Archive for the ‘Traumatology’ Category

ch. 17 Bone tumors

Posted: May 6, 2012 in Traumatology

Classifications

Primary bone tumors

  1. –       Benign bone tumors (osteoma, osteoid osteoma, osteochondroma, osteoblastoma, enchondroma, giant cell tumor of bone, aneurysmal bone cyst, and fibrous dysplasia of bone)
  2. –       Malignant  bone tumors (osteosarcoma, chondrosarcoma, Ewing’s sarcoma, fibrosarcoma, and other types)
  3. –       While malignant fibrous histiocytoma (MFH)
  4. –       Germ cell tumors, including teratoma

Secondary bone tumors

All secondary bone tumors are metastatic lesions which have spread from other organs, most commonly carcinomas of the breast, lung, and prostate.

Bone Tumors

Osteoma :

An osteoma (plural: “osteomata”) is a new piece of bone usually growing on another piece of bone, typically the skull. Osteoma represents the most common benign neoplasm of the nose and paranasal sinuses.

Osteoid osteoma :

An osteoid osteoma is a benign bone tumor which arises from osteoblasts and originally thought to be a smaller version of an osteoblastoma. Osteoid osteomas tend to be less than 1.5 cm in size. The tumor can be in any bone in the body but are most common in long bones, such as the femur and tibia

Osteoblastoma :

It has clinical and histologic manifestations similar to those of osteoid osteoma.A lthough similar to osteoid osteoma, it is larger (between 2 and 6 cm).

Osteochondroma :

Osteochondroma is a type of benign tumor that consists of cartilage and bone. They generally occur at the end of the growth plates of long bones, often at joints. They most commonly form at the shoulder or the knee but have been known to occur in the long bones of the forearm (i.e. the radius and ulna).

   Enchondroma :

An Enchondroma is a cartilage cyst found in the bone marrow.It can appear after Fracure as a complication.

Giant-cell tumor of bone :

Giant-cell tumor of the bone (GCTOB) is a relatively uncommon tumor of the bone. It is characterized by the presence of multinucleated giant cells (osteoclast-like cells).

Aneurysmal bone cyst :

Aneurysmal bone cyst is a benign osteolytic bone neoplasm characterized by blood filled spaces separated by fibrous septa.

Fibrous dysplasia of bone :

Fibrous dysplasia is a disease that causes bone thinning  and growths or lesions in one or more bones, and leads to bone weakness and scar formation within the bones.

Osteosarcoma :

Osteosarcoma is an aggressive malignant neoplasm arising from primitive transformed cells of mesenchymal origin (and thus a sarcoma) that exhibit osteoblastic differentiation and produce malignant osteoid. It is the most common histological form of primary bone cancer.

Chondrosarcoma:

Chondrosarcoma is a cancer composed of cells derived from transformed cells that produce cartilage.

Ewing sarcoma :

Ewing sarcoma is a malignant round-cell tumour. It is a rare disease in which cancer cells are found in the bone or in soft tissue. The most common areas in which it occurs are the pelvis, the femur, the humerus, the ribs and clavicle.

Fibrosarcoma :

Fibrosarcoma (fibroblastic sarcoma) is a malignant tumor derived from fibrous connective tissue and characterized by the presence of immature fibroblasts or undifferentiated anaplastic spindle cells. It is usually found in males aged 30 to 40. It originates in fibrous tissues of the bone and invades long or flat bones such as femur, tibia, and mandible. It also involves periosteum and overlying muscle.

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ch. 16 Osteochondrosis

Posted: May 6, 2012 in Traumatology

Osteochondrosis or Osgood-Schlatter disease is a family of orthopedic disorder of the joint that occur in children and adolescents and in rapidly growing animals, particularly pigs, horses, and dogs.

They are characterized by interruption of the blood supply of a bone, in particular to the epiphysis  followed by localized bony necrosis  and later, regrowth of the bone.

Osteochondrosis is an abnormality in this normal development of bones, and generally affects the joints. It resembles, but is distinct from Hip Displasia in many respects, in that it too is a developmental disorder of cartilage-bone formation.The ends of a bone grow in two places. Firstly, at the epiphyseal plate. This is a cartilaginous region of the growing bone, the location of the greatest part of growth. Secondly, the cartilage which overlies the end of the bone, at the joint, also grows, and becomes ossified at the junction of bone and cartilage.

Etiology :

The ultimate cause for these conditions is unknown, but the most commonly cited etiologic factors are rapid growth, heredity, trauma (or overuse), anatomic conformation, and dietary imbalances.

 

ch. 15 Scoliosis

Posted: May 6, 2012 in Traumatology

 Scoliosis as defined by the Scoliosis Research Society is a “lateral deviation of the spine by more than 10 degrees”. It is more than this, it is a three dimensional deformity in which the spine is bent to the side as one looks from back to front, and twisted when viewed from above. The spine of an individual with scoliosis may look more like an “S” or a “C”, rather than a straight line.

Classiffication :

  1. Congenital (caused by vertebral anomalies present at birth)
  2. Idiopathic(cause unknown, subclassified as infantile, juvenile, adolescent, or adult, according to when onset occurred)
  3. Neuromuscular (having developed as a secondary symptom of another condition, such as Spina bifida, Cerebral Palsy,Spinal Muscular Atrophy, or physical trauma. )

Other Spinal Deformities: Two other types of spinal curvature are  (swayback) and kyphosis (roundback). Sometimes people generalize and refer to these conditions as scoliosis, but they have unique characteristics. Scoliosis is a sideways curve of the spine; lordosis is a forward curve of the spine; and kyphosis is a hump-like, backward curve of the spine. With physical examination, medical history, X-ray, and curve measurement, a doctor can determine what type of curvature a person has and how to proceed with treatment.

Treatment :

  1. Curvature of 10 degrees or less: This slight curvature is considered to be within a normal range, making treatment unnecessary.
  2. Curvature between 10 degrees and 20 degrees: These curvatures may warrant monitoring by a physician. If the patient is in his or her growing years, the curvature could become more severe over time. No additional follow-up is need for patients in this range when skeletal growth is complete.
  3. Curvature between 20 degrees and 45 degrees: Wearing an orthotic brace can stop the progression of the curvature, but not cure it.
  4. Curvature exceeding 45 degrees: Surgery is the recommended treatment for curvature of this severity.

ch. 15 Poliomyelitis

Posted: May 6, 2012 in Traumatology
Poliomyelitis ; Polio; Infantile paralysis; Post-polio syndrome : Poliomyelitis is a viral disease that can affect nerves and can lead to partial or full paralysis.
The virus enters through the mouth and nose, multiplies in the throat and intestinal tract, and then is absorbed and spread through the blood and  lymph nodes. The time from being infected with the virus to developing symptoms of disease (incubation) ranges from 5 – 35 days (average 7 – 14 days).
 
Etiology :
  1. Direct person-to-person contact
  2. Contact with infected mucus or phlegm from the nose or mouth
  3. Contact with infected feces


ch. 14 Little’s Disease

Posted: May 6, 2012 in Traumatology

Spastic diplegia, historically known as , is a form of  Cerebral Palsy (CP) that is a Neuro-Muscular condition of Hypertonic and Spastic muscles of the lower extremities of the human body, usually those of the Legs, Hips and Pelvis.This condition is by far the most common type of CP, occurring in almost 70% of all cases.

Doctor William John Little’s first recorded encounter with cerebral palsy is reported to have been among children who displayed signs of spastic diplegia.

Congenital clubfoot is present at birth (the definition of “congenital”) and affects the foot and/or ankle. There is no known cause for clubfoot, and it is twice as common in male children as it is in female children. The frequency of congenital clubfoot is approximately 1 per 1,240 live births.

Etiology :

  • There are several potential causes for clubfeet, but no one knows the exact cause of clubfeet
  • Genetic deformities
  • Malposition during Pregnancy
  • Abnormalities in the region of chromosome 17 in four patients, and three of the patients had recurrent DNA duplications with one who had a small DNA recurrent deletion on the chromosome 17

Types :

  1. Talipes equinus (flexion)
  2. Talipes calcaneus (extension- dorsiflexion)
  3. Talipes varus (inversion)
  4. Talipes valgus (eversion)
  5. Talipes cavus (hollowing)

Congenital Torticollis  is a stiff neck associated with muscle spasm, classically causing lateral flexion contracture of the cervical spine musculature.

Etiology : Ubknown Etiology causes damage to the Sternocleidomastoid Muscles in the neck.The muscles affected are principally those supplied by the spinal accessory nerve.

  1. Birth trauma
  2. Intrauterine malposition

Common treatments  :

  1. Low-impact exercise to increase strong form neck stability
  2. Manipulation of the neck by a Doctor of Chiropractic, Physical Therapist, or Doctor of Osteopathic Medicine.
  3. Extended heat application.
  4. Repetitive shiatsu massage.