Case Study Osteoporosis

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Case Study

1. What is meant by a "complete, comminuted, intertrochanteric fracture of the right hip"?
A. Complete - refers to a fracture completely through the bone:

B. Comminuted - refers to a fracture in which the broken bone has shattered into several smaller pieces:

C. Intertrochanteric - refers to a fracture located between the greater trochanter and lesser trochanter of the femur:

2. Draw a picture of what you think Margaret's fracture looks like.

3. The radiologist reported signs of osteoporosis. Describe the characteristics of an osteoporotic femur as seen on an X-ray. (How does it differ in appearance from a normal femur?)
Osteoporosis is marked by a decreased bone volume. Loss of spongy ("cancellous") bone is greater than
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cartilage-forming cells) and lay down a fibrocartilage splint (i.e. soft tissue callus) |

C. bony callus(starting 3 to 4 weeksafter the injury) | - osteoblasts begin to replace the fibrocartilage splint with spongy and compact bone, forming a bulge that is initially wider than the original bony shaft |

D. bone remodeling | - as the patient starts to use (or bear weight on) the bone, the bone starts to remodel along lines of maximal stress (this remodeling process requires the activity of both osteoblasts and osteoclasts |

7. During her long recovery, Margaret is advised by her physician to begin weight-bearing as soon as she can. How does weight-bearing influence the process you described in question #6? (Be specific in your answer and describe what weight-bearing does to bone at the microscopic level.)
The most popular hypothesis regarding the effect of weight-bearing on bone remodeling is called Wolff's law . Wolff's law states that bone grows and remodels in response to the mechanical stresses placed upon it (e.g. from muscle pull or gravitational pull). Thus, bone is laid down along lines of maximal stress. This is presumably why:
A. long bones are the thickest midway down the diaphysis, where the stresses are the greatest.
B. curved bones are the thickest where they are most likely to buckle (e.g. note the thick greater

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