and 5 cm below the distal portion of the femur. This region of the femur is made of cortical bone, as a result; the bone is denser, harder and stiffer. Consequently, the healing process is slow. This region of the femur is an area where a big number of muscles are inserted, therefore this region is exposed up to six times the body weight during activities of daily living. (Mark A Lee, 2016)
Osteoporosis is a generalized, progressive diminution of bone tissue mass per unit volume, causing skeletal weakness, even though the ratio of mineral to organic elements is unchanged in the remaining morphologically normal bone. Histologically there is a reduction in cortical thickness and in the number and size of the trabeculae of cancellous bone, normal width of the osteoid seams. Bone reabsorption is increased, bone formation appears to be normal but be defective. The major clinical manifestations of osteoporosis are bone fractures. The most common form of metabolic bone disease is the idiopathic osteoporosis in sub-adults of both sexes with normal gonadal functions. Post menopausal osteoporosis, of course between 50 & 70 years of age, and is six times more common in women than men (pathologia). There is a much greater loss of trabecular bone (cancellous) than cortical bone. It is largely responsible for vertebral crush fracture cooles’ fractures. Senile osteoporosis occurs mainly in individuals older than 70 years of age, is twice as common in women compared to men. It affects both trabecular and cortical
The type of fracture in the knee X-ray is an avulsion fracture of the tibia tubercle. Avulsion fractures are the result of tensile loading on the bone (McKinnis, 2014; Smith, n.d.). Fragments of bone are pulled away from the main body of the bone resulting from a tensile loading on the bone, through active muscle contraction or resistance of a ligament. Additionally, an avulsion fracture will appear radiolucent on a radiograph as a result of hemorrhage and the space between the bone fragment and main body of bone (McKinnis, 2014; Smith, n.d.). An avulsion fracture of the tibia most commonly is seen in athletic males, aged 14-16 years, during the time of the transitional phase of physeal closure just prior to completion of growth (Ertl, 2014).
Fist of all, as people grow older, several conditions appear. Some of the common conditions that appear in older people are diabetes, hip fracture, osteoporosis and arthritis. These people are frequently seen by PTs, and PTAs. For example, my father with non-insulin-dependent diabetes, diet and exercise are very important for his health. PTs play an important role in developing exercises programs that consider helpful to help people like my father. In hip fractures, there is a combination of osteoporosis and accidental falls. Therefore, a hip fracture is one of the most common problems in older people. PTs are essential in the rehabilitation of patients after hip fracture. PTs teach patients and their families to regain additional skills, such