Module 21: Bone Tissue and the Skeletal System

Lesson 5: Fractures and Bone Repair

Gãy Xương Và Sửa Chữa Xương

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Dưới đây là danh sách những thuật ngữ Y khoa của module Bone Tissue and the Skeletal System.
Khái quát được số lượng thuật ngữ sẽ xuất hiện trong bài đọc và nghe sẽ giúp bạn thoải mái tiêu thụ nội dung hơn. Sau khi hoàn thành nội dung đọc và nghe, bạn hãy quay lại đây và luyện tập (practice) để quen dần các thuật ngữ này. Đừng ép bản thân phải nhớ các thuật ngữ này vội vì bạn sẽ gặp và ôn lại danh sách này trong những bài học (lesson) khác của cùng một module.

Medical Terminology: Bone Tissue and the Skeletal System

articular cartilage
thin layer of cartilage covering an epiphysis; reduces friction and acts as a shock absorber
articulation
where two bone surfaces meet
bone
hard, dense connective tissue that forms the structural elements of the skeleton
canaliculi
(singular = canaliculus) channels within the bone matrix that house one of an osteocyte’s many cytoplasmic extensions that it uses to communicate and receive nutrients
cartilage
semi-rigid connective tissue found on the skeleton in areas where flexibility and smooth surfaces support movement
central canal
longitudinal channel in the center of each osteon; contains blood vessels, nerves, and lymphatic vessels; also known as the Haversian canal
closed reduction
manual manipulation of a broken bone to set it into its natural position without surgery
compact bone
dense osseous tissue that can withstand compressive forces
diaphysis
tubular shaft that runs between the proximal and distal ends of a long bone
diploë
layer of spongy bone, that is sandwiched between two the layers of compact bone found in flat bones
endochondral ossification
process in which bone forms by replacing hyaline cartilage
endosteum
delicate membranous lining of a bone’s medullary cavity
epiphyseal line
completely ossified remnant of the epiphyseal plate
epiphyseal plate
(also, growth plate) sheet of hyaline cartilage in the metaphysis of an immature bone; replaced by bone tissue as the organ grows in length
epiphysis
wide section at each end of a long bone; filled with spongy bone and red marrow
external callus
collar of hyaline cartilage and bone that forms around the outside of a fracture
flat bone
thin and curved bone; serves as a point of attachment for muscles and protects internal organs
fracture
broken bone
fracture hematoma
blood clot that forms at the site of a broken bone
hematopoiesis
production of blood cells, which occurs in the red marrow of the bones
hole
opening or depression in a bone
hypercalcemia
condition characterized by abnormally high levels of calcium
hypocalcemia
condition characterized by abnormally low levels of calcium
internal callus
fibrocartilaginous matrix, in the endosteal region, between the two ends of a broken bone
intramembranous ossification
process by which bone forms directly from mesenchymal tissue
irregular bone
bone of complex shape; protects internal organs from compressive forces
lacunae
(singular = lacuna) spaces in a bone that house an osteocyte
long bone
cylinder-shaped bone that is longer than it is wide; functions as a lever
medullary cavity
hollow region of the diaphysis; filled with yellow marrow
modeling
process, during bone growth, by which bone is resorbed on one surface of a bone and deposited on another
nutrient foramen
small opening in the middle of the external surface of the diaphysis, through which an artery enters the bone to provide nourishment
open reduction
surgical exposure of a bone to reset a fracture
orthopedist
doctor who specializes in diagnosing and treating musculoskeletal disorders and injuries
osseous tissue
bone tissue; a hard, dense connective tissue that forms the structural elements of the skeleton
ossification
(also, osteogenesis) bone formation
ossification center
cluster of osteoblasts found in the early stages of intramembranous ossification
osteoblast
cell responsible for forming new bone
osteoclast
cell responsible for resorbing bone
osteocyte
primary cell in mature bone; responsible for maintaining the matrix
osteogenic cell
undifferentiated cell with high mitotic activity; the only bone cells that divide; they differentiate and develop into osteoblasts
osteoid
uncalcified bone matrix secreted by osteoblasts
osteon
(also, Haversian system) basic structural unit of compact bone; made of concentric layers of calcified matrix
osteoporosis
disease characterized by a decrease in bone mass; occurs when the rate of bone resorption exceeds the rate of bone formation, a common occurrence as the body ages
perforating canal
(also, Volkmann’s canal) channel that branches off from the central canal and houses vessels and nerves that extend to the periosteum and endosteum
perichondrium
membrane that covers cartilage
periosteum
fibrous membrane covering the outer surface of bone and continuous with ligaments
primary ossification center
region, deep in the periosteal collar, where bone development starts during endochondral ossification
projection
bone markings where part of the surface sticks out above the rest of the surface, where tendons and ligaments attach
proliferative zone
region of the epiphyseal plate that makes new chondrocytes to replace those that die at the diaphyseal end of the plate and contributes to longitudinal growth of the epiphyseal plate
red marrow
connective tissue in the interior cavity of a bone where hematopoiesis takes place
remodeling
process by which osteoclasts resorb old or damaged bone at the same time as and on the same surface where osteoblasts form new bone to replace that which is resorbed
reserve zone
region of the epiphyseal plate that anchors the plate to the osseous tissue of the epiphysis
secondary ossification center
region of bone development in the epiphyses
sesamoid bone
small, round bone embedded in a tendon; protects the tendon from compressive forces
short bone
cube-shaped bone that is approximately equal in length, width, and thickness; provides limited motion
skeletal system
organ system composed of bones and cartilage that provides for movement, support, and protection
spongy bone
(also, cancellous bone) trabeculated osseous tissue that supports shifts in weight distribution
trabeculae
(singular = trabecula) spikes or sections of the lattice-like matrix in spongy bone
yellow marrow
connective tissue in the interior cavity of a bone where fat is stored
zone of calcified matrix
region of the epiphyseal plate closest to the diaphyseal end; functions to connect the epiphyseal plate to the diaphysis
zone of maturation and hypertrophy
region of the epiphyseal plate where chondrocytes from the proliferative zone grow and mature and contribute to the longitudinal growth of the epiphyseal plate
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A fracture is a broken bone. It will heal whether or not a physician resets it in its anatomical position. If the bone is not reset correctly, the healing process will keep the bone in its deformed position.

When a broken bone is manipulated and set into its natural position without surgery, the procedure is called a closed reduction. Open reduction requires surgery to expose the fracture and reset the bone. While some fractures can be minor, others are quite severe and result in grave complications. For example, a fractured diaphysis of the femur has the potential to release fat globules into the bloodstream. These can become lodged in the capillary beds of the lungs, leading to respiratory distress and if not treated quickly, death.
Fractures are classified by their complexity, location, and other features (Figure 1). Table 1 outlines common types of fractures. Some fractures may be described using more than one term because it may have the features of more than one type (e.g., an open transverse fracture).
When a bone breaks, blood flows from any vessel torn by the fracture. These vessels can be in the periosteum, osteons, and/or medullary cavity. The blood begins to clot, and about six to eight hours after the fracture, the clotting blood forms a fracture hematoma (Figure 2a). The disruption of blood flow to the bone results in the death of bone cells around the fracture.

Within about 48 hours after the fracture, chondrocytes from the endosteum create an internal callus (plural = calli) by secreting a fibrocartilaginous matrix between the two ends of the broken bone, while the periosteal chondrocytes and osteoblasts create an external callus of hyaline cartilage and bone, respectively, around the outside of the break (Figure 2b). This stabilizes the fracture.

Over the next several weeks, osteoclasts resorb the dead bone; osteogenic cells become active, divide, and differentiate into osteoblasts. The cartilage in the calli is replaced by trabecular bone via endochondral ossification (Figure 2c).

Eventually, the internal and external calli unite, compact bone replaces spongy bone at the outer margins of the fracture, and healing is complete. A slight swelling may remain on the outer surface of the bone, but quite often, that region undergoes remodeling (Figure 2d), and no external evidence of the fracture remains.

OpenStax. (2022). Anatomy and Physiology 2e. Rice University. Retrieved June 15, 2023. ISBN-13: 978-1-711494-06-7 (Hardcover) ISBN-13: 978-1-711494-05-0 (Paperback) ISBN-13: 978-1-951693-42-8 (Digital). License: Attribution 4.0 International (CC BY 4.0). Access for free at openstax.org.

Compare healthy bone with different types of fractures: (a) closed fracture, (b) open fracture, (c) transverse fracture, (d) spiral fracture, (e) comminuted fracture, (f) impacted fracture, (g) greenstick fracture, and (h) oblique fracture.

TypesDescription
TransverseOccurs straight across the long axis of the bone
ObliqueOccurs at an angle that is not 90 degrees
SpiralBone segments are pulled apart as a result of a twisting motion
ComminutedSeveral breaks result in many small pieces between two large segments
ImpactedOne fragment is driven into the other, usually as a result of compression
GreenstickA partial fracture in which only one side of the bone is broken
Open (or compound)A fracture in which at least one end of the broken bone tears through the skin; carries a high risk of infection
Closed (or simple)A fracture in which the skin remains intact

The healing of a bone fracture follows a series of progressive steps: (a) A fracture hematoma forms. (b) Internal and external calli form. (c) Cartilage of the calli is replaced by trabecular bone. (d) Remodeling occurs.

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Script:
  1. Fractured bones can undergo repair through either closed reduction or open reduction.
  2. Fractures are categorized based on their complexity, location, and other characteristics.
  3. Common types of fractures include transverse, oblique, spiral, comminuted, impacted, greenstick, open (or compound), and closed (or simple).
  4. The healing process of fractures initiates with the formation of a hematoma, then followed by the development of internal and external calli.
  5. Osteoclasts play a role in resorbing dead bone, while osteoblasts create new bone and replace the cartilage in the calli.
  6. Eventually, the calli unite, which means remodeling occurs, and the healing process is complete.
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